Electronic health record compatibility at the nation's only fully integrated Defense and Veterans Affairs departments hospital remains an only partially-achieved ambition, says the Government Accountability Office.

In a July 19 report, the GAO says the DoD and VA have either implemented, or are in process of implementing integrated operations at the James A. Lovell Federal Health Care Center in North Chicago, Ill. However, in the case of information technology, rollout of joint EHR capability has been delayed or indefinitely postponed, the report states.

Specifically, implementation of a system to ensure laboratory work order portability between the DoD EHR, known as AHLTA, and the VA system, known as VistA, had been postponed until an undetermined date, the report says. Hospital officials told GAO auditors they decided for a delay "in order to allow more time to correct problems, such as difficulty managing large numbers of automated laboratory test orders" and to conduct training.

An interim solution for pharmacy order compatibility is up and running, the report says, but it's required the hospital to hire five full-time pharmacists to conduct manual checks of the VA and DOD EHRs to ensure that patients don't end up with drugs that could cause negative interactions.

The report also faults the FHCC for not testing order portability sufficiently, noting that on-site testing reveled some requirements in pharmacy and radiology orders didn't meet clinicians' needs. Hospital officials told auditors that a previous round of system testing was conducted in an off-site environment "that did not effectively simulate the FHCC environment."

GAO auditors also chided the center for being late in rolling out a single sign-on and patient registration capability for AHLTA and VistA. Although both capabilities were implemented on Dec. 13, 2010, they were supposed to have been in place by Oct. 1, the day that the hospital officially became a fully integrated facility, the report says.

For more:
- download the report, GAO-11-570 (.pdf)

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