By Stephen Spotswood

CHICAGO — A government report shows that delays in integrating VA and DoD IT systems at the James A. Lovell Federal Health Care Center (FHCC) in Chicago have proven costly for the jointly-run facility. VA officials responded, however, that lessons learned during this process may prove helpful in the attempt to integrate systems on a national level.

VISN 12 Network Director Dr. Jeffrey Murawsky, MD, (left) with VA Secretary Eric Shinseki and Milwaukee VA Medical Center Director Robert Beller in 2010. - VA photo by Luis Alani

Costly Workarounds

A Government Accountability Office (GAO) report released in June found that, despite investing more than $120 million for IT capabilities at the FHCC, the agencies have not completed work on all of the components set out in a 2010 sharing agreement, and even the completed components were late. Also, according to the report, VA and DoD have yet to agree on a full set of benchmarks by which to evaluate the process.

An executive agreement said specific areas of the departments’ IT systems would need to be shared for the FHCC to function efficiently and would be operational by the facility’s opening in October 2010. Those include:

• a single medical sign-on, which would allow staff to use one screen to access both VA and DoD health-records systems;
• single patient registration, which would allow staff to register patients in both systems simultaneously; and
• orders portability, which would allow VA and DoD clinicians to place, manage and update clinical orders from either health-records system for radiology, laboratory, consults and pharmacy services.

Both the single sign-on and single patient registration were delivered in December 2010. The radiology component came online in June 2011, and the laboratory component was up and running in March 2012.

According to VA and DoD officials, radiology portability was delayed because the amount of work required to allow VA and DoD’s systems to exchange information was underestimated. The laboratory component was delayed because of software differences between the two systems. Prior to that component coming online, the FHCC instituted a workaround that required health providers to review both VA and DoD systems for notifications of lab results.

FHCC officials were unable to quantify how much these workarounds cost but reported to GAO that the workload equivalent of 23 full-time employees was being used to manage the workarounds.

GAO recommendations include determining those costs, as well as the development of clearer timelines for IT-sharing.