Experts debate progress on DOD medical records

Government and private-sector executives disagreed today on whether the departments of Defense and Veterans Affairs have adequate program management, enterprise architecture and data standards to effectively move forward on a project to create common, electronic medical records.

Common medical records will mean the departments of Defense and Veterans Affairs will share patient information, creating one seamless medical record that moves with each military member during their active duty service and as veterans.

The two departments have been working to create common medical records for more than 15 years.

"Patience is a virtue, but this subcommittee is running out," Rep. Steve Buyer, chairman of the House Veterans Affairs subcommittee on oversight and investigations, said at a March 17 subcommittee hearing.

Dr. John Halamka, chief information officer at Harvard Medical School in Boston, testified that more progress should be made on the project in the next year than in the previous decade. In the past, the project was hampered by the lack of data standards and a master patient index; both exist today, along with institutional will and good program management, Halamka said.

"It seems like they are doing the right thing," said Halamka, who oversaw the integration of 9 million patient records at numerous Boston-area medical facilities into common electronic medical records.

But General Accounting Office official Linda Koontz said the two departments do not have adequate program management and neither has the authority to make decisions affecting the other.

"Until essential program management is established, the departments will lack assurance that they can share information two ways. They also lack a well-defined architecture," said Koontz, director of information management issues at the watchdog agency.

James Reardon, chief information officer for the Defense Department's Military Health System, said the project's draft program management plan needs to be more detailed. An improved plan will be finalized this month, he said. He said the two departments continue to enhance the project's architecture.

Dr. Robert Roswell, under secretary for health at the Veterans Affairs Department, said the two departments are working aggressively to establish data standards that will allow sharing of each of the 65,000 data elements in each patient's medical record.