GAO contends HHS legacy system in dire need of modernization

The Department of Health and Human Services has made the list of the 10 most critical federal legacy systems in desperate need of modernization.

According to the Government Accountability Office, the HHS legacy system—the name of which the GAO would not disclose because of sensitivity concerns—is 50 years old with both high-risk “criticality” and security issues.

“HHS’s component, Indian Health Service’s (IHS) uses the system to gather, store and display clinical, administrative and financial information on patients seen in a clinic, hospital or remotely through the use of telehealth and home visit practices,” notes the GAO’s report.

However, the system’s technical architecture and infrastructure are outdated, which HHS acknowledges has resulted in challenges in developing new capabilities in response to business and regulatory requirements.

One of the problems with the system is that it is coded in Massachusetts General Hospital Utility Multi-Programming System (MUMPS), a programming language that HHS considers to be a legacy language.

HHS HQ

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“The agency noted that it has become increasingly difficult to find programmers proficient in writing code for MUMPS,” according to GAO. “Lastly, the system’s more than 50 modules were added over time to address new business requirements. The software is installed on hundreds of separate computers, which has led to variations in the configurations at each site.”

Auditors reveal that “this type of add-on development becomes detrimental over time and eventually requires a complete redesign to improve database design efficiency, process efficiency, workflow integration and graphical user interfaces.”

Making matters worse, GAO found that although HHS officials believe that the modernization of the system is imperative, the agency does not have documented plans to do so.

“HHS had entered into a contract to begin a modernization initiative, but had not yet completed its plans,” states the GAO’s report.

In its written comments to the report, HHS said that it intends to evaluate ways to provide its modernization plan, including milestones and a description of the work necessary to modernize the system.

According to HHS, the agency will be completing its modernization plan over the next five years, but anticipates that it may be able to begin to execute the implementation as early as 2020.

“With regards to potential cost savings, HHS noted that the modernization will take significant capital investment to complete, and it is unknown whether the modernization will lead to cost savings,” states the report. “HHS officials stated that this modernization could improve interoperability with its healthcare partners, the Department of Veterans Affairs and the Department of Defense, and significantly enhance direct patient care.”

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