While officials are making progress implementing upgrades at the Captain James A. Lovell Federal Health Care Center (FHCC), a GAO report has cited costly IT delays for the VA and DoD.

Despite an investment of more than $122 million for IT capabilities at the FHCC (pictured above), the Department of Veterans Affairs and Department of Defense have not completed work on all components required by an Executive Agreement, which were to have been in place in time for the FHCC’s opening in October 2010.

Upgrade plans for the FHCC were outlined in the Executive Agreement in April 2010. The agreement resulted from the National Defense Authorization Act (NDAA) for Fiscal Year 2010, which authorized VA and DOD to establish a 5-year demonstration to integrate medical care into a first-of-its-kind FHCC in North Chicago, Illinois.

The report released this week is the second of three examining progress.

According to the Government Accountability Office report, officials have implemented many recommendations from the first report in 2011, including establishing the facility’s governance structure and patient priority system as well as quality assurance and contingency planning. Others, including property and fiscal authority, remain in progress.

IT delays, however, have resulted in additional costs and administrative burden for the FHCC because of the need for workarounds to address them. There also are other IT capabilities required by the Executive Agreement that are ill-defined and for which plans have not been established. FHCC has been unable to quantify the total costs resulting from these delays.

The report also states that VA and DOD officials have not yet established an evaluation plan or performance standards for an assessment of the FHCC at the end of the 5-year demonstration. Without VA and DOD agreement on the measures and standards, FHCC leadership is unable to track progress and make any midcourse adjustments to improve performance in areas VA and DOD have determined are necessary for the FHCC’s success.

GAO recommends that VA and DOD

  • determine the costs associated with the workarounds required because of delays in implementing IT capabilities laid out in the FHCC Executive Agreement
  • develop plans with clear definitions, specifications, deliverables, and time frames for IT capabilities required by the Executive Agreement but not yet defined
  • develop and agree to an evaluation plan, to include all performance measures and standards to be used in evaluating the FHCC demonstration
  • establish measures related to the cost-effectiveness of the FHCC as part of their evaluation

VA and DOD generally concurred and noted steps to address GAO’s recommendations.