text: b' Report No. DODIG\xe2\x80\x912015\xe2\x80\x91008\n\n\n\n I nspec tor Ge ne ral\n U.S. Department of Defense\n\n OCTOBER 23, 2014\n\n\n\n\n Followup Audit: Enterprise Blood\n Management System Not Ready for\n Full Deployment\n\n\n\n\nI N T E G R I T Y \xef\x82\xab E F F I C I E N C Y \xef\x82\xab A C C O U N TA B I L I T Y \xef\x82\xab E X C E L L E N C E\n\x0c I N T E G R I T Y \xef\x82\xab E F F I C I E N C Y \xef\x82\xab A C C O U N TA B I L I T Y \xef\x82\xab E X C E L L E N C E\n\n\n\n\n Mission\n Our mission is to provide independent, relevant, and timely oversight\n of the Department of Defense that supports the warfighter; promotes\n accountability, integrity, and efficiency; advises the Secretary of\n Defense and Congress; and informs the public.\n\n\n\n Vision\n Our vision is to be a model oversight organization in the Federal\n Government by leading change, speaking truth, and promoting\n excellence\xe2\x80\x94a diverse organization, working together as one\n professional team, recognized as leaders in our field.\n\n\n\n\n Fraud, Waste & Abuse\n\n HOTLINE\n Department of Defense\n dodig.mil/hotline | 8 0 0 . 4 2 4 . 9 0 9 8\n\n\n\n\nFor more information about whistleblower protection, please see the inside back cover.\n\x0c Results in Brief\n Followup Audit: Enterprise Blood Management System\n Not Ready for Full Deployment\n\n\n\nOctober 23, 2014 Findings (cont\xe2\x80\x99d)\n\nObjective product inventories. This occurred because the Program\n Executive Officer and the Component Acquisition Executive\nOur objective was to determine whether for Defense Health Agency did not manage the donor,\nthe system configuration and early transfusion, and the Theater Blood capability as a DoD\noperational assessment for the Enterprise information technology portfolio. As a result, the Program\nBlood Management System (EBMS) will Executive Officer did not achieve maximum efficiencies for the\nmeet the system requirements as agreed Department\xe2\x80\x99s blood program and is at an increased risk of not\nto in Recommendations A.4. and B.3 from fully reaching the overall blood program\xe2\x80\x99s performance goals.\nDoD\xc2\xa0OIG Report No. D\xe2\x80\x912002\xe2\x80\x91010, \xe2\x80\x9cArmed\nServices Blood Program Defense Blood\nStandard System,\xe2\x80\x9d and whether these Recommendations\ncorrective actions intended to mitigate the The Program Executive Officer should continue\xc2\xa0efforts\nidentified problems. to implement corrective actions as agreed to in\n Recommendation\xc2\xa0A.4 and B.3.a of DoD OIG Report\nFindings No.\xc2\xa0D\xe2\x80\x912002\xe2\x80\x91010. The Component Acquisition Executive should\n evaluate how EBMS, Theater Blood capability, and any other\nThe Program Executive Officer for the DoD information technology blood product capabilities would\nDefense Health Clinical Systems could benefit from being interoperable as an information technology\nnot demonstrate that the system design, portfolio, as\xc2\xa0required.\nconfiguration, and early operational\nassessment for EBMS will meet the\nrequirements as agreed. This occurred Management Comments and\nbecause the Program Executive Officer was\nstill in the early stages of the acquisition\n Our Response\n The Director, Defense Health Agency, responding for the\nprocess for the donor system and did not\n Component Acquisition Executive, Program Executive Officer,\ninitially require the Composite Health Care\n and Director, Armed Services Blood Program, fully addressed\nSystem to interface with the transfusion all specifics of the recommendations, and no further\nsystem. As a result, after 13 years, the comments are required. Please see the Recommendations\nProgram Executive Officer\xe2\x80\x99s actions were not Table on the back of this page.\ncompleted to show that EBMS will meet the\nintent of Recommendations A.4 and\xc2\xa0B.3.a.\nThe Military Health System leaders deployed\nthe Theater Blood capability to meet the\nintent of recommendation B.3.b instead\nof\xc2\xa0EBMS.\n\nThe Program Executive Officer planned\nto acquire three stand-alone DoD blood\nproduct information technology capabilities\nthat will manage information about the\ndonors, donations, transfusions, and blood\n Figure. Scanning inventory.\n Source: Af.mil\nVisit us at www.dodig.mil\n\n\n DODIG-2015-008 (Project No. D2013-D000XD-0207.000) \xe2\x94\x82 i\n\x0c Recommendations Table\n Recommendations No Additional\n Management Requiring Comment Comments Required\n Component Acquisition Executive for Defense B.1, B.2, B.3\n Health Agency\n Program Executive Officer for the Defense Health A.1, A.2\n Clinical Systems\n Director, Armed Services Blood Program A.1, A.2\n\n\n\n\nii \xe2\x94\x82 DODIG-2015-008 (Project No. D2013-D000XD-0207.000)\n\x0c INSPECTOR GENERAL\n DEPARTMENT OF DEFENSE\n 4800 MARK CENTER DRIVE\n ALEXANDRIA, VIRGINIA 22350\xe2\x80\x911500\n\n\n October 23, 2014\n\nMEMORANDUM FOR DISTRIBUTION ASSISTANT SECRETARY OF DEFENSE FOR\n HEALTH\xc2\xa0AFFAIRS\n\nSUBJECT:\t Followup Audit: Enterprise Blood Management System Not Ready for Full\n Deployment (Report No. DODIG-2015-008)\n\nWe are providing this report for your information and use. The Program Executive Officer\nfor the Defense Health Clinical Systems could not demonstrate after 13 years that officials\nimplemented the necessary actions to mitigate the identified system problems as agreed.\nSpecifically, these were interface problems with the Composite Health Care System and double\ncounting of inventory. The Component Acquisition Executive for Defense Health Agency also\ndid not manage the Enterprise Blood Management System or Theater Blood capability as a\nDoD Information Technology portfolio.\n\nWe considered management comments on the draft report when preparing the final\nreport. Comments from the Director, Defense Health Agency addressed all specifics of the\nrecommendations and conformed to the requirements of DoD Directive 7650.3; therefore, we\ndo not require additional comments.\n\nWe appreciate the courtesies extended to the staff. Please direct questions to me at\n(703)\xc2\xa0604\xe2\x80\x918905 (DSN 664-8905).\n\n\n\n Amy J. Frontz\n Principal Assistant Inspector General\n for Auditing\n\n\n\n\n DODIG-2015-008 \xe2\x94\x82 iii\n\x0c Contents\n Introduction\n Objective__________________________________________________________________________________________1\n Background______________________________________________________________________________________1\n Defense Blood Standard System________________________________________________________________2\n Enterprise Blood Management System________________________________________________________2\n Theater Blood Capability________________________________________________________________________4\n Review of Internal Controls_____________________________________________________________________4\n\n Finding A. Enterprise Blood Management System\n Will Not Be Ready for Full Deployment______________________________6\n Prior Audit Summary____________________________________________________________________________6\n Finding A: Recommendation A.4___________________________________________________________7\n Finding B: Recommendation B.3___________________________________________________________7\n Agreed Upon Actions_ ______________________________________________________________________8\n Agreed\xe2\x80\x91Upon Actions Not Demonstrated______________________________________________________8\n Mitigation of Double Counting Awaiting Deployment of Donor\xc2\xa0System________________8\n Interface with the Composite Health Care System_______________________________________9\n Conclusion________________________________________________________________________________________9\n Management Comments on Background and Finding A and Our Response________________9\n Recommendations, Management Comments, and Our Response_ ________________________ 10\n\n Finding B. DoD Management of Blood Products\n Information Technology Capabilities May Have\n Missed Opportunities to Leverage Efficiencies_______________ 12\n DoD Blood Product Information Technology Capabilities Acquisition____________________ 12\n DoD Blood Products Information Technology Portfolio_______________________________ 13\n Interface of DoD Blood Product Information Technology Capabilities ______________ 15\n Management Actions Taken on the Transfusion System___________________________________ 16\n Management Comments on Background and Finding B and Our Response______________ 16\n Recommendations, Management Comments, and Our Response_ ________________________ 17\n\n\n\n\niv \xe2\x94\x82 DODIG-2015-008\n\x0cContents (cont\xe2\x80\x99d)\nAppendix\nScope and Methodology_______________________________________________________________________ 19\nUse of Computer\xe2\x80\x91Processed Data _ __________________________________________________________ 20\nUse of Technical Assistance___________________________________________________________________ 20\nPrior Coverage _________________________________________________________________________________ 20\n\nManagement Comments\nDefense Health Agency________________________________________________________________________ 21\n\nGlossary___________________________________________________________________________________ 25\nAcronyms and Abbreviations______________________________________________ 27\n\n\n\n\n DODIG-2015-008 \xe2\x94\x82 v\n\x0c\x0c Introduction\n\n\n\n\nIntroduction\nObjective\nOur audit objective was to determine whether the system configuration and early\noperational assessment for the Enterprise Blood Management System (EBMS) will\nmeet the system requirements as agreed to in Recommendations A.4 and B.3 of\nDoD OIG Report No. D\xe2\x80\x912002\xe2\x80\x91010, \xe2\x80\x9cArmed Services Blood Program Defense Blood\nStandard System,\xe2\x80\x9d October 22, 2001, and whether these corrective actions intended\nto mitigate the identified problems.