A joint audit from the Offices of Inspector General (IG) at both the Department of Defense (DoD) and Department of Veterans Affairs (VA) found that the two agencies have not taken enough action to achieve interoperability of patient health care information through the Electronic Health Record (EHR) system.
The DoD purchased Cerner Corporation’s Millennium EHR platform in 2015, while the VA acquired the platform in 2018. Then the two agencies established the Federal Electronic Health Record Modernization (FEHRM) Program Office to provide direction and oversight to agency organizations deploying the Cerner Millennium system – with interoperability between the two EHR systems being a major headline goal of the multi-billion investments by the agencies.
However, the IGs found that the FEHRM Program Office “did not develop and implement a plan to achieve” interoperability between the two agencies’ systems, nor did it “take an active role to manage the program’s success as authorized by its charter.”
“Instead, FEHRM Program Office officials limited their role to facilitating discussions when disputes arose between the DoD and the VA, and would only provide direction if the departments reported a problem,” the report says.
The IGs found that the DoD and VA did not consistently migrate patient health care information from the legacy electronic health care systems into the new EHR system. Additionally, the agencies did not develop interfaces from all medical devices to Cerner Millennium so that patient health care information would automatically upload to the new system.
The IGs also said the agencies did not ensure users were granted access to the EHR system for only the information needed to perform their duties.
The IG offices recommended the agencies “develop and implement a plan” to address those issues, and that they review FEHRM Program Office’s actions and direct the office “to develop processes and procedures in accordance with the FEHRM Program Office charter and the National Defense Authorization Acts.”
The agencies generally agreed with such recommendations. The Director of the FEHRM Program Office, William Tinston, did as well, but noted that appropriate funding and staffing are “paramount” to achieving the mission.
“The FEHRM’s funding is allocated by the departments,” Tinston said. “The FEHRM will continue to assume greater responsibilities in accordance with the FEHRM Charter as funding and resources become available.”
“The FEHRM’s ability to deliver on the recommendations will depend on the authorities delegated to its office,” he added.