Overruns plague patient data system

"Computer-Based Patient Records: Better Planning and Oversight by VA, DOD, and IHS Would Enhance Health Data Sharing"

The Defense Department and the Department of Veterans Affairs have made little progress in their plans to create a system that would enable them to share patient health data, according to the General Accounting Office.

The Government Computer-Based Patient Record (GCPR) project was initiated in 1998 to enable health care professionals to "share clinical information via a comprehensive, lifelong medical record," according to early project documents.

But a report GAO released this week said the system has been hindered by expanding schedules and cost estimates, inadequate accountability and poor planning.

"With accountability for GCPR blurred across several management entities, basic principles of sound information technology project planning, development and oversight have not been followed, creating barriers to progress," according to the GAO report "Computer-Based Patient Records: Better Planning and Oversight by VA, DOD and IHS Would Enhance Health Data Sharing." DOD's Military Health System, the VA's Veterans Health Administration and the Indian Health Service originally were scheduled to begin worldwide deployment of GCPR on Oct. 1, 2000, but that date has been pushed forward with no new deadline set.

Cost estimates have also proven to be unreliable. Initial estimates in September 1999 called for about $270 million over 10 years. By August 2000, projections had jumped to $360 million — "estimates that GCPR project managers acknowledge are probably understated," according to GAO.

Officials with DOD, the VA and IHS have outlined a new approach that will designate a lead entity with decision-making authority. "I will work closely with the secretary of Defense and the director [of] IHS to establish that lead entity with a clear line of authority," VA Secretary Anthony Principi stated in a letter.

"We began more aggressive planning and oversight last fall," said J. Jarrett Clinton, acting assistant secretary of Defense for health affairs.

Clinton noted, however, that the role of GCPR is not designed to "carry the whole weight for the service members' health records and the related health information systems within each of the three agencies." Rather, it is designed to handle the transfers of data between the organizations.