Sharing Health Records for Servicemembers and Veterans

Thumbnail Health CareThe Departments of Defense (DOD) and Veterans Affairs (VA) operate two of the nation’s largest health care systems, providing care to more than 9.6 million active-duty servicemembers and 6.3 million veterans. For many years, DOD and VA have known that better sharing of health care data could help them:

  • make patient information more available to health care providers;
  • reduce medical errors; and
  • streamline administrative functions to save time and money.

Electronic health records are an essential part of delivering quality care to veterans and servicemembers—especially the 5 million shared patients who receive health care and services from both DOD and VA.

DOD and VA’s Electronic Health Record Efforts

More than 97 percent of DOD and VA’s requirements for supporting inpatient care are the same, but because their health information is stored in different systems, data sharing has been challenging. Both departments were planning to replace their separate systems with new systems that were more interoperable. In February 2011, we identified DOD and VA’s separate efforts to modernize electronic health records as a case of unnecessary duplication and we recommended actions they could take to address it.

In March 2011, the Secretaries of both departments committed to replacing their separate systems with a joint system, the integrated electronic health record (iEHR). This would have allowed the departments to avoid the interoperability and data sharing challenges they previously had.

After spending almost 2 years on the project, DOD and VA determined that the system was too expensive and would take too long to develop. The departments’ ineffective implementation of the Interagency Program Office (which was intended to facilitate collaboration on iEHR) may have also contributed to the project’s derailment.

DOD and VA reverted to replacing the two existing systems with two new ones. In February of this year, we assessed the iEHR project and in July we made additional recommendations to improve collaboration between DOD and VA as they replace their electronic health record systems.  Ensuring interoperability of the new systems is important to optimize the quality of health care the departments provide to servicemembers and veterans.

  • Questions on the content of this post? Contact Valerie Melvin at
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Podcast on Medical Credit Cards

GAO Podcast IconFinancial institutions offer medical credit cards through participating providers to pay for services not covered by health insurance. These services may include dental and cosmetic procedures, or veterinary care.

Hear our latest podcast with Cindy Brown Barnes, a director in GAO’s Financial Markets and Community Investment team, who led a recent look at the marketplace for medical credit cards.

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Tracking Progress on Financial Stability and Reform

thumbnail_financeIn response to the worst financial crisis in more than 75 years, U.S. policymakers undertook wide-ranging reforms. For example, the 2010 Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank Act) aims, among other things:

  • to promote the financial stability of the nation by improving accountability and transparency in the financial system,
  • to deal with issues around “too big to fail,”
  • to protect taxpayers by ending bailouts, and
  • to protect consumers from abusive financial services practices.

Since the Dodd-Frank Act was passed, we have published numerous reports on various topics related to the U.S. financial regulatory system, including:

Implementation of many of the act’s reforms has proved challenging, and many of them have yet to be finalized or to take effect.

We have made numerous recommendations to regulators in these areas, and agencies have taken steps to implement some of them. You can also see more of our work on modernizing the U.S. financial regulatory system in our High Risk report.

  • Questions on the content of this post? Contact A. Nicole Clowers at
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Celebrating GAO’s 93 Years with Some Glimpses into History

thumbnail_gaoHere at GAO, we strive for accountability, integrity, and reliability in the work we do, but the way we do it evolves with time. As the month of July marks GAO’s 93rd anniversary, we thought we would share a few snapshots of GAO’s office culture over the years. Continue reading

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The Risks of Virtual Currencies

GAO Podcast IconIn February 2014, the Mt. Gox virtual currency exchange filed for bankruptcy, stating that a security breach resulted in the loss of bitcoins worth more than $460 million at the time. This incident is one of many real-world illustrations of the risks involved in using virtual currencies. In June, we released a report on virtual currencies and related consumer protection, regulatory, and law enforcement challenges. You can hear our podcast on it below.

Continue reading

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Questionable Business Practices and Pension Advances

thumbnail retirement securityPensions, in addition to Social Security, are what allow millions of middle-class retirees to maintain a reasonable standard of living. Any loss of pension benefits (partial or otherwise) can significantly affect a retiree’s ability to pay monthly living expenses, medical bills, or other unexpected expenses. Unfortunately, some companies may be attempting to take advantage of financially distressed retirees by offering pension advances. We released a report earlier this week that identified at least 38 companies that offered lump-sum payments in exchange for receiving part or all of a retiree’s pension payments. Continue reading

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Climate Change Adaptation and National Security

thumbnail_defenseIn a new report, we assessed the Department of Defense’s (DOD) actions to adapt its U.S. infrastructure to the challenges of climate change. While it’s not possible to link any individual weather event to climate change, these events provide insight into potential climate-related vulnerabilities. Continue reading

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Our Independence

Security guards raising American and GAO flagsOn July 4th, Americans celebrate our country’s adoption of the Declaration of Independence, which expressed the ideals of political and individual freedom upon which our country and government were founded. We at GAO uphold these ideals as we work to support the Congress in meeting its constitutional responsibilities and to maximize the federal government’s benefits to the American public.

GAO’s mission and core values are centered on providing information that is objective, fact-based, nonpartisan, nonideological, fair, and balanced. Therefore, we adhere to an additional kind of independence: All GAO employees working on audits must be capable of providing objective and impartial judgment, and maintain both independence of mind and independence in appearance. Continue reading

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Planning for the 2020 Census

Photo Credit: U.S. Census Bureau, Public Information Office

Photo Credit: U.S. Census Bureau, Public Information Office

Although the 2020 Census is about 6 years away, preparations are well under way. The Census Bureau has designated today as Census Day 2014, as the Bureau is conducting its first significant test of the methods and technologies it’s considering for the 2020 Census.

We have often reported on lessons learned from the 2010 Census, and on what steps the Bureau can take to control costs while maintaining accuracy for the 2020 Census. The U.S. population is growing steadily larger, more diverse, increasingly difficult to find, and reluctant to participate in the census. Due in part to these factors, the traditional approach of mailing paper questionnaires and following up in person with people who don’t respond is no longer cost effective. The cost of conducting the census has increased by more than 500 percent over the past five decades, while the mail response rate declined 15 percentage points over the same period. Continue reading

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GAO’s Health Care Team

Thumbnail Health CareGAO’s workforce is organized largely by subject area, with most employees working in 1 of 14 mission teams. Today, we’ll be putting the spotlight on the Health Care team, which supports congressional oversight of federal agencies responsible for health care delivery and financing. These programs tangibly affect the lives of all Americans. Expenditures on federal health care programs represent about a quarter of all federal spending each year. Ensuring that these programs provide access to quality care, protect the public, and remain fiscally sustainable is one of the greatest challenges facing Congress and the President in the 21st century. Continue reading

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