Excellence: More or Less?

Deadly Drugs

The Defense Health Board has endorsed a controversial recommendation allowing doctors to prescribe multiple psychotropic medications for individual troops, despite the fact the Military Health System lacks a unified pharmacy database to track prescription drug use. Military and private clinicians and the families of troops who died due to multidrug toxicity view these recommendations as potentially deadly.

As Nextgov has reported, 20 percent of 1.1 million active-duty troops surveyed by the Defense Department's PharmacoEconomic Center, or 213,972 soldiers, took some form of pyschotrophic drug as of June 2010. In a July 2010 report on suicide, the Army said these prescription drugs have contributed to an epidemic of suicides. The report found that prescription drugs were involved in one-third of the 162 suicides by active-duty soldiers in 2009, and another 101 soldiers died accidentally from the toxic mixing of prescription drugs from 2006 to 2009.

Gen. Peter Chiarelli, the Army's vice chief of staff, said at the time the service had to develop better controls for prescription drugs: "Let's make sure when we prescribe that we put an end date on that prescription so it doesn't remain an open-ended opportunity for somebody to be abusing drugs."

For the past two years, Congress has directed the Pentagon to improve its drug-tracking systems. In June 2010, the Senate faulted Defense for its inability to monitor psychotropic drug use in combat zones and directed it to quickly develop "a reliable method to track and manage the prescription and use of pharmaceuticals, to include psychotropic medications, by deployed service members."

In June, the House noted that the department still cannot track prescription medications.

-- Bob Brewin

Slashing Websites

The Energy Department might win the prize for the first agency to actually shut down a website in connection with the governmentwide campaign to bring order to the federal online footprint.

In August, the department shut down Energyempowers .gov, a sort of online energy news service, and folded that content into its flagship Energy.gov site. Department managers made the changes during a redesign of Energy .gov's user interface and as the site was transferred from Energy servers to Amazon's public EC2 computer cloud. The department says the move to cloud hosting will save taxpayers $50,000 annually.

The consolidation was part of an agency campaign to slash the government's Web presence, which has mushroomed to more than 20,000 sites since the early 1990s. In addition to saving the cost of maintaining thousands of websites, officials say the campaign is aimed at cleaning up the government's loose Web presence, which contains dozens of different architectures and designs and often leaves users confused about what's an official government site and what isn't.

--Joseph Marks

Phone Hacking Fears

While there is no evidence that reporters at the now- defunct British tabloid News of the World eavesdropped on stateside mobile voicemails, U.S. citizens' smartphones are penetrable by adversaries and unscrupulous journalists, the U.S. Joint Chiefs of Staff vice chairman told reporters this summer after the Pentagon announced a new cybersecurity strategy.

The phone hacking scandal demonstrates the need for fortified consumer smartphones that block call interceptions, Gen. James E. Cartwright says, noting that the Pentagon pays a lot of money for such technology today.

--Aliya Sternstein

Paper Trails

Despite the fact the Veterans Health Information Systems and Technology Architecture electronic health record system has been around for decades, it took the Veterans Affairs Department until August to take action to get rid of its paper medical files. VA issued a solicitation seeking help with a project to eliminate paper records for 9 million patients stored in 139 medical centers.

The department has initially targeted 22 facilities for the project, called File Room Reduction-Closure Services. Each facility stores between 1,000 feet (1.5 million pages) and 5,000 feet (7.5 million pages) of documents and needs some help scanning and indexing this mass of paper.

One wonders why it took so long to kick off this project.

-- Bob Brewin

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