Government needs 'urgent' help on $80B IT projects

GAO details worries over EHR projects, cost overruns, missed deadlines, lack of discipline, oversight
By Bernie Monegain
10:27 AM
Washington DC

Even as a couple of Congressional panels are bent on achieving health IT interoperability, where the industry has not yet been able to, it appears the government itself could use a helping hand on this complex matter – and many other aspects of IT work.

A new report from the Government Accountability Office, calls for "urgent action" on all government IT projects.

David A. Powner, director of IT management issues for the GAO, testified June 10 before the House Subcommittees on Government Operations and Information Technology, Committee on Oversight and Government Reform.

He told the panels that from October 2009 through December 2014, GAO made 737 recommendations to the Office of Management and Budget and other agencies to improve the management and oversight of IT. However, as of January 2015, only about 23 percent had been fully implemented.

The government spends more than $80 billion a year on information technology, according to the GAO report.

"These investments frequently fail, incur cost overruns and schedule slippages, or contribute little to mission-related outcomes," Powner reported. "This underperformance of federal IT projects can be traced to a lack of disciplined and effective management and inadequate executive-level oversight."

The report comes just as the Department of Defense is scheduled to announce this month its pick for its massive planned EHR project.  

The DoD's $11 billion Healthcare Management Systems Modernization Electronic Health Record program would replace and modernize the existing EHR system, which supports more than 9.7 million beneficiaries, including active duty, retirees and their dependents. It serves patients and clinicians in 2,300 locations around the world.

The vendor teams in the running for the government contract are:

  • IBM and Epic
  • Computer Sciences Corp., partnered with HP and Allscripts
  • Cerner, Leidos, Accenture Federal and Intermountain Healthcare

[See also: One out, three bids left for DoD EHR and Choose an open EHR, DoD is urged.]

In listing a half dozen particularly troubled IT projects, Powner named the DOD's and VA's efforts to modernize their EHRs.    

"DOD's and VA's initiatives to modernize their electronic health records systems are intended to address sharing data among the departments' health information systems, but achieving this has been a challenge for these agencies over the last 15 years. In February 2013, the two departments' Secretaries announced that instead of developing a new common, integrated electronic health record system, the departments would focus on achieving interoperability between separate DOD and VA systems," Powner noted in his report.

"The departments' change and history of challenges in improving their health information systems heighten concern about whether they will be successful," he added. 

Powner also put the spotlight on troubles at the VA, noting the agency had invested "significant resources" in developing an outpatient appointment scheduling system, yet the initiative has been riddled with setbacks.

After failing to implement a new platform, in October 2009, VA began a new initiative it refers to as HealtheVet Scheduling.

"In May 2010, we recommended that, as the department proceeded with future development, it take actions to improve key processes, including acquisition management, system testing, and progress reporting, which are essential to the department’s second outpatient scheduling system effort," Powner said.