Medical ADP Systems

As the backbone of the military's medical operations, the Composite Health Care System--an automated medical system developed by the Defense Department (DOD) at a cost of $2.8 billion--will provide doctors and nurses with almost instant access to patient information, from medical history to current treatment and vital statistics. DOD should be able to significantly improve operations at its medical facilities while reducing costs. Improved appointment scheduling will increase patients' access to health care, while better access to patient information will save medical personnel time. If DOD is to realize the system's full potential, however, physicians and other health care providers must be able to access the system at all times. Although DOD's backup and recovery plan provides for recovery from disruptions in computer service because of power outages, it does not effectively address major disruptions requiring the repair or the replacement of equipment damaged by a natural disaster. Health care providers have become dependent on the patient data in the system, so any major disruption could result in injury or even death. DOD could greatly reduce this risk by developing a more effective backup and recovery plan for its equipment.

GAO found that: (1) DOD completed deployment of CHCS to 526 medical treatment facilities worldwide, which was difficult because of the system's complexity and the number of sites involved; (2) two DOD officials ensured the deployment's success by providing leadership and using fundamental information management practices; (3) DOD expects CHCS benefits to exceed its costs by $1.3 billion over the system's expected life; (4) CHCS should improve scheduling, give greater and quicker access to patient information, and increase the timeliness of medical care; (5) DOD has made progress in addressing its two previously identified problems by developing a prototype clinically oriented graphical user interface to make patient order-entry less cumbersome and strengthening the tools and methodology needed to manage CHCS performance; (6) DOD has updated its CHCS performance management plan and developed performance simulation models for each CHCS computer platform; (7) the lack of an effective plan for rapidly repairing or replacing CHCS equipment damaged by disaster remains a problem; and (8) DOD did not address this problem because of cost concerns and a lack of accurate information, but it is reconsidering its options for providing equipment adequate backup.

Recommendations

Our 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.

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