The Institute of Medicine has identified inefficiencies at Captain James A. Lovell Federal Health Care Center in North Chicago, Ill., managed jointly by the Department of Defense and Department of Veterans Affairs, in part due to issues with the center's electronic health records, according to an Institute of Medicine report (pdf).
The DOD and VA replaced two separate centers in North Chicago when it opened Lovell FHCC. DOD asked the IOM to evaluate whether Lovell FHCC has improved healthcare access, quality and cost for the DOD and VA compared with operating two separate facilities. IOM also examined whether patients and healthcare providers are satisfied with joint VA/DOD delivery of healthcare.
Since Lovell FHCC has been in operation for less than two years, data on changes in efficiency and cost savings from the integration were not available. However, the report did highlight differences in policies and procedures that could be resolved. Findings from the report include:
• Two electronic health record systems have been maintained separately so veterans and naval personnel may use multiple medical centers. However, the two EHRs have limited ability to share patient information — a significant clinical inefficiency.
• There is a lack of interoperability between single patient registration and sign-on interfaces, which requires time-consuming work-arounds to keep both records systems current.
• Lovell FHCC has not fully developed a joint electronic health record because officials have not been able to create a numbering system for prescriptions, despite an investment of $100 million since 2009
According to the report, IOM gave the VA and DOD a few recommendations:
• No new federal healthcare center should be implemented until an interoperable or joint EHR system is available.
• The VA and DOD should standardize their policies, procedures and business practices to overcome differing approaches to handling the same functions.
• The VA and DOD should develop a comprehensive evaluation plan to objectively judge its success or failure with measurable criteria.
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The DOD and VA replaced two separate centers in North Chicago when it opened Lovell FHCC. DOD asked the IOM to evaluate whether Lovell FHCC has improved healthcare access, quality and cost for the DOD and VA compared with operating two separate facilities. IOM also examined whether patients and healthcare providers are satisfied with joint VA/DOD delivery of healthcare.
Since Lovell FHCC has been in operation for less than two years, data on changes in efficiency and cost savings from the integration were not available. However, the report did highlight differences in policies and procedures that could be resolved. Findings from the report include:
• Two electronic health record systems have been maintained separately so veterans and naval personnel may use multiple medical centers. However, the two EHRs have limited ability to share patient information — a significant clinical inefficiency.
• There is a lack of interoperability between single patient registration and sign-on interfaces, which requires time-consuming work-arounds to keep both records systems current.
• Lovell FHCC has not fully developed a joint electronic health record because officials have not been able to create a numbering system for prescriptions, despite an investment of $100 million since 2009
According to the report, IOM gave the VA and DOD a few recommendations:
• No new federal healthcare center should be implemented until an interoperable or joint EHR system is available.
• The VA and DOD should standardize their policies, procedures and business practices to overcome differing approaches to handling the same functions.
• The VA and DOD should develop a comprehensive evaluation plan to objectively judge its success or failure with measurable criteria.
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