The private sector was mandated by the HITECH Act to use an Electronic Health Records Systems (EHRs) that has the electronic capability to exchange key clinical information with other healthcare providers.  This capability is also known as interoperability.  Charged with sharing health information for service members transitioning to civilian life since 1982, the  Department of Veterans Affairs (VA) and the Department of Defense (DOD) have been trying to hand over medical information to one another, first in paper format and then electronically, but keep stumbling over a number of interoperability obstacles along the way. Rather than working together to develop a single EHR system from the start, the two departments created their own individual EHRs, the Veterans Health Information Systems and Technology Architecture (VistA) and the Armed Forces Health Longitudinal Technology Application (AHLTA).  Because the two systems were developed separately, they were unable to electronically share critical healthcare information for returning service members and veterans.  In 2009, Congress directed the agencies to develop joint interoperable health record capability by September 2009.  In May, 2009, the Virtual Lifetime Electronic Record (VLER) program was established to provide portability and accessibility of health, benefits and administrative data for service members and veterans.  However, this system was still not fully interoperable. In March 2011, DOD and VA agreed to create a new joint iEHR to be fully implemented by 2017.  However, after already spending more than $1 billion on the new iEHR system, the departments announced on February 5, 2013 they were terminating the program due to the high cost of building the new system from scratch.  Following this announcement, the House Committee on Veterans’ Affairs held a hearing on February 27, 2013, entitled “Electronic Health Record U-Turn:  Are VA and DOD Headed in the Wrong Direction?” Following the hearing, House Veterans’ Affairs Committee Chairman Jeff Miller (R-Fla.) issued a release in which he declared,

Previous attempts by DOD and VA to use disparate computer systems to produce universal electronic health records have failed, and unfortunately it appears they are repeating past mistakes.

The House Veterans’ Affairs Committee Ranking Member Michael Michaud (D-Maine) stated,

For at least a decade the two largest agencies in the government have worked this issue – often taking two steps forward and one step back.”  Michaud went on to say, “It seems to me that we have regressed back to 2004 when the Bidirectional Health Information Exchange was the way electronic information was exchanged.  I am hoping this is not the case.

On February 8, 2013, DOD issued a request for information on a new EHR to replace its aging AHLTA system, trying to find a system that contains the most capabilities for the least cost.  According to a March 28, 2013 story on Federal News Radio, VA submitted a proposal for DOD to use the VistA system, in order to provide a common starting point for interoperability.  The article continued that DOD was also considering other commercial health records products in its search for a new system. One would hope that DOD will take interoperability into consideration of any new EHR system it selects.  A decision on DOD’s new system selection is expected shortly.