VA Health Care Delivery

Top Management Leadership Critical to Success of Decision Support System Gao ID: AIMD-95-182 September 29, 1995

One of the main missions of the Department of Veterans Affairs (VA) is to provide health care to veterans. VA's Veterans Health Administration (VHA) runs the largest health care system in the nation, with an annual budget of more than $16 billion. Despite its size and complexity, however, VHA lacks detailed, reliable information on the operating costs of its 172 hospitals. Consequently, as GAO reported in December 1992 (GAO/OCG-93-4TR), VHA could not determine which of its facilities were working well and which procedures were cost-effective. This report assesses VA's efforts to develop a medical decision support system, a computer system that has provided hospitals in the private sector with improved data on patterns of patient care and the cost of providing health care services. As of July 1995, VA had started implementing its decision support system at 38 hospitals. GAO examines (1) the benefits that such a system can provide VA, (2) whether VA is pursuing the comprehensive business strategy needed to achieve these benefits, and (3) whether VA is establishing an adequate information infrastructure for the system.

GAO found that: (1) DSS has the potential to be an effective tool for improving the quality and cost-effectiveness of VHA health care operations; (2) VA has not formulated business goals or a comprehensive implementation strategy to clearly define how it will use DSS-generated information or prioritize its limited resources to implement DSS; (3) VA also has not established the information infrastructure needed to support DSS; (4) some of the data provided to DSS from other VA information systems are incomplete and inaccurate, limiting VA ability to make sound business decisions; and (5) sustaining top management leadership and commitment within VHA is critical to the successful implementation and use of DSS.


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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