\n\nMilitary Health System (MHS) leaders and the Services replaced the Theater\nDefense Blood Standard System (DBSS) with the Theater Blood capability instead\nof EBMS to meet the intent of Recommendation B.3.b. Please refer to the Appendix\nfor additional details about our scope and methodology. Also, see the Glossary for\nthe definition of key terms.\n\n\nBackground\nThe Armed Services Blood Program (ASBP) is a military Services and unified\nCommands joint operation. The ASBP Office (ASBPO) manages the DoD blood\nprogram under the authority of the Secretary of Defense through the Assistant\nSecretary of Defense for Health Affairs\xc2\xa0(ASD[HA]) and the operational control of\nthe Joint Chiefs of Staff. ASBPO\xe2\x80\x99s mission is to provide quality blood products and\nservices for all customers in peace and war with specific responsibilities for:\n\n \xe2\x80\xa2\t overseeing operations of the blood program during contingencies;\n \xe2\x80\xa2\t coordinating day\xe2\x80\x91to\xe2\x80\x91day activities of ASBP for the Army, Navy, and\n Air\xc2\xa0Force Service blood programs; and\n \xe2\x80\xa2\t coordinating theater blood program matters with the Combatant\n Commands.\n\nThe Deputy Secretary of Defense established the Defense Health Agency\xc2\xa0(DHA)\non October 1, 2013. DHA is responsible for shared services, functions, and\nactivities of the MHS. DHA\xe2\x80\x99s role is to accomplish greater integration of health care\ndelivery systems by achieving medical readiness, improving health, enhancing the\nexperience of care, and lowering healthcare costs.\n\n\n\n\n DODIG-2015-008 \xe2\x94\x82 1\n\x0cIntroduction\n\n\n\n Under DHA, the Program Executive Officer for the Defense Health Clinical\n Systems\xc2\xa0(PEO[DHCS]):\n\n \xe2\x80\xa2\t produces and delivers products that support the MHS;\n \xe2\x80\xa2\t supports health care operations through design, development, test,\n evaluation, and deployment of medical information systems; and\n \xe2\x80\xa2\t manages the DBSS and EBMS information systems and the Theater Blood\n capability.\n\n Defense Blood Standard System\n DBSS is an MHS legacy blood product information management system. According\n to Report No. D\xe2\x80\x912002\xe2\x80\x91010, the Food and Drug Administration (FDA) cleared this\n system as a medical device. According to PEO(DHCS) officials, it has an estimated\n life\xe2\x80\x91cycle cost of about $217.5\xc2\xa0million.1 The report stated that blood program\n organizations used the system to maintain and track blood donations and blood\n product inventories, as well as to provide transfusion service management and\n system administration.\n\n According to Report No. D\xe2\x80\x912002\xe2\x80\x91010, ASD(HA) officials developed Theater DBSS\n as an interim solution pending the release of the Theater Medical Information\n Program. The report stated that this program provided theater commanders\n with all the functional capabilities of DBSS in a theater environment. Specifically,\n PEO(DHCS) officials stated that Theater DBSS was a database that accounted for\n inventory for the blood support detachments in Iraq and Afghanistan.\n\n\n Enterprise Blood Management System\n According to the Acquisition Program Baseline, EBMS is a mission essential\n automated information system. EBMS is comprised of two different FDA cleared\n medical devices, commercial off\xe2\x80\x91the\xe2\x80\x91shelf products\xe2\x80\x93the Blood Donor Management\n System (donor system) and the Blood Management Blood Bank/Transfusion\n Service (transfusion system). The Component Acquisition Executive (CAE) for\n DHA considered these two systems as a single Defense acquisition category\xc2\xa0III\n automated information system. 2 According to the transfusion system Business\n Case Analysis, EBMS will enhance the DoD blood program capabilities for blood\n banking and transfusion services through the improved integration of blood\n products inventory management and shipment availability. The CAE for DHA is the\n milestone decision authority for EBMS.\n\n \t1\t\n PEO(DHCS) officials stated that they did not have substantiating records for the cost from FY 1991 through FY 2010\n ($174\xc2\xa0million) because they no longer have access to verifiable cost details.\n \t2\t\n Acquisition categories are established to facilitate decentralized decision\xe2\x80\x91making and execution and compliance with\n statutory imposed requirements. Acquisition category\xc2\xa0III automated information systems are not designated as special\n interest nor meet the threshold of a major system (categories\xc2\xa0I or\xc2\xa0II).\n\n\n\n2 \xe2\x94\x82 DODIG-2015-008\n\x0c Introduction\n\n\n\nThe donor system\xe2\x80\x99s design and requirements documents state that it would support\ndonor screening, registration, and manufacturing functions. The transfusion\nsystem\xe2\x80\x99s design and requirements documents state that it is used to organize the\nmanagement of blood bank and transfusion services. The transfusion system will\ninterface with outside systems such as Composite Health Care System (CHCS). The\nmain functions of the transfusion system are to manage:\n\n \xe2\x80\xa2\t blood products inventory levels and availability;\n \xe2\x80\xa2\t blood products test results;\n \xe2\x80\xa2\t pre\xe2\x80\x91transfusion and compatibility test results;\n \xe2\x80\xa2\t patient information;\n \xe2\x80\xa2\t blood bank and services reports across the enterprise; and\n \xe2\x80\xa2\t blood bank user accreditation and training in the use of the application.\n\nThe donor system would correct the double counting inventory problem and the\ntransfusion system would mitigate the CHCS interface problem. The current life\ncycle cost estimate for EBMS is about $245.5\xc2\xa0million. According to PEO(DHCS)\nofficials, the donor system would cost about $123.2\xc2\xa0million3 and the transfusion\nsystem would cost about $122.3\xc2\xa0million.4\n\nFigure 1 shows bags and vials of blood waiting to be processed during an\nASBP\xc2\xa0blood drive.\n\n\n\n\n Figure 1. Processing of bags and vials of blood.\n Source: Armylive.dodlive.mil\n\n\n\n\t3\t\n PEO(DHCS) officials did not have any acquisition documentation to support this estimate.\n\t4\t\n The estimated life cycle costs were from the approved transfusion system Acquisition Program Baseline.\n\n\n\n\n DODIG-2015-008 \xe2\x94\x82 3\n\x0cIntroduction\n\n\n\n Theater Blood Capability\n In 2011, MHS leaders and the Services replaced Theater DBSS with the Theater\n Blood capability. This capability is a module under the Theater Medical Data\n Store and Medical Situational Awareness in Theater. According to PEO(DHCS)\n officials, the Theater Blood capability addresses Combatant Command medical\n assets requirements for the U.S. Central Command. ASBPO official further stated\n they deployed the Theater Blood capability to locations in U.S. Central Command\n and ships afloat. The officials are considering deployment to locations in Pacific\n Command and U.S. Southern Command. According to officials, the capability is\n a web\xe2\x80\x91based IT product used to track blood products in theater. Specifically,\n theater\xe2\x80\x91based medical treatment facilities use it to track blood product inventory,\n collection, and disposition. Officials could not provide the estimated costs for\n this\xc2\xa0capability.\n\n The FDA blood establishment computer software criteria do not apply to\n the Theater Blood capability. According to PEO(DHCS) officials, FDA\xe2\x80\x99s Blood\n Establishment Computer Software criteria applies to software designated for use in\n a blood establishment and is intended for use in the diagnosis of disease or other\n conditions in donors, or in the prevention of disease in humans by preventing the\n release of unsuitable blood and blood components. Since medical personnel located\n in theater use this capability only to track the blood product inventory, no FDA\n medical device clearance is necessary.\n\n\n Review of Internal Controls\n DoD Instruction 5010.40, \xe2\x80\x9cManagers\xe2\x80\x99 Internal Control Program Procedures,\xe2\x80\x9d\n May\xc2\xa030, 2013, requires DoD organizations to implement a comprehensive system of\n internal controls that provides reasonable assurance that programs are operating\n as intended and to evaluate the effectiveness of the controls. We identified internal\n control weaknesses related to the EBMS acquisition process. Specifically, the:\n\n \xe2\x80\xa2\t PEO(DHCS) could not demonstrate that EBMS will meet the\n requirements as agreed to in Recommendations A.4 and B.3.a of DoD OIG\n Report\xc2\xa0D-2002\xe2\x80\x91010.\n \xe2\x80\xa2\t PEO(DHCS) planned to acquire three stand-alone DoD blood product\n information technology capabilities instead of a DoD IT portfolio.\n\n\n\n\n4 \xe2\x94\x82 DODIG-2015-008\n\x0c Introduction\n\n\n\n \xe2\x80\xa2\t CAE for DHA and PEO(DHCS) did not approve several critical acquisition\n documents for the transfusion system before entering milestone C of the\n DoD business capability model as required by DoD Instruction 5000.02;\n however, PEO(DHCS) officials provided the signed documents during this\n audit.\n\nWe will provide a copy of the report to the senior officials responsible for internal\ncontrols in ASD(HA).