Poor information sharing puts veterans at risk, says GAO

Veterans who receive health care from both the Defense and Veterans Affairs departments are at risk of receiving erroneously filled prescriptions and medications with dangerous side effects, according to a new report by the General Accounting Office.

The report, "VA and Defense Health Care: Increased Risk of Medication Errors for Shared Patients" (GAO-02-1017) found that Defense and VA do not share patient records with one another, making it difficult for pharmacists at one department to know what drugs patients are receiving from the other department. Without this information, pharmacists cannot be sure whether they are filling prescriptions that could be dangerous if used in combination with other drugs.

"Automatic checks for drug allergies and interactions are not complete for shared patients because medications dispensed by the other agency will not be included in the check," said the report. About 800,000 veterans are eligible for health care from both Defense and the VA, according to both departments.

Information sharing is even lacking at seven health care sites where Defense and the VA share space and services. Both departments maintain electronic systems that store patient histories, but these systems are not linked and often are only accessible to employees within the parent department. GAO found that pharmacists at four joint sites are unable to access the systems maintained by the other agency.

Pharmacists do get some information on patients from other departments, and most referrals are accompanied by a medical history, according to GAO. Pharmacists can also call the referring doctor at the other department for more information.

Still, personnel with Defense and VA interviewed for the report acknowledged that information gaps could cause problems with treatment. For example, a patient with diabetes under the care of a VA physician could have prescriptions filled at a Defense pharmacy. The Defense pharmacist could not safely prescribe drugs without first seeing the patient's lab results, but the pharmacist would have to call the VA pharmacist to get this information, GAO said.

GAO recommended that the departments open up their patient information systems to one another. Both departments agreed, although they regard this consolidation as a long-term effort with several technical hurdles. GAO said that both departments could take interim steps to improve information sharing before these technical issues are resolved.