Conclusions

GCPR’s aim to allow health care providers to electronically share comprehensive patient information should provide VA, DOD, and IHS a valuable opportunity to improve the quality of care for their beneficiaries. But without a lead entity, a clear mission, and detailed planning to achieve that mission, it is difficult to monitor progress, identify project risks, and develop appropriate contingency plans to keep the project moving forward and on track. Critical project decisions were not made, and the agencies were not bound by those that were made. The VA and DOD CIOs’ action to focus on short-term deliverables and to capitalize on existing technologies is warranted and a step in the right direction. However, until problems with the two agencies’ existing systems and issues regarding planning, management, and accountability are resolved, projected costs are likely to continue to increase, and implementation of the larger GCPR effort— along with its expected benefits—will continue to be delayed.
What GAO Found

In November 1997, the President called for the Department of Veterans Affairs (VA) and the Department of Defense (DOD) to create an interface that would allow the two agencies to share patient health information. By allowing health care providers to electronically share comprehensive patient information, computer-based patient record's (GCPR) should help VA, DOD, and the Indian Health Service (IHS) to improve the quality of care for their beneficiaries. But without a lead entity, a clear mission, and detailed planning to achieve that mission, it is difficult to monitor progress, identify project risks, and develop appropriate contingency plans to keep the project moving forward and on track. Critical project decisions were not made, and the agencies were not bound by those that were made. The VA and DOD Chief Information Officers' (CIO) action to focus on short-term deliverables and to capitalize on existing technologies is warranted and a step in the right direction. However, until problems with the two agencies' existing systems and issues regarding planning, management, and accountability are resolved, project costs will likely continue to increase and implementation of the larger GCPR effort--and its expected benefits--will continue to be delayed.