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Secretary Hagel Commits to Resolving Medical Record Interoperability Issues

April 16, 2013
By George I. Seffers
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Defense Department will decide on a path forward within 30 days.

Secretary of Defense Chuck Hagel told members of Congress on April 16 that he is personally committed to solving the database interoperability problems between the Defense Department (DOD) and the Department of Veterans Affairs (VA) that have left thousands of veterans waiting months while benefits claims are processed.

According to VA officials, the agency has been breaking records in the number of claims processed, yet it now takes an average of 273 days to process a claim. The VA has fallen increasingly behind as veterans return from Iraq and Afghanistan, and that backlog is expected to increase as the drawdown in Afghanistan continues.

Part of the issue is that the VA uses an electronic processing system known as the Veterans Health Information Systems and Technology Architecture (VistA), while the Defense Department uses the Armed Forces Health Longitudinal Technology Application (AHLTA) for processing medical records.

Introduced in 1996, VistA offers an automated environment that supports day-to-day operations at local VA health care facilities. It is built on a client-server architecture, which ties together workstations and personal computers with graphical user interfaces at various VA facilities, as well as software developed by local medical facility staff. The system also includes the links that allow commercial off-the-shelf software and products to be used with existing and future technologies.

AHLTA, on the other hand, is the Defense Department’s computerized health care system. It is intended to establish a single, comprehensive, and longitudinal health record for each patient containing all the clinical information from each interaction with Defense Department medical personnel. With this centralized record, health care personnel worldwide can access complete, accurate and informed patient care—at the point of care—anytime, anywhere.

But the two systems do not talk to each other. Many claims still are filed on paper, and VA officials have revealed that thousands of claims sit in boxes waiting to move forward.

During the hearing before the House Appropriations Subcommittee, Hagel admitted he is not an expert on interoperability but testified that he is personally involved in finding a solution. Hagel reported that during his first week in office, he visited with Gen. Eric Shinseki, USA (Ret.), secretary of Veterans Affairs, about the issue, and the Defense Department has established a team to work directly with the VA. He added that officials from the two departments met again the day before the hearing. “Interoperability is the real key, assuring that there are electronic transfer highways. We produce the veterans at DOD, and there should be a seamless process to allow the veteran to have assurance and reliability that his or her records are moved to VA,” Hagel said.

Hagel admitted that the Defense Department is behind the VA in choosing an interoperable system and testified that he personally stopped a request for proposals from going out in March, “because I didn’t think we knew what the hell we were doing.” He committed to making a decision in the coming days. “We’ll have something decided within 30 days. We’re way behind. We will do better.”

The defense secretary revealed that he is reorganizing parts of the department to provide greater accountability and gain better control of the situation. Additionally, he vowed that the department would spend no more money on the issue until he could fully understands the complexities involved. “I can’t sit here and defend what we’ve done. I’m going to acknowledge that we’re way behind. We will do better. I am personally taking this on,” he promised. “That doesn’t mean we aren’t making progress. We are making progress. A lot of good things are happening,” he said.

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