HealthCare.gov, VA Health IT Systems Make GAO’s High-Risk List

February 12, 2015 in News

Delayed or failed federal IT projects, such as the Department of Veterans Affairs’ decision to scrap plans to update its scheduling software after spending $127 million, is a “high-risk” budget issue, according to a report by the Government Accountability Office, the Washington Post reports.

Report Details

The biannual GAO high-risk report lists various federal programs that are particularly vulnerable to “fraud, waste, abuse and mismanagement” (Hicks/Wax-Thibodeaux, Washington Post, 2/12). This year’s report highlighted 32 “high-risk” areas across the federal government that could cause budget issues (Daly, AP/Washington Times, 2/11). According to FCW, the VA and IT acquisition projects were two new additions to the 2015 report.

Report Findings

Chris Mihm, managing director of GAO’s strategic issues team, said that the federal government invests about $80 billion in IT projects annually, across all federal agencies. He added, “Unfortunately, fairly consistently, we find problems with these projects. And these seem to center on a lack of discipline and effective management practices, the need for improvements in project planning, and poor program oversight in governance” (Rockwell, FCW, 2/11).

Specifically, the report cited problems with VA, noting that it has failed to completely address more than 100 GAO recommendations regarding its:

  • Lack of oversight and accountability;
  • Outdated health IT systems;
  • Poor care coordination and data interoperability; and
  • Inadequate training for VA staff members.

For example, the report cited ongoing efforts by VA and DOD to secure interoperability between its electronic health record systems (Bresnick, EHR Intelligence, 2/11).

In February 2013, DOD and VA officials announced plans to halt a joint integrated EHR, or iEHR system, and instead focus on making their current EHR systems more interoperable (iHealthBeat, 1/9).

GAO wrote that “the quality of care may be adversely affected if important clinical information is not promptly communicated between VA and non-VA providers” (EHR Intelligence, 2/11).

In addition, the report noted that the VA spent $127 million to update its appointment scheduling software before deciding to halt the project (Washington Post, 2/12).

Meanwhile, the GAO report also cited issues with other federal health agencies and projects, such as:

  • HHS’ HealthCare.gov website (FCW, 2/11); and
  • Future Medicare spending as the agency works to move towards value-based models and advances health IT implementation efforts, such as the meaningful use program.

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments (EHR Intelligence, 2/11).

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