Mar 28 2013

VistA and AHLTA on the Daily Show

Published by at 12:04 am under AHLTA,VistA

I just watched Jon Stewart’s Daily Show for March 27 and was amazed to see VistA and ALHTA mentioned (starting around minute 7), castigating both the VA and the DoD for their “incompatible” medical record systems.  Since this has been my briar patch for 35 years now, it is amazing to see this play out on national TV.

I had a working VA/DoD medical record system working in 1985:
Tom Munnecke, Ingeborg Kuhn, George Boyden, Beth Teeple showing off the first VA/DoD Health IT interface

It was thoroughly studied by Congress, GAO, VA, and Arthur D. Little consultants, and passed with flying colors (well, except for some of the dirty tricks that DoD pulled, trying to make it look bad).  Here is an oral history interview about the system.

Creating a shared VA/DoD/Indian Health Service government-wide system was always the vision of our gang. We sought to create a common platform of shared information, controlled by “metadata” (or information-about-information). It was technically a correct solution, but politically incorrect. DoD did not want anything to do with VA, due to a “not invented here” syndrome. Plus, the realized that if they shared information systems, it could lead to shared VA/DoD facilities, which infringed on their turf.

One thing I’ve learned in bureaucracies: Never stand between bureaucrats and their pensions. Creating a more efficient system, which increases their productivity, allows them to do the same amount of work with fewer people.

However, bureaucrats are compensated by the number of people working under them. Fewer people means lower salaries, less job security, and less bureaucratic turf.

The problem of VA/DoD incompatibility is not a technical problem. It is a political turf war, and has been going on for decades. I don’t know if Chuck Hagel has the chops to solve this problem, but it deals with a fundamentally intransigent bureaucracy – in the mid levels – that sees VA/DoD sharing as competition for their jobs and security.

And Veterans and taxpayers lose.


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