The Department of Veterans Affairs (VA) is engaged in an ongoing effort to share electronic medical information with the Department of Defense (DOD), which is important in helping to ensure high-quality health care for active duty military personnel and veterans. Also important, in the face of current military responses to national and foreign crises, is ensuring effective and efficient delivery of veterans' benefits, which is the focus of VA's development of the Veterans Service Network (VETSNET), a modernized system to support benefits payment processes. GAO is testifying on (1) VA's efforts to exchange medical information with DOD, including both near-term initiatives involving existing systems and the longer term program to exchange data between the departments' new health information systems, and (2) VA's ongoing project to develop VETSNET. To develop this testimony, GAO relied on its previous work and followed up on agency actions to respond to GAO recommendations.

The Department of Veterans Affairs (VA) depends on information technology (IT) to effectively serve our nation's veterans, with an IT budget of about $1 billion annually. However, it has encountered numerous challenges in managing its IT programs and initiatives. To address these challenges, VA is realigning its IT organization and management to a centralized model founded on a defined set of improved management processes. Begun in October 2005, the realignment is planned to be complete by July 2008. In this testimony, GAO discusses its recent reporting on VA's realignment effort and its management of other IT programs and initiatives, including ongoing systems development efforts and work to share electronic health information with the Department of Defense (DOD). To prepare this testimony, GAO reviewed its past work in these areas.

The Department of Veterans Affairs (VA) has laid the groundwork for an integrated, departmentwide enterprise architecture--a blueprint for evolving its information systems and developing new systems to optimize their mission value. Crucial executive support is in place and the department has a strategy to define products and processes critical to its development. VA is now recruiting a chief architect to help implement and manage the enterprise architecture. VA has tried to strengthen its information security management program by mandating information security performance standards and greater management accountability for senior executives. It has also updated security policies, procedures, and standards to implement critical security measures. Despite these efforts, VA continues to report pervasive and serious information security weaknesses. The Veterans Benefits Administration is still far from launching a modernized system to replace its aging benefits delivery network. The Veterans Health Administration (VHA) has made good progress in expanding the use of its decision support system (DSS) for clinical and financial decision making. The use of DSS data for the fiscal year 2002 resource allocation process, and a requirement that veteran integrated service network directors better account for their use of this system, have raised awareness of, and promoted its use, among VHA facilities. VA has made little progress in sharing data with the Department of Defense and Indian Health Service as part of a computer-based patient record initiative. Implementation strategies continue to be revised, the scope of the initiative has been substantially narrowed, and it continues to operate without clear lines of authority or comprehensive, coordinated plans.