May 5, 2022 – The FY2020 National Defense Authorization Act (NDAA), added requirements that the DoD and VA develop EHR systems with the ability to interpret, use, and exchange health care information from medical systems, devices, and applications. As of December 2021, Cerner Millennium had deployed at 49 DoD health care facilities and one VA facility. Far short of the DoD plans for its 490 healthcare facilities, and the planned 1454 healthcare facilities operated by the VA.
According to the joint audit findings, “the DoD and the VA did not take all action necessary to achieve interoperability because FEHRM Program Office officials did not develop and implement a plan to achieve all FY 2020 NDAA requirements or 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. Because the Federal Electronic Health Record Modernization (FEHRM) Program Office limited its role, the DoD and the VA took separate actions to migrate patient health care information, develop interfaces, and grant user access to Cerner Millennium.”
Achieving interoperability between the DoD, VA, and external health care providers through the deployment of a single EHR system is critical because health care providers will have the ability to securely transfer and share health care information for the Nation’s 9.6 million DoD Armed Forces members, dependents, and retirees, and 9.21 million enrolled users.
The response to the recommendations to get the job done, having laid the blame solidly at the feet of the FEHRM Program Office, all parties agreed to get the job done.
“The FEHRM Program Office Director agreed with the recommendations to determine the type of health care information that constitutes a complete EHR, develop and implement a plan to migrate that patient information to Cerner Millennium, and develop and Finding (cont’d) DODIG Report No. 2022-089 iii VA OIG Report No. 2018-04227-91 Results in Brief Joint Audit of the Department of Defense and the Department of Veterans Affairs Efforts to Achieve Electronic Health Record System Interoperability implement a plan for creating interfaces between medical devices and Cerner Millennium.
However, the Director stated that the FEHRM Program Office needed resourcing and appropriate delegations of authority from the DoD and VA to properly address the recommendations. The Director also stated that the FEHRM Program Office was prepared to begin executing actions when funding, staffing, and authorities are allocated. Although the Director agreed, we consider the recommendations unresolved because the Director made any actions contingent upon the DoD and VA providing additional authorities and resources.”