\n\n\n\n\n DODIG-2015-008 \xe2\x94\x82 5\n\x0cFinding A\n\n\n\n\n Finding A\n Enterprise Blood Management System Will Not Be\n Ready for Full Deployment\n The PEO(DHCS) could not demonstrate that the system design, configuration, and\n early operational assessment for EBMS will meet the requirements as agreed to\n in Recommendations A.4 and B.3.a of DoD OIG Report D-2002\xe2\x80\x91010. This occurred\n because PEO(DHCS) officials were still developing the donor system requirements\n and initially deployed the transfusion system as a stand-alone system that did\n not interface with CHCS. As a result, after 13 years the PEO(DHCS) officials\xe2\x80\x99\n actions still were not complete to show that EBMS will meet the intent of\n Recommendations A.4 and B.3.a.\n\n\n\n\n Prior Audit Summary\n According to DoD OIG Report No. D\xe2\x80\x912002\xe2\x80\x91010, DBSS implementation was not\n adequate to meet ASBP mission needs and, as a result, the use of DBSS affected the\n asset accountability, increased workload and risk of inventory errors, and possibly\n resulted in the inappropriate release of blood product. Also,\n results indicated that the deployment and use of DBSS\n As a result, a was not consistent throughout DoD. Specifically,\n consistent blood\n the audit found that only 46\xc2\xa0percent of the fixed\n product management\n was not achieved, facilities used the CHCS interface; 54\xc2\xa0percent of\n workload increased, and the Theater DBSS laptops were ready for use; and\n DoD may not achieve total the Theater DBSS reporting to Joint Medical Asset\n asset accountability of Repository\xc2\xa0(JMAR) was not complete. As a result,\n blood products.\n a consistent blood product management was not\n achieved, workload increased, and DoD may not achieve\n total asset accountability of blood products.\n\n\n\n\n6 \xe2\x94\x82 DODIG-2015-008\n\x0c Finding A\n\n\n\nFinding A: Recommendation A.4\nDoD OIG Report No. D\xe2\x80\x912002\xe2\x80\x91010 stated that DBSS and JMAR\n DBSS\nProject Offices did not ensure accurate reporting from and JMAR\nDBSS to JMAR. Specifically, there was an instance when Project Offices\nJMAR did not accurately reflect a blood product shipment did not ensure\nthat was received by a blood program organization. This accurate reporting\n from DBSS to\npotentially could have resulted in a temporary double\n JMAR.\ncounting of inventory.\n\nRecommendation A.4 stated that the JMAR and DBSS Project\nOffices should modify their system, as necessary, to ensure that in\xe2\x80\x91transit inventory\nis not counted twice. ASD(HA), ASBPO, the Army, and the Navy concurred with the\nrecommendation. ASD(HA) stated that appropriate action was initiated to ensure\nin\xe2\x80\x91transit inventory was not counted twice in JMAR.\n\nFinding B: Recommendation B.3\nDoD OIG Report No. D\xe2\x80\x912002\xe2\x80\x91010 stated that the blood program offices and the\nDBSS Project Office did not adequately oversee the implementation of the CHCS\n interface with DBSS. The report further stated that users\n The blood\n found operational problems that included having to\n program offices re\xe2\x80\x91enter data or create duplicate in\xe2\x80\x91transit records.\n and the DBSS The\xc2\xa0blood program offices and the DBSS Project Office\n Project Office did not also did not adequately oversee the implementation of\n adequately oversee the\n implementation of\n the Theater DBSS hardware and software. As a result,\n the CHCS interface Military Departments identified hardware and software\n with DBSS. problems with the Theater DBSS deployment.\n\n Recommendation B.3 stated that the Service blood program\noffices, the ASBPO, and the DBSS Project Office\xc2\xa0jointly:\n\n a.\t Develop and implement a plan to correct the software deficiencies\n identified with the interface between the CHCS and DBSS and establish\n a time frame for the Military Departments to implement the interface at\n military treatment facilities.\n b.\t Develop and implement a plan to correct the hardware and software\n deficiencies identified with the Theater DBSS, or find another\n means to meet the needs of the unified commands for a blood\n management\xc2\xa0capability.\n\nASD(HA), ASBPO, and the Services concurred with the recommendation. ASD(HA)\nstated that the organizations were planning appropriate actions.\n\n\n\n\n DODIG-2015-008 \xe2\x94\x82 7\n\x0cFinding A\n\n\n\n Agreed Upon Actions\n For Recommendations A.4 and B.3.a, ASD(HA) agreed to modify DBSS in 2001 to\n ensure the accurate reporting of JMAR to resolve double counting of inventory\n and the ability to interface with CHCS. However, officials were unable to modify\n DBSS. In\xc2\xa02009, MHS leaders and the Services decided to replace DBSS with EBMS\n to prevent the double counting of inventory and correct the system interface\n problems. In 2010, ASD(HA) issued a denial of authority to operate DBSS based on\n security vulnerabilities. The denial of authority was because DBSS did not meet\n the required accreditation activities to obtain a full authorization to operate the\n system and its overall security risk was high.\n\n\n Agreed\xe2\x80\x91Upon Actions Not Demonstrated\n Although the PEO(DHCS) plans to replace DBSS with EBMS, the\n The PEO(DHCS) could not demonstrate that EBMS will mitigate\n PEO(DHCS) problems identified in the DoD OIG Report\xc2\xa0No.\xc2\xa0D\xe2\x80\x912002\xe2\x80\x91010.\n could not The donor system is in the early stages of the acquisition\n demonstrate that\n EBMS will mitigate\n process to verify whether it will mitigate problems with\n problems identified in double counting of inventory (Recommendation\xc2\xa0A.4),\n the DoD OIG Report and PEO(DHCS) officials initially deployed the\n No.\xc2\xa0D\xe2\x80\x912002\xe2\x80\x91010.\n transfusion system without an interface with CHCS\n (Recommendation\xc2\xa0B.3.a).\n\n Mitigation of Double Counting Awaiting Deployment of\n Donor\xc2\xa0System\n According to PEO(DHCS) officials, the donor system is in the early stages of\xc2\xa0the\n acquisition process and has not received a Milestone designation. PEO(DHCS)\n officials planned the early operational assessment for the first quarter of FY\xc2\xa02015,\n the operational test for the second quarter FY\xc2\xa02015, and the full deployment for\n the first quarter of FY\xc2\xa02016. 5 PEO(DHCS) officials indicated that the donor system\n will have the capability to obtain the necessary tracking information of blood\n products in real time and the donor system would eliminate the need to use JMAR\n for tracking blood products. We also observed a system capabilities presentation\n by the vendor that indicated that the system would facilitate real\xe2\x80\x91time data and\n track blood product inventory. However, we could not substantiate the system\xe2\x80\x99s\n capabilities. There are no specifics as to how the donor system will facilitate\n real\xe2\x80\x91time data and track blood product inventory in the Interface Control, Software\n Requirements Specification, and the Preliminary Design Review/Critical Design\n\n\n \t5\t\n In response to the draft report, DHA indicated that they have revised deployment date for donor system from the first\n quarter to the fourth quarter of FY 2016.\n\n\n\n\n8 \xe2\x94\x82 DODIG-2015-008\n\x0c Finding A\n\n\n\nReview documents. Therefore, the donor system is not far enough along the\nacquisition process to determine whether its requirements will address or mitigate\nthe in\xe2\x80\x91transit blood product inventory problems.\n\nInterface with the Composite Health Care System\nThe PEO(DHCS) initiated the deployment of the transfusion system on\nFebruary\xc2\xa027,\xc2\xa02014, as a stand-alone system. This is because\na senior MHS official approved the transfusion system,\n The\nin\xc2\xa02009, as a stand-alone system to expedite the process. PEO(DHCS)\nPEO(DHCS) officials obtained a waiver for the transfusion initiated the\nsystem not to interface with CHCS until FY\xc2\xa02015. In deployment of the\n transfusion system on\nthe meantime, technicians are required to manually February\xc2\xa027, 2014,\ninput patient information into the transfusion system. as a stand-alone\nPEO(DHCS) officials explained that technicians have been system.\nmanually inputting information since\xc2\xa02010. According to\nPEO(DHCS) officials, EBMS\xe2\x80\x99s capabilities surpass the value of\nthe system as a whole compared to the impact of manually entering the patient\ninformation into the transfusion system. Therefore, PEO(DHCS) officials were not\nable to demonstrate whether the transfusion system would mitigate the system\ninterface problems with CHCS as agreed to in Recommendation B.3.a.\n\n\nConclusion\nPEO(DHCS) officials could not demonstrate whether replacing DBSS with EBMS\nwill mitigate the problems identified in DoD OIG Report D\xe2\x80\x912002\xe2\x80\x91010. PEO(DHCS)\nofficials were still implementing the corrective actions for Recommendations A.4\nand B.3.a. We will continue to monitor and consider future audits of EBMS and the\nTheater Blood capability.\n\n\nManagement Comments on Background and Finding A\nand Our Response\nThe Director, DHA, provided the following comments related to the Background\nand Finding A. For the full text of the Director\xe2\x80\x99s technical comments, see the\nManagement Comments section of the report.\n\n \xe2\x80\xa2\t Capitalize the \xe2\x80\x9cTheater Medical Information Program\xe2\x80\x9d title in the\n second paragraph under the Defense Blood Standard System section\n of\xc2\xa0the\xc2\xa0Background.\n\n\n\n\n DODIG-2015-008 \xe2\x94\x82 9\n\x0cFinding A\n\n\n\n \xe2\x80\xa2\t Add \xe2\x80\x9cTheater Medical Information Program\xe2\x80\x93Joint information system\xe2\x80\x9d in the\n paragraph under the Theater Blood capability section of the Background.\n \xe2\x80\xa2\t Change the title for Finding A to \xe2\x80\x9cPEO(DHCS) Could Not Demonstrate That\n EBMS Will Meet the Requirements As Agreed\xe2\x80\x9d because the title appears\n unrelated to the Finding\xc2\xa0A\xe2\x80\x99s conclusion.\n \xe2\x80\xa2\t Revise the donor system\xe2\x80\x99s deployment date to the fourth quarter of FY 2016 in\n the paragraph under the Mitigation of Double Counting Awaiting Deployment of\n Donor System section of Finding A.\n\n Our Response\n We capitalized the \xe2\x80\x9cTheater Medical Information Program\xe2\x80\x9d title and added a\n footnote in the paragraph under the section in Finding A titled, \xe2\x80\x9cMitigation of\n Double Counting Awaiting Deployment of Donor System\xe2\x80\x9d to show the planned date for\n the donor system\xe2\x80\x99s deployment. However, we did not make any further changes\n to Finding\xc2\xa0A or the Background of the Report. We did not add \xe2\x80\x9cTheater Medical\n Information Program\xe2\x80\x93Joint information system\xe2\x80\x9d in the Background because we\n did not review or verify the system as part of our audit since it was outside of our\n announced objective. Also, we did not change the title of Finding\xc2\xa0A, \xe2\x80\x9cEnterprise\n Blood Management System Will Not Be Ready for Full Deployment,\xe2\x80\x9d because\n the title is descriptive of the finding and the conclusion that EBMS could not\n demonstrate it addressed what was agreed to in Recommendations A.4 and B.3 of\n DoD\xc2\xa0OIG\xc2\xa0Report\xc2\xa0No. D-2002-010.\n\n\n Recommendations, Management Comments, and\n Our Response\n Recommendation A\n We recommend that the Program Executive Officer for the Defense Health\n Clinical Systems, in coordination with the Director for Armed Services Blood\n Program, continue efforts to:\n\n 1.\t Ensure that in\xe2\x80\x91transit inventory is not counted twice in the\n Enterprise Blood Management System.\n 2.\t Develop and implement the Blood Management Blood Bank\n Transfusion Services interface capability with Composite Health\n Care\xc2\xa0System.\n\n\n\n\n10 \xe2\x94\x82 DODIG-2015-008\n\x0c Finding A\n\n\n\nDirector, Defense Health Agency Comments\nThe Director, DHA, responding for the PEO(DHCS) and the Director, ASBP, agreed,\nstating that the PEO(DHCS), in coordination with the Director for ASBP, will\ncontinue to develop and implement the transfusion system interface capability with\nCHCS or its replacement, as required. He stated that the CHCS interface will be\nimplemented by the fourth quarter of FY 2016.\n\nAdditionally, the Director stated that the PEO(DHCS) will continue to ensure that\nno issues will arise with double counting of in-transit inventory in EBMS. The\nDirector further stated that the PEO(DHCS) planned for the deployment of the\ndonor system for the fourth quarter of FY 2016.\n\nOur Response\nThe response from the Director addressed all specifics of the recommendations,\nand no further comments are required.\n\n\n\n\n DODIG-2015-008 \xe2\x94\x82 11\n\x0cFinding B\n\n\n\n\n Finding B\n DoD Management of Blood Products Information\n Technology Capabilities May Have Missed\n Opportunities to Leverage Efficiencies\n The PEO(DHCS) planned to acquire three, stand-alone, DoD blood product\n information technology (IT) capabilities6 that will manage information about the\n donors, donations, transfusions, and blood product inventories. This occurred\n because the PEO(DHCS) and the CAE for DHA did not manage the donor,\n transfusion, and the Theater Blood IT capabilities as a DoD IT portfolio as required\n by DoD Instruction 8115.02, \xe2\x80\x9cInformation Technology Portfolio Management\n Implementation,\xe2\x80\x9d October 30, 2006. As a result, the PEO(DHCS) and the CAE for\n DHA may not achieve maximum efficiencies for the Department\xe2\x80\x99s blood program.\n The program is also at an increased risk of not fully reaching the blood program\xe2\x80\x99s\n overall performance goals that ultimately could negatively impact the warfighters,\n veterans, and their families.\n\n\n DoD Blood Product Information Technology\n Capabilities Acquisition\n The ASD(HA) did not comply with DoD regulatory requirements when acquiring\n DoD blood product IT capabilities. Specifically, when replacing DBSS, the\n ASD(HA) did not follow DoD Instruction 5000.02, \xe2\x80\x9cOperation\n The of the Defense Acquisition System,\xe2\x80\x9d December 8, 2008;7\n ASD(HA)\n DoD Directive 8115.01, \xe2\x80\x9cInformation Technology\n did not consider\n maximum efficiencies Portfolio Management,\xe2\x80\x9d October\xc2\xa010,\xc2\xa02005; and DoD\n for the Department\xe2\x80\x99s Instruction 8115.02, \xe2\x80\x9cInformation Technology Portfolio\n blood program by Management Implementation,\xe2\x80\x9d October 30, 2006, by\n not considering a acquiring three different blood product IT capabilities\n potential IT\n that would not interface with each other. According to\n portfolio.\n PEO(DHCS) and ASBPO officials, there was no operational\n need for the IT capabilities to interface with each other.\n The ASD(HA) did not consider maximum efficiencies for the Department\xe2\x80\x99s blood\n program by not considering a potential IT portfolio.\n\n\n\n\n \t6\t\n For the purposes of this finding, we will refer to the donor system, transfusion system, and the Theater Blood capability\n as DoD blood product IT capabilities.\n \t7\t\n DoD Instruction 5000.02 implements DoD Directive 5000.01, \xe2\x80\x9cThe Defense Acquisition System,\xe2\x80\x9d certified current\n as of\xc2\xa0November 20, 2007. DoD Instruction 5000.02 has been updated by an Interim DoD Instruction 5000.02, dated\n November 25, 2013, which cancelled the 2008 version, with the exception of Enclosure 9.\n\n12 \xe2\x94\x82 DODIG-2015-008\n\x0c Finding B\n\n\n\nDoD Blood Products Information Technology Portfolio\nThe ASD(HA) officials planned to acquire the DoD blood product IT capabilities\nas stand-alone IT capabilities rather than integral parts of a DoD enterprise\xe2\x80\x91wide\ncapability for managing the DoD blood program. DoD Instruction 5000.02\nestablishes a management framework for translating capability needs and\ntechnology opportunities, based on approved capability needs, into stable,\naffordable, and well\xe2\x80\x91managed acquisition programs that include automated\ninformation systems. It states that the materiel development decision review is the\nformal entry point into the acquisition process in where multiple DoD communities\nassist in formulating operational goals and would consider potential materiel\nsolutions. DoD Directive 8115.01 mandates portfolios to be used as a management\ntool in each of the Department\xe2\x80\x99s decision support systems to include the Defense\nAcquisition System (DoD Instruction 5000.02).\n\nDoD Directive 8115.01 requires that the Heads of the DoD Components establish\nthe Component portfolio so that IT investments align to Mission Area. It further\nrequires that the head of the Component manage IT investments as portfolios to:\n\n \xe2\x80\xa2\t ensure IT investments support the Department\xe2\x80\x99s vision, mission, and goals;\n \xe2\x80\xa2\t ensure efficient and effective delivery of capabilities to the warfighter; and\n \xe2\x80\xa2\t maximize return on investment to the Enterprise.\n\nAccording to DoD Instruction 8115.02, 8 the Department has moved at an\naccelerating pace toward capabilities\xe2\x80\x91based planning, resource allocation, and\nacquisition, based on the principles of joint interoperability and network\xe2\x80\x91centric\nwarfare. The instruction states that historically, IT resources have been managed\nand acquired as stand\xe2\x80\x91alone IT capabilities rather than as integral parts of a\nnet\xe2\x80\x91centric capability having an effect of allowing duplicative investment in systems\nor platforms that would deliver the same or similar capabilities. According\xc2\xa0to\nthe instruction, IT portfolio management is a key enabler of information sharing\nand it provides a balanced strategy based on enterprise strategic planning\nand integrated architectures. The instruction addresses that in order for an\neffective implementation, the IT portfolio management strategy requires a\nrobust governance structure, enabled by consistent, repeatable processes at\nall levels to foster greater management efficiency, better communications, and\neffective\xc2\xa0collaboration.\n\n\n\n\n\t8\t\n DoD Instruction 8115.02 implements DoD Directive 8115.01.\n\n\n\n\n DODIG-2015-008 \xe2\x94\x82 13\n\x0cFinding B\n\n\n\n In addition, in a memorandum dated March 11, 2013, \xe2\x80\x9cImplementation of Military\n Health System Governance Reform,\xe2\x80\x9d the Deputy Secretary of Defense emphasized\n on the responsibility for shared services, functions, and activities of the MHS and\n other common clinical and business processes. The Deputy Secretary of Defense\n further stated that:\n\n In doing so, we must attain greater integration of our direct and\n purchased healthcare delivery systems, essential to accomplishing\n the quadruple aim of the MHS: to assure medical readiness,\n improve the health of our people, enhance the experience of care,\n and lower our healthcare costs.\n\n Although the donor, the transfusion, and Theater Blood IT capabilities are managed\n by the PEO(DHCS), duplicate work may be present when using stand\xe2\x80\x91alone\n IT\xc2\xa0capabilities to manage the data. As indicated by a PEO(DHCS)\n official, a technician would have to access more than one IT Duplicate\n capability to acquire information about a patient and input work may be\n it in another IT capability to register the patient in both present when\n using stand\xe2\x80\x91alone\n blood product management IT capabilities. For example, IT capabilities to\n this would occur when military personnel (patient) who manage the\n donated blood required a blood transfusion. As a result, data.\n officials would maximize the Department\xe2\x80\x99s return on investment\n by setting up an interface that would connect the IT capabilities and enable data\n sharing among these capabilities. This would also save the technicians time\n and streamline patient registration and blood product management processes\n by reusing accessible data rather than recreating it; therefore, achieving\n better\xc2\xa0efficiencies.\n\n The Additionally, the PEO(DHCS) officials could not provide all\n PEO(DHCS) of the known costs for the proposed DoD blood product IT\n officials could capabilities. According to officials, the estimated costs\n not provide all of\n the known costs for to phase\xe2\x80\x91out DBSS and the known life\xe2\x80\x91cycle costs for the\n the proposed DoD IT blood products IT management capabilities totaled\n blood product IT $289\xc2\xa0million. Please see Table 1 for a breakdown of the\n capabilities.\n known costs provided by the PEO(DHCS) officials.\n\n\n\n\n14 \xe2\x94\x82 DODIG-2015-008\n\x0c Finding B\n\n\n\nTable 1. Total Known Costs of Portfolio\n IT Blood Product Estimated Costs (in millions)\n Transfusion $122.3\n Donor $123.2\n Theater Blood Unknown1\n DBSS $43.52\n Total $289.0\n1\n Officials could not provide the estimated life\xe2\x80\x91cycle costs.\n2\n This amount represents the FY 2011 through FY 2015 estimated costs to phase\xe2\x80\x91out DBSS.\n\n\nBy having three, stand-alone, DoD blood product IT capabilities, the PEO(DHCS) and\nthe CAE for DHA may have missed the opportunity to leverage IT efficiencies that\ncould have potentially increased the Department\xe2\x80\x99s return on investment.\n\nInterface of DoD Blood Product Information\nTechnology Capabilities\nAccording to PEO(DHCS) and ASBPO officials, they did not identify an operational\nneed to have the IT blood products interface with each other. However, these IT\nproducts all provide blood management functions and capabilities. For example,\nthe transfusion and Theater Blood9 both track the inventory levels, availability of\nall blood products, test results of blood products, results of pre\xe2\x80\x91transfusion, and\ncompatibility tests. The donor and Theater Blood also have the ability to track\nblood products and document donors by blood types. The transfusion and donor\nsystems have the capability of patient registrations. As a result, the Department\ncould achieve better efficiencies if these IT capabilities shared information or\ninterface as part of an enterprise DoD blood product solution. This could also\nstreamline ASBP\xe2\x80\x99s mission to provide quality blood products and services for all\nworldwide customers in peace and war.\n\n\n\n\n\t9\t\n Theater Blood functions and capabilities mentioned in this section were taken from PEO(DHCS) officials\xe2\x80\x99 statements.\n\n\n\n\n DODIG-2015-008 \xe2\x94\x82 15\n\x0cFinding B\n\n\n\n The As a result, the PEO(DHCS) and the CAE for DHA did\n PEO(DHCS) not implement a joint interoperability strategy, which\n and the CAE for could result in delivering inefficient and ineffective\n DHA did not implement\n a joint interoperability blood product IT capabilities to the warfighter.\n strategy, which could result Therefore, the PEO(DHCS) and the CAE for DHA\n in delivering inefficient and should assess EBMS (donor and transfusion systems),\n ineffective blood product Theater Blood, and any other DoD blood product\n information system\n management IT capabilities\xe2\x80\x99 processes, functions,\n capabilities to the\n warfighter. and capabilities before reaching a Milestone Decision\n for the donor system. The PEO(DHCS) and the CAE for\n DHA should then evaluate how the DoD blood product IT\n management capabilities would benefit from being interoperable as required by DoD\n Instruction\xc2\xa08115.02. Throughout this process, the PEO(DHCS) and the CAE for DHA\n should identify and document any opportunities for efficiencies and develop a plan of\n actions and milestones to implement the potential new strategy.\n\n\n Management Actions Taken on the Transfusion System\n Although the CAE approved the transfusion system to enter into the business\n capability lifecycle acquisition business model at milestone C on July 9, 2013, he\n did not initially approve the Analysis of Alternatives, the Acquisition Strategy, the\n Acquisition Program Baseline, and the Life Cycle Sustainment Plan, as required\n by DoD Instruction 5000.02. However, based on our audit, PEO(DHCS) officials\n provided the approved Acquisition Program Baseline and Business Case Analysis on\n February 5, 2014.10\n\n\n Management Comments on Background and Finding B\n and Our Response\n The Director, DHA, provided the following comments related to the Background\n and Finding B. For the full text of the Director\xe2\x80\x99s technical comments, see the\n Management Comments section of the report. The Director requested that we\n replace any reference to \xe2\x80\x9csystems\xe2\x80\x9d with the word \xe2\x80\x9ccapabilities\xe2\x80\x9d when referring to\n the donor system, transfusion system, and Theater Blood capability throughout\n the Background and Finding B sections. The Director explained that it would\n be inaccurate for two reasons. First, the Theater Blood capability is not a\n system or application but a capability under the Theater Medical Data Store and\n Medical Situational Awareness in Theater application within the Theater Medical\n Information Program\xe2\x80\x93Joint information system. Secondly, by calling it a system\n\n\n \t10\t\n The Business Case Analysis included the Analysis of Alternatives as well as the summaries of the Acquisition Strategy and\n Life Cycle Sustainment Plan.\n\n\n\n\n16 \xe2\x94\x82 DODIG-2015-008\n\x0c Finding B\n\n\n\nthe Theater Blood capability could also be perceived as a stand-alone system. Also,\nthe Director requested that we change the title of Finding B to \xe2\x80\x9cDoD Management\nof Blood Products Information Systems May Have Missed Opportunities to Leverage\nEfficiencies\xe2\x80\x9d because the finding\xe2\x80\x99s discussion did not show that specific inefficiencies were\ndiscovered, and implementation of recommendation will determine whether efficiencies\ncan be achieved.\n\nOur Response\nFor accuracy and consistency in the Report, we replaced any reference to\n\xe2\x80\x9capplication\xe2\x80\x9d with \xe2\x80\x9ccapability\xe2\x80\x9d when referring to Theater Blood capability. We\nalso replaced \xe2\x80\x9csystems\xe2\x80\x9d with \xe2\x80\x9ccapability\xe2\x80\x9d when referring to the donor system,\ntransfusion system, and the Theater Blood capability. Additionally, we changed the\ntitle of Finding B to: \xe2\x80\x9cDoD Management of Blood Products Information Technology\nCapabilities May Have Missed Opportunities to Leverage Efficiencies.\xe2\x80\x9d\n\n\nRecommendations, Management Comments, and\nOur Response\nRecommendation B\nWe recommend that prior to reaching a Milestone Decision for the Blood\nDonor Management System, the Component Acquisition Executive for the\nDefense Health Agency assess the Enterprise Blood Management System,\nTheater Blood capability, and any other DoD blood product information\ntechnology capabilities\xe2\x80\x99 processes, functions, and capabilities to determine\nwhether efficiencies could be achieved by managing as integral parts\nof a net\xe2\x80\x91centric interoperable information technology portfolio. This\nassessment\xc2\xa0should:\n\n 1.\t Evaluate how the DoD blood product information technology\n capabilities would benefit from being interoperable as an information\n technology portfolio.\n 2.\t Identify and document opportunities for efficiencies throughout\n the process among the DoD blood product information technology\n management capabilities.\n 3.\t Develop a plan of actions and milestones to implement the revised\n information technology portfolio interoperability strategy.\n\n\n\n\n DODIG-2015-008 \xe2\x94\x82 17\n\x0cFinding B\n\n\n\n Director, Defense Health Agency Comments\n The Director, DHA, responding for the CAE for DHA, agreed, stating that the CAE\n agreed to assess DoD blood management capabilities and determine whether DHA\n could leverage any potential benefits of the interoperability. The Director indicated\n that this evaluation was expected to be conducted in the third quarter of FY 2015.\n\n Our Response\n The response from the Director addressed all specifics of the recommendations, and no\n further comments are required.\n\n\n\n\n18 \xe2\x94\x82 DODIG-2015-008\n\x0c Appendix\n\n\n\n\nAppendix\nScope and Methodology\nWe conducted this performance audit from August 2013 through August 2014\nin accordance with generally accepted government auditing standards. Those\nstandards require that we plan and perform the audit to obtain sufficient,\nappropriate evidence to provide a reasonable basis for our findings and conclusions\nbased on our audit objectives. We believe that the evidence obtained provides a\nreasonable basis for our findings and conclusions based on our audit objectives.\n\nFor Recommendations A.4 and B.3.a of DoD OIG Report No.\xc2\xa0D\xe2\x80\x912002\xe2\x80\x91010, we\ncollected, reviewed, and analyzed acquisition related documents for Defense\nBlood Standard System and Enterprise Blood Management System. For example,\namong the documents were the transfusion system Acquisition Decision\nMemorandum, Business Case Analysis, Acquisition Program Baseline, Life Cycle\nSustainment Plan, Test and Evaluation Master Plan, and system testing documents\nfor the early operational assessment and operations testing. Additionally, we\nreviewed available\xc2\xa0donor system documentation related to the system interface,\nrequirements, and design.\n\nFor Recommendation B.3.b of DoD OIGReport No.\xc2\xa0D\xe2\x80\x912002\xe2\x80\x91010, the Program\nExecutive Officer for the Defense Health Clinical Systems officials replaced the\nTheater Defense Blood Standard System with the Theater Blood capability,\nnot the Enterprise Blood Management System. This action met the intent of\nthe recommendation to find another means to meet the needs of the unified\ncommands for a blood management capability. However, we did not evaluate the\nimplementation of the Theater Blood capability since it was outside the scope of the\nannounced audit objective.\n\nWe compared the acquisition documents and testing results to applicable\nacquisition regulations, such as:\n\n \xe2\x80\xa2\t DoD Instruction 4630.8, \xe2\x80\x9cProcedures for Interoperability and\n Supportability of Information Technology and National Security Systems\xe2\x80\x9d\n \xe2\x80\xa2\t DoD Directive 5000.01, \xe2\x80\x9cThe Defense Acquisition System\xe2\x80\x9d\n \xe2\x80\xa2\t DoD Instruction 5000.02, \xe2\x80\x9cOperation of the Defense Acquisition System\xe2\x80\x9d\n \xe2\x80\xa2\t DoD Directive 8115.01, \xe2\x80\x9cInformation Technology Portfolio Management\xe2\x80\x9d\n \xe2\x80\xa2\t DoD Instruction 8115.02, \xe2\x80\x9cInformation Technology Portfolio\n Management\xc2\xa0Implementation\xe2\x80\x9d\n\n\n\n\n DODIG-2015-008 \xe2\x94\x82 19\n\x0cAppendix\n\n\n\n \xe2\x80\xa2\t DoD Instruction 8510.01, \xe2\x80\x9cDoD Information Assurance Certification and\n Accreditation Process\xe2\x80\x9d\n \xe2\x80\xa2\t Defense Acquisition Guidebook\n\n We also interviewed representatives from:\n\n \xe2\x80\xa2\t Component Acquisition Executive for Defense Health Agency;\n \xe2\x80\xa2\t Program Executive Officer for the Defense Health Clinical Systems;\n \xe2\x80\xa2\t TRICARE Management Activity Office of the Chief Information Officer,\n Deployment and Readiness Systems;\n \xe2\x80\xa2\t Armed Services Blood Program Office;\n \xe2\x80\xa2\t Army, Navy, and Air Force blood program offices; and\n \xe2\x80\xa2\t Walter Reed National Military Medical Center Blood Services.\n\n Use of Computer\xe2\x80\x91Processed Data\n We did not use computer\xe2\x80\x91processed data to perform this audit.\n\n\n Use of Technical Assistance\n We did not use technical assistance for this audit.\n\n\n Prior Coverage\n During the last 5 years, the DoD Office of Inspector General (DoD IG) issued\n one\xc2\xa0report related to the Defense Blood Standard System. Unrestricted DoD IG\n reports can be accessed at http://www.dodig.mil/pubs/index.cfm.\n\n DoD IG\n Report No. D\xe2\x80\x912002\xe2\x80\x91010, \xe2\x80\x9cArmed Services Blood Program Defense Blood Standard\n System,\xe2\x80\x9d October 22, 2001\n\n\n\n\n20 \xe2\x94\x82 DODIG-2015-008\n\x0c Management Comments\n\n\n\n\nManagement Comments\nDefense Health Agency\n Final Report\n Reference\n\n\n\n\n DODIG-2015-008 \xe2\x94\x82 21\n\x0cManagement Comments\n\n\n\n Defense Health Agency (cont\xe2\x80\x99d)\n Final Report\n Reference\n\n\n\n\n22 \xe2\x94\x82 DODIG-2015-008\n\x0c Management Comments\n\n\n\nDefense Health Agency (cont\xe2\x80\x99d)\n Final Report\n Reference\n\n\n\n Replaced\n throughout the\n Report\n\n\n\n\n Revised Background\n Section on Page 2\n\n\n\n\n DODIG-2015-008 \xe2\x94\x82 23\n\x0cManagement Comments\n\n\n\n Defense Health Agency (cont\xe2\x80\x99d)\n\n\n Replaced\n throughout\n Finding B\n\n\n\n\n Added Footnote in\n Finding A on Page 8\n\n\n\n\n24 \xe2\x94\x82 DODIG-2015-008\n\x0c Glossary\n\n\n\n\nGlossary\nApplication \xe2\x80\x93 A computer program that accomplishes a specific task for the user.\n\nCapability \xe2\x80\x93 The ability to execute a specified course of action.\n\nComposite Health Care System \xe2\x80\x93 The automated medical information system\nsupporting all military treatment facilities worldwide in providing comprehensive\nhealth care to military personnel, retirees, and their dependents. Specifically, it\nprovides the Services with patient facility data management and communication\ncapabilities such as patient administration, reporting, scheduling, laboratory\norders, quality control, and medication processing.11\n\nDeployment \xe2\x80\x93 Fielding a weapon system by placing it into operational use with\nunits in the field/fleet.\n\nInformation Technology (IT) \xe2\x80\x93 Any equipment, or interconnected system or\nsubsystem of equipment, which is used in the interchange, transmission, or\nreception of data or information.\n\nInformation Technology Portfolio \xe2\x80\x93 A grouping of IT investments by capability\nto accomplish a specific functional goal, objective, or mission outcome. An IT\ninvestment is the development and sustainment resources needed in support of IT\nor IT\xe2\x80\x91related initiatives. Resources include research, development, test, and various\ntypes of appropriations, such as procurement appropriations.\n\nInterface \xe2\x80\x93 Computer hardware or software connections that allow two or more IT\ncomponents to share data and communicate with each other.\n\nInteroperability \xe2\x80\x93 The ability of systems to exchange data, information, or\nmateriel and services that enable them to operate effectively together.\n\nJoint Medical Asset Repository \xe2\x80\x93 A data repository designed to integrate\ninformation from various medical logistics systems throughout DoD into a centrally\nmanaged data warehouse that gives users the ability to see the location and status\nof medical supplies and equipment whether in storage, in transit, or in theater.12\n\n\n\n\n\t11\t\n This information is from Appendix C of DoD OIG Report No. D\xe2\x80\x912002\xe2\x80\x91010, \xe2\x80\x9cArmed Services Blood Program Defense Blood\n Standard System,\xe2\x80\x9d October 22, 2001.\n\t12\t\n This information is from Appendix C of DoD OIG Report No. D\xe2\x80\x912002\xe2\x80\x91010, \xe2\x80\x9cArmed Services Blood Program Defense Blood\n Standard System,\xe2\x80\x9d October 22, 2001.\n\n\n\n\n DODIG-2015-008 \xe2\x94\x82 25\n\x0cGlossary\n\n\n\n Materiel Solution \xe2\x80\x93 The correction of a deficiency, satisfaction of a capability gap,\n or incorporation of new technology that results in the development, acquisition,\n procurement, or fielding of a new item necessary to equip, operate, maintain,\n and support military activities without disruption as to its application for\n administrative or combat purposes.\n\n Materiel Development Decision \xe2\x80\x93 The decision that a new product is needed and\n activities to analyze alternative solutions will occur.\n\n Medical Situational Awareness in Theater \xe2\x80\x93 A web\xe2\x80\x91based application through\n Secret Internet Protocol Router Network, which combines information from\n multiple databases to provide worldwide asset visibility and decision support for\n Combatant Commands and Joint Task Force Commanders\xe2\x80\x99 medical staff.\n\n Net\xe2\x80\x91centricity \xe2\x80\x93 Robust, globally interconnected network environment in which\n data is shared timely and seamlessly among users, applications, and platforms.\n Net\xe2\x80\x91centricity enables improved military situational awareness and significantly\n shortened decision\xe2\x80\x91making cycles.\n\n Real Time \xe2\x80\x93 The actual time in which a process under computer control occurs.\n\n Stand-alone \xe2\x80\x93 A computer or other device that is able to function independently of\n other devices.\n\n Theater Medical Data Store \xe2\x80\x93 It provides web\xe2\x80\x91based access to service member\n information collected at theater\xe2\x80\x91based medical treatment facilities using\n other\xc2\xa0systems.\n\n\n\n\n26 \xe2\x94\x82 DODIG-2015-008\n\x0c Acronyms and Abbreviations\n\n\n\n\nAcronyms and Abbreviations\n ASBP Armed Services Blood Program\n ASBPO Armed Services Blood Program Office\n ASD(HA) Assistant Secretary of Defense (Health Affairs)\n CAE Component Acquisition Executive\n CHCS Composite Health Care System\n DBSS Defense Blood Standard System\n DHA Defense Health Agency\n EBMS Enterprise Blood Management System\n FDA Food and Drug Administration\n IT Information Technology\n JMAR Joint Medical Asset Repository\n MHS Military Health System\n PEO(DHCS) Program Executive Officer for the Defense Health Clinical Systems\n\n\n\n\n DODIG-2015-008 \xe2\x94\x82 27\n\x0c\x0c Whistleblower Protection\n U.S. Department of Defense\nThe Whistleblower Protection Enhancement Act of 2012 requires\nthe Inspector General to designate a Whistleblower Protection\nOmbudsman to educate agency employees about prohibitions\non retaliation, and rights and remedies against retaliation for\nprotected disclosures. The designated ombudsman is the DoD Hotline\nDirector. For more information on your rights and remedies against\n retaliation, visit www.dodig.mil/programs/whistleblower.\n\n\n\n\n For more information about DoD IG\n reports or activities, please contact us:\n Congressional Liaison\n congressional@dodig.mil; 703.604.8324\n\n Media Contact\n public.affairs@dodig.mil; 703.604.8324\n\n Monthly Update\n dodigconnect-request@listserve.com\n\n Reports Mailing List\n dodig_report@listserve.com\n\n Twitter\n twitter.com/DoD_IG\n\n DoD Hotline\n dodig.mil/hotline\n\x0cD E PA R T M E N T O F D E F E N S E \xe2\x94\x82 I N S P E C T O R G E N E R A L\n 4800 Mark Center Drive\n Alexandria, VA 22350-1500\n www.dodig.mil\n Defense Hotline 1.800.424.9098\n\x0c'


type: other

text:
Voľby a referendum > Voľby 2014
 Tento rok sa budú konať troje volieb:
 1. Prezidentské voľby.
 2. Voľby do Európskeho parlamentu.
 3. Komunálne voľby.
 V zmysle § 16 ods. 9 zákona SNR č. 346/1990 Zb. o voľbách do orgánov samosprávy obcí v znení neskorších predpisov zverejňujeme počet obyvateľov obce Valaská. Ku dňu 22.08.2014 eviduje obec Valaská 3750 obyvateľov s trvalým pobytom na území obce.
 Výsledky komunálnych volieb obce Valaská
 Zoznam kandidátov na starostu obce Valaská
 pre voľby starostu obce Valaská
 dňa 15.novembra 2014
 Miestna volebná komisia vo Valaskej podľa § 23 zákona SNR č. 346/1990 Zb. o voľbách do orgánov samosprávy obcí v znení neskorších predpisov vyhlasuje, že pre voľbu starostu obce zaregistrovala týchto kandidátov :
 1. Peter Bánik, Ing., 55 r., informatik, Valaská, Pod Hrbom 569/7, SNS
 2. Zuzana Kúdelková , PhDr. , 49 r., učiteľka, Valaská, Partizánska cesta 527/18, KSS
 3. Štefánia Lénartová , Mgr., 48 r., vedúca skladu zásobovania, Valaská, Tehelná 468/9, nez.kand.
 4. Ľubomír Štubňa r, 48 r., podnikateľ, Valaská, TDH 453/43, SMER- SD
 5. Juraj Uhrin , Ing., 41 r., starosta obce, Valaská, Cesta Osloboditeľov 210/31, nezávislý kandidát
 Vo Valaskej, dňa 25. septembra 2014
  Katarína Paprčková
 predseda volebnej komisie
 Zoznam kandidátov volebný obvod č.: 1
 pre voľby poslancov Obecného zastupiteľstva vo Valaskej
 vo volebnom okrsku č. 1
 Miestna volebná komisia vo Valaskej podľa § 18 zákona SNR č. 346/1990 Zb. o voľbách do orgánov samosprávy obcí v znení neskorších predpisov vyhlasuje, že pre voľby poslancov obecného zastupiteľstva zaregistrovala týchto kandidátov :
 1. Karol Babčan, 58 r., technik, Valaská, Pod Hrbom 563/1, SIEŤ
 2. Peter Bánik, Ing., 55 r., informatik, Valaská Pod Hrbom 569/7, SNS
 3. Stanislava Benediková, PaedDr., 30 r., stredoškolská učiteľka, Valaská, Kukučínova 514/3, SNS
 4. Anna Dobríková, 62 r., ekonómka, Valaská, Októbrová 470/5, SMER-SD
 5. Ján Holko, Ing., 52 r., konateľ s. r. o., Valaská, Pod Lipovou 610/2, SaS
 6. Igor Hrebíček, Ing., 46 r., technológ ŽP, Valaská, Októbrová 470/9, SMER-SD
 7. Roman Kubaliak, 39 r., informátor, Valaská, Hronská 424/40, ĽS Naše Slovensko
 8. Štefánia Lénartová, Mgr., 48 r., vedúca skladu zásobovania, Valaská, Tehelná 648/9, nez.kand.
 9. Matúš Magera, PaedDr., 27 r., učiteľ ZŠ, Valaská, TDH 463/8, NÁŠ KRAJ
 10. Jozef Mikloš, Ing., 46 r., marschal golfového ihriska, Valaská, TDH 457/28, SNS
 11. Pavol Molčan,Bc., 38 r., strojník, Valaská, TDH 462/18, SNS
 12. Mária Pacerová, Mgr., 60 r., učiteľka ZŠ, Valaská, Pod Lipovou 613/5, SIEŤ
 13. Blažena Pastírová, 67 r., dôchodkyňa, Valaská, Októbrová 470/5, SMER-SD
 14. Eva Pepichová, 47 r., zdravotná sestra, Valaská, Chalupkova 500/1, SIEŤ
 15. Ján Sukič, 57 r., živnostník, Valaská, Štúrova 481/5, SIEŤ
 16. Pavel Vilhan, 44 r., kontrolór, Valaská, Cesta Osloboditeľov 174/103, ĽS Naše Slovensko
 Zverejnené 2.10.2014
 Zoznam kandidátov volebný obvod č.: 2
 vo volebnom okrsku č. 2
 1. Dušan Baran, 45 r., robotník, Valaská, Hronská 425/34, SNS
 2. Dušan Blahut, 39 r., živnostník, Valaská, Hronská 416/45, SNS
 3. Milena Dobrotová, 50 r., živnostníčka, Valaská, Hronská 418/53, SNS
 4. Ján Dundovič, Ing., 40 r., vedúci oddelenia expedície, Valaská, Hronská, 426/34, SMER-SD
 5. Peter Faško, Ing., 33 r., manažér, Valaská, Školská 448/8, SIEŤ
 6. Roman Hadžega, Mgr., 43 r., stredoškolský učiteľ, Valaská, Tehelná 651/6, SIEŤ
 7. Zuzana Kúdelková, PhDr., 48 r., učiteľka, Valaská, Partizánska cesta 527/18, KSS
 8. Alena Ličková, 40 r., evidentka hotovej výroby, Valaská, TDH 443/31, SMER-SD
 9. Zdenko Oravec, 54 r., IT technik, Valaská, TDH 454/51, SNS
 10. Marek Poliak. 37 r., zásobovač, Valaská, TDH 464/4, SaS
 11. Peter Sorkovský, 45 r., živnostník, Valaská, TDH 440/9, SIEŤ
 12. Aurel Starke, 49 r., operátor dopravnej služby, Valaská, Školská 446/3, SMER-SD
 13. Ľubomír Štubňa, 48 r., podnikateľ, Valaská, TDH 453/43, SMER-SD
 14. Zdenka Vojteková, 55 r., administratívna pracovníčka, Valaská, Štúrova 480/2, SIEŤ
 Zoznam kandidátov volebný obvod č.: 3
 vo volebnom okrsku č. 3
 1. Viera Babčanová, 65 r., dôchodkyňa, Valaská, Piesok, Pod Dielom 325/2, SMER-SD
 2. Marian Dobiš, 59 r., invalidný dôchodca, Valaská, Na Studničke 246/13, SNS
 3. Miroslav Filipko, Ing., 45 r., technológ energetických zariadení, Valaská, C Oslobod. 90/22, SIEŤ
 4. Jozef Hucík, 45 r., živnostník, Valaská, Piesok, Strojárenská 320/50, SNS
 5. Cecília Karasová, 62 r., dôchodkyňa, Valaská, Cesta Osloboditeľov 137/16, SMER-SD
 6. Martin Krupa, 62 r., strojník, Valaská, Tatranská 60/30, SNS
 7. Miroslav Zelenčík, 29 r., hasič OR HaZZ, Valaská, Tatranská 38/76, SMER-SD
 Volebné obvody a počet poslancov v nich určilo obecné zastupiteľstvo obce na svojom zasadnutí 11.8.2014 nasledovne:
 v obci Valaská v zmysle § 11, ods. 3 písmeno e) zákona č. 369/1990 Zb. počet poslancov 11 pre voľby do orgánov samosprávy obcív obci Valaská v zmysle § 11, ods. 3 písmeno e) zákona č. 369/1990 Zb. počet poslancov 11 pre voľby do orgánov samosprávy obcí
 v zmysle § 9 odst. 3 zákona č. 346/1990 Zb. o voľbách do orgánov samosprávy obcí volebné obvody pre voľby do orgánov samosprávy obcí:
 VO č. 1 - Valaská, sídlisko – východ
 Počet volených poslancov – 4
 Budovateľská, Chalupkova, Kpt. J. Nálepku, Kukučínova, Nám. 1. mája 459 – 461, Októbrová 469, 470, 472-478, Partizánska cesta, Pod Hrbom, Štúrova 480-482, TDH 455- 458, 462- 464,Tehelná, Pod Lipovou
 VO č. 2 – Valaská – sídlisko – západ
 Počet volených poslancov - 4
 Hronská 417- 421, 424- 432, RD: 395 – 413, 433 – 434, Švermova 449- 45, TDH 439- 445, 453, 454, Školská 446- 448
 VO č. 3 – Valaská – materská časť obce a miestna časť Piesok
 Počet volených poslancov - 3
 Cesta osloboditeľov, Javorová, Na Studničke, Potôčky, Tatranská, Vl. Valacha, Záhradná
 Mierová, Pod Dielom, Robotnícka, Strojárenská
 Voľby do Európskeho parlamentu sa uskutočnia v sobotu 24. mája 2014 v čase od 7.00 do 22.00 h.
