Defense Department’s EHR Effort Falters

From reader DKBerry:

You’d think that buying a common EHR platform and deploying it across all of Defense Department’s medical centers (Army, Navy, Air Force) … that they would have done better.  How did VA succeed where DoD is failing?

Unless the Defense Department addresses weaknesses in project planning and management that have hampered its current electronic health-record system’s capabilities, it risks undermining its new EHR initiatives, according to a Government Accountability Office report (PDF) requested by Sen. Judd Gregg (R-N.H.), the ranking minority member of the Senate Budget Committee.

The report notes how the Defense Department has obligated some $2 billion since 1988 to an EHR system for the 9.6 million active-duty service members, their families and other beneficiaries but has come up short and has scaled back its original expectations for AHLTA. (AHLTA was originally an acronym for “Armed Forces Health Longitudinal Technology Application,” but the department later declared it was no longer an acronym, but a brand.)

After finding AHLTA’s early performance “problematic” in terms of speed, usability and availability, the Department of Defense has sought to acquire a new system known as EHR Way Ahead, according to the report.

The new system, according to the GAO report, “is expected to address performance problems; provide unaddressed capabilities such as comprehensive medical documentation; capture and share medical data electronically within DOD; and improve existing information sharing with the Department of Veterans Affairs,” and has initiated efforts to “stabilize” AHLTA so it can act as a bridge until the system is ready.

The Defense Department has allocated $302 million in its 2011 budget request, according to the report, but has not changed its EHR acquisition process to avoid the same shortcomings it experienced with AHLTA.


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John Lynn

John Lynn

John Lynn is the Founder of, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

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  • No shocker. The VA system is good b/c it’s set-up to serve a fixed population (they don’t travel much). The DoD system has too many competing requirements. They have a mobile patient population and they want it to work in such a wide range of environments, serving everyone’s needs. Too many cooks in the kitchen. They won’t succeed if they keep trying to serve everyone’s preference. The user community is too diverse to come to agreement on how it should work, look and feel.

    Still, the DoD and VA have done what no other EHR system has been able to accomplish to date, 10 years before their time.

  • Interesting post. The DoD failure certainly raises concern for the potential of the current national initiative to succeed. If the government could not make a comprehensive fully integrated system work in an environment that it has full control over, how will the current EHR program succeed in an environment with hundreds of thousands of “independent contractors”/providers?

  • Frank MD,
    I’m not sure which “current EHR program” you mean. If you mean EHR stimulus money, there’s a decent chance that it might not succeed. Although, the real questions would be what are its goals. It seems that most people have a different view of what the goals of the EHR stimulus money are and so it would be hard to define it as a success or not.

    If we look more simply at widespread EHR adoption and interoperability, I think it’s clear that we’re a LONG ways from that becoming a reality. We’ll get there at some point. I think it’s just not clear which EHR softwares will be the winners and how they’ll inter operate.

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