In addition to VA’s better known missions—to provide  health care and benefits to veterans and medical research and education—  VA has a fourth mission: to provide medical backup to DOD in times of  war and civilian health care backup in the event of disasters producing  mass casualties. Medical Recordkeeping and Surveillance During the Gulf War Was Lacking

Investigations into the unexplained illnesses of service members and  veterans who had been deployed to the Persian Gulf uncovered the need  for DOD to implement an effective medical surveillance system to obtain  comprehensive medical data on deployed service members, including  Reservists and National Guardsmen. The council concluded  that the Gulf War exposed many deficiencies in the ability to collect,  maintain, and transfer accurate data describing the movement of troops,  potential exposures to health risks, and medical incidents in theater. Medical Surveillance Under Operation Joint Endeavor Improved but Was Not Comprehensive

In response to these reports, DOD strengthened its medical surveillance  system under Operation Joint Endeavor when service members were  deployed to Bosnia-Herzegovina, Croatia, and Hungary. Despite the Department’s progress, we and others have reported on DOD’s  implementation difficulties during Operation Joint Endeavor and the  shortcomings in DOD’s ability to maintain reliable health information on  service members. DOD  also recently established guidelines and additional policy initiatives for  improving military medical surveillance. DOD has several other initiatives for improving its information technology  capabilities, which are in various stages of development. In addition to its ongoing information technology initiatives, DOD recently  issued two major policies for advancing its military medical surveillance  system. Concluding Observations

Clearly, the need for comprehensive health information on service  members and veterans is compelling, and much more needs to be done.
What GAO Found

The Department of Defense (DOD) and the Department of Veterans Affairs (VA) recently established a medical surveillance system to respond to the health care needs of both military personnel and veterans. A medical surveillance system involves the ongoing collection and analysis of uniform information on deployments, environmental health threats, disease monitoring, medical assessments, and medical encounters and its timely dissemination to military commanders, medical personnel, and others. GAO and others have reported extensively on weaknesses in DOD's medical surveillance capability and performance during the Gulf War and Operation Joint Endeavor. Investigations into the unexplained illnesses of Gulf War veterans revealed DOD's inability to collect, maintain, and transfer accurate data on the movement of troops, potential exposures to health risks, and medical incidents during deployment. DOD improved its medical surveillance system under Operation Joint Endeavor, which provided useful information to military commanders and medical personnel. However, several problems persist. DOD has several efforts under way to improve the reliability of deployment information and enhance its information technology capabilities. Although its recent policies and reorganization reflect a commitment to establish a comprehensive medical surveillance system, much needs to be done to implement the system. To the extent DOD's medical surveillance capability is realized, VA will be better able to serve veterans and provide backup to DOD in times of war.