Composite Health Care System
Outpatient Capability Is Nearly Ready for Worldwide Deployment Gao ID: IMTEC-93-11 December 15, 1992The Defense Department's (DOD) development of the Composite Health Care System--an automated approach to patient records intended for use in more than 600 military health care facilities around the globe--is progressing, and the problems it is encountering are to be expected when developing and deploying a system of this size and complexity. To begin worldwide deployment of the outpatient components at this time, however, would be a mistake--one that could lead to later problems and pose greater risks to patient safety. Although the system shows promise for enhancing DOD's ability to manage patient data, improve the quality of care, and cut costs, several major issues still need to be addressed. DOD has not yet completed an operational test and evaluation of all essential system capabilities or done a credible cost/benefit analysis of the system. In addition, worldwide deployment of the system will be difficult, even after these two issues have been addressed, because DOD has not presented an adequate plan for deploying the system.
GAO found that: (1) the outpatient portion of CHCS is not ready for worldwide deployment, since DOD has not performed a complete OT&E of the system, the cost-benefit analysis for CHCS is still unclear and unsubstantiated, and the DOD plan for deploying CHCS lacks specificity; (2) the OT&E that DOD performed was incomplete because it did not include two critical system capabilities; (3) DOD did not follow standard life-cycle cost estimating procedures to produce cost estimates and has not been able to validate estimated CHCS benefits; (4) DOD based its estimates primarily on assumptions of enhanced medical services rather than on empirical data from actual medical treatment facilities; and (5) the DOD plan for deployment does not provide any specific information relating to the deployment schedule or deployment costs, and does not address DOD strategy for configuring and managing the system's hardware and software.
RecommendationsOur recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.
Director: Team: Phone: