Lawmakers decry inability to share veterans' health data

House lawmakers on Wednesday expressed concern over how long it is taking to foster the sharing of medical records between the Veterans Affairs and Defense departments.

It is critical that the two military-related Cabinet agencies be able to share medical information on veterans, Indiana Republican Steve Buyer, chairman of the House Veterans' Affairs Oversight and Investigations Subcommittee, said at a hearing by his panel. He said it is an "established fact" that the technology to complete the transfer exists but that "the endgame is not yet in sight."

Efforts to develop the electronic transfer of medical records for retired veterans seeking health care have been underway since 1982. Most recently, the president's task force to improve healthcare delivery for nation's veterans recommended that by fiscal 2005, Defense and VA have electronic systems with the same standards and ability to share information.

Oregon Rep. Darlene Hooley, ranking Democrat on the subcommittee, questioned why, after 21 years, the system is not working. "Immediate transfer [of information] is more than just a convenience. ... It is necessary ... to assure that the appropriate care is tendered," she said.

While Hooley acknowledged that the available information-sharing technology has improved dramatically, "cultural barriers" between the departments are hampering progress. If those issues are overcome, "problems relating to technology will be minor," she said.

Linda Koonz, director of information management issues at the General Accounting Office, praised the "near-term effort" of the departments, pointing to the current one-way, monthly transfer of electronic health data from Defense to a VA repository. "This occurred largely because both [departments] recognized the need for more accountability, more oversight and better planning," she said.

On a larger scale, however, she said the departments "face significant challenges in implementing full data exchange. The departments have not yet clearly articulated [plans for a] clear infrastructure about how they plan to exchange or what they can exchange by 2005."

"Without standardization," she concluded, "the task is made more complex and may not prove successful."

Frances Murphy, VA's deputy undersecretary for health policy coordination, maintained that the department is on track to "share available electronic medical records" by the deadline. Murphy said the biggest delay in developing a complete system, however, is simply collecting from Defense the information, such as patient and personnel data, that is necessary to determine eligibility for services.

VA has worked with Defense to develop a program "to collect comprehensive health data from all service personnel at entry into the military" in order to address those concerns, Murphy said.

Jeanne Fites, a deputy Defense undersecretary involved in program integration, said the Defense Integrated Military Human Resources System will electronically feed to the VA an essential personnel form detailing "a service member's periods of active service [and] resolve the inefficiencies and deficiencies" within the program.

That system, however, will not be operational in all of the services until 2007, Fites said.