The Department of Defense and Department of Veterans Affairs healthcare information data-sharing project – often held out as an example of two powerhouse health information networks becoming interoperable – was given a warning this week by the Government Accountability Office.

A GAO report, written for the House Committee on Veterans' Affairs, said the project needs better strategic management and budgeting for the sharing of long-term care information.

By law, the DOD and VA are required to accelerate the exchange of health information between their departments and develop systems or capabilities that allow for interoperability and are compliant with federal standards.

According to the report, the DOD and VA are exchanging pharmacy and drug allergy data on more than 21,000 shared patients, an increase of about 2,700 patients between June and October 2008, the report said. Further, they recently expanded the number of standards and specifications to be used in interoperability initiatives. In addition, the DOD reported that its electronic health system has been certified.

However, "neither plan identifies results-oriented performance goals and measures that are characteristic of effective planning and can be used as a basis to track and assess progress toward the delivery of new interoperable capabilities," the report said. "In the absence of results-oriented goals and performance measures, the departments are not positioned to adequately assess progress toward increasing interoperability."

In January 2009, the departments approved a program office charter to describe, among other things, the mission and function of the office. Nonetheless, the DOD and VA have not yet fully executed their plan to set up the program office, the GAO said. For example, among other activities, they have not yet filled key positions for the director and deputy director, or 22 of 30 other positions identified for the office.

"In the continued absence of a fully established program office, the departments will remain ineffectively positioned to assure that interoperable electronic health records and capabilities are achieved by the required date," the GAO said.

DOD and VA officials, commenting on a draft of the report, agreed with the GAO's recommendations to boost management efforts.