The Department of Defense’s (DoD) cost and schedule estimates for fully deploying its latest-generation electronic health record system (EHRM) are unreliable and could have the impact of depriving agency leadership of the right information upon which to base deployment decisions, according to a new report by the Government Accountability Office (GAO).

DoD began to implement its Military Health System (MHS) GENESIS program in 2017 with a goal of integrating inpatient and outpatient medical and dental information. The program’s contract award totals $5.5 billion.

MHS GENESIS is intended to be implemented in 24 phases, the first of which was completed in October 2017, with the final phase expected by December 2023.

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However, DoD hasn’t fully met the characteristics for developing MHS GENESIS cost and schedule estimates, in addition to not providing sufficient details about its methodology or data used for the cost estimates, GAO said.

“MHS GENESIS’s cost estimate was unreliable because it did not substantially meet all four characteristics of a reliable cost estimate, as described in GAO’s cost guide,” wrote the watchdog agency in its report.

DoD has minimally met the “credible” characteristic associated with reliable cost estimates because it didn’t provide evidence that a sensitivity analysis, a risk and uncertainty analysis, or an independent cost estimate were conducted.

The lack of reliable program cost and schedule estimates increase DoD’s risk that management will not have information necessary for effective decision-making, GAO said.

GAO made two recommendations for DoD, both of which were agreed to by the Pentagon. The recommendations are:

  1. Ensure that the program office develops a reliable cost estimate using GAO’s Cost Estimating and Assessment Guide for best practices; and
  2. Develop a reliable schedule using GAO’s Estimating and Assessment Guide for best practices.

Interoperability Concerns

A recent report conducted jointly by inspectors general (IG) from DoD and the Department of Veterans Affairs (VA) found that the Federal EHRM program office hasn’t yet developed a plan to achieve interoperability between DoD and VA systems.

Interoperability between the two has been a long-range goal set in motion since the 2008 National Defense Authorization Act, and is considered an outcome that is “critical,” according to the IG report.

Both organizations said they plan to continue to works towards interoperability of the EHRM systems.

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Jordan Smith
Jordan Smith
Jordan Smith is a MeriTalk Senior Technology Reporter covering the intersection of government and technology.