Bucking a trend, GAO report gives a thumbs-up to CHCS

After nearly 10 years of critical diagnoses, the General Accounting Office this month gave the Defense Department's Composite Health Care System a clean bill of health.

"I think the management of the whole program at the assistant secretary level and the program management level has been very good," said Frank Reilly, director of information systems management and support at GAO's Accounting and Information Management Division. "The obstacles they've overcome have been remarkable."

CHCS, awarded in 1988 to Science Applications International Corp., automates all facets of health care and DOD medical facilities. Although the contract expired last month, SAIC is in the final stages of negotiating an interim deal with DOD to provide equipment and services pending the award of a much-delayed replacement contract. Late last year the department completed its deployment of CHCS equipment.

`No Substitute for Training People'

Reilly said Defense officials did a particularly good job of training managers to run the CHCS program and getting all the military services to cooperate on the program. "The really refreshing thing is that the people put in charge were trained for extremely complex technical/medical activities," he said. "There is no substitute for training people to successfully manage these large-scale [systems]. It's not something that just happens."

The report, "Medical ADP Systems: Defense Achieves Worldwide Deployment of Composite Health Care System," quoted DOD estimates that the system will save $4.1 billion due to increased productivity and expected decreases in malpractice claims.

Reilly said he did not audit the department's claims but added that his observations supported DOD's contention. "There is a dramatic change in the way hospitals operate under this system," he said. "I remember six years ago surgeons used to tell me stories about how they had to waste time to get information on a patient. Now they can go to a computer and find out what has happened to their patients most recently. It makes a huge difference."

The only sour note sounded in the otherwise favorable report was a concern that CHCS lacked a backup and recovery plan to minimize disruption in case of an emergency.

David Brooks, senior vice president and CHCS program manager at SAIC, said the program has succeeded thanks to cooperation among his company, DOD and GAO. "A lot of hard work—including a program management approach where GAO was included as a member of the family, so to speak—had a very great payoff for this project," Brooks said.

"GAO has privately told me that very few programs meet such high standards of delivering on their promise," he added.