 V obci Valaská budú zriadené štyri volebné okrsky.
 Okrsok č. 1: Knižnica
 Okrsok č. 2: Odoborné učilište internátne
 Okrsok č. 3: KD Stará Valaská
 Okrsok č. 4: KD Piesok
 priamo sazúčastňuje na legislatívnych procedúrach a v mnohých oblastiach prijíma rozhodnutia spolu s Radou EÚ.
 VÝSLEDKY VOĽBY PREZIDENTA SR V OBCI VALASKÁ, KONANEJ DŇA 29.03.2014. II. KOLO
 Volebný okrsok č. 1 Valaská sídlisko - východ
 1. Fico Robert, doc. JUDr., CSc. 328 hlasov
 2. Kiska Andrej, Ing. 308 hlasov
 Volebný okrsok č. 2 Valaská sídlisko – západ
 1. Fico Robert, doc. JUDr.,CSc. 323 hlasov
 2. Kiska Andrej, Ing. 225 hlasov
 Volebný okrsok č. 3 Valaská – materská časť obce
 1. Kiska Andrej, Ing. 107 hlasov
 2. Fico Robert, doc. JUDr., CSc. 127 hlasov
 Volebný okrsok č. 4 Piesok
 1. Fico Robert, doc. JUDr., CSc. 53 hlasov
 2. Kiska Andrej, Ing. 57 hlasov
 1. Fico Robert, doc. JUDr., CSc. 811 hlasov
 2. Kiska Andrej, Ing. 717 hlasov
 Do zoznamu voličov bolo zapísaných 3087 oprávnených voličov, volieb sa zúčastnilo 1553 oprávnených voličov, čo predstavuje 50,3% účasť vo voľbách.
 Výsledky voľby prezidenta SR v obci Valaská, konanej dňa 15. 03. 2014. I. KOLO
 1. Fico Robert, doc. JUDr., CSc. 218 hlasov
 2. Kiska Andrej, Ing. 135 hlasov
 3. Procházka Radoslav, JUDr., PhD 81 hlasov
 1. Fico Robert, doc. JUDr., CSc. 204 hlasov
 2. Kiska Andrej, Ing. 96 hlasov
 3. Procházka Radoslav, JUDr., PhD 70 hlasov
 Volebný okrsok č. 3 Valaská – materská časť
 1. Kiska Andrej, Ing. 65 hlasov
 2. Fico Robert, doc. JUDr.CSc. 60 hlasov
 3. Procházka Radoslav, JUDr., PhD 28 hlasov
 1. Fico Robert, doc. JUDr., CSc. 36 hlasov
 2. Kiska Andrej, Ing. 28 hlasov
 3. Procházka Radoslav, JUDr., PhD 15 hlasov
 1. Fico Robert, doc. JUDr., CSc. 518 hlasov
 2. Kiska Andrej, Ing. 324 hlasov
 3. Procházka Radoslav, JUDr., PhD 194 hlasov
 Do zoznamu voličov bolo zapísaných 3088 občanov, volieb sa zúčastnilo 1300 občanov, čo predstavuje 42, 1% účasť vo voľbách.
 Aktualizované 2.4.2014
 Informácia o voľbe okrsok 1.pdf (189.1 kB)
 Informácia o voľbe okrsok 2.pdf (186 kB)
 Informácia o voľbe okrsok 3.pdf (185.8 kB)
 Informácia o voľbe okrsok 4.pdf (185.6 kB)


type: contracts

jurisdiction: EU

text:
 14.10.2016
 ET
 Euroopa Liidu Teataja
 L 278/50
 AKV-ELi SUURSAADIKUTE KOMITEE OTSUS nr 4/2016,
 30. september 2016,
 põllumajanduse ja maapiirkondadega seotud koostöö tehnilise keskuse juhatuse liikme ametisse nimetamise kohta [2016/1820]
 AKV–ELi SUURSAADIKUTE KOMITEE,
 võttes arvesse ühelt poolt Aafrika, Kariibi mere ja Vaikse ookeani piirkonna riikide rühma ning teiselt poolt Euroopa Ühenduse ja selle liikmesriikide vahel 23. juunil 2000. aastal Cotonous alla kirjutatud partnerluslepingut, (1) mida muudeti esimest korda 25. juunil 2005 Luxembourgis (2) ja teist korda 22. juunil 2010 Ouagadougous, (3) eriti selle III lisa artikli 3 lõiget 5,
 võttes arvesse AKV–ELi suursaadikute komitee 7. novembri 2013. aasta otsust nr 5/2013 põllumajanduse ja maapiirkondadega seotud koostöö tehnilise keskuse põhikirja kohta, (4) eriti selle lisa artikli 5 lõiget 4,
 ning arvestades järgmist:
 (1)
 Põllumajanduse ja maapiirkondadega seotud koostöö tehnilise keskuse põhikirja artikli 5 lõikes 4 on sätestatud, et suursaadikute komitee kehtestatud menetluse kohaselt nimetab AKV–ELi suursaadikute komitee põllumajanduse ja maapiirkondadega seotud koostöö tehnilise keskuse juhatuse liikmed maksimaalselt viieks aastaks, kusjuures poole ametiaja möödumisel esitatakse nende tegevuse kohta vahearuanne.
 (2)
 Kooskõlas AKV–ELi suursaadikute komitee 12. oktoobri 2015. aasta otsusega nr 1/2015 põllumajanduse ja maapiirkondadega seotud koostöö tehnilise keskuse juhatuse liikme ametisse nimetamise kohta (5) lõppeb ühe juhatuse liikme ametiaeg 6. novembril 2016,
 (3)
 AKV-ELi partnerluslepingu kehtivusaeg lõppeb 29. veebruaril 2020 vastavalt selle artikli 95 lõikele 1. Seega on järelejäänud ametiajaks enne lepingu kehtivusaja lõppemist vaja ametisse nimetada uus juhatuse liige,
 ON TEINUD JÄRGMISE OTSUSE:
 Artikkel 1
 Põllumajanduse ja maapiirkondadega seotud koostöö tehnilise keskuse juhatuse liikmeks nimetatakse järgmine isik:
 —
 Frederike PRAASTERINK.
 Artikkel 2
 Ilma et see piiraks edaspidiseid otsuseid, mida AKV–ELi suursaadikute komitee võib oma pädevuse kohaselt teha, koosneb põllumajanduse ja maapiirkondadega seotud koostöö tehnilise keskuse juhatus järgmistest isikutest:
 —
 Frederike PRAASTERINK,
 kelle ametiaeg lõppeb 29. veebruaril 2020, ning
 —
 prof Baba Y. ABUBAKAR,
 —
 prof Augusto Manuel CORREIA,
 —
 Helena JOHANSSON,
 —
 dr Faustin R. KAMUZORA ja
 —
 prof Clement K. SANKAT,
 kelle ametiaeg lõppeb 6. novembril 2018.
 Artikkel 3
 Käesolev otsus jõustub selle vastuvõtmise kuupäeval.
 Brüssel, 30. september 2016
 AKV–ELi suursaadikute komitee nimel
 eesistuja
 L. M. ISHMAEL
 (1) EÜT L 317, 15.12.2000, lk 3.
 (2) Leping, millega muudetakse koostöölepingut ühelt poolt Aafrika, Kariibi mere ja Vaikse ookeani piirkonna riikide rühma ning teiselt poolt Euroopa Ühenduse ja selle liikmesriikide vahel, millele on alla kirjutatud Cotonous 23. juunil 2000 (ELT L 209, 11.8.2005, lk 27).
 (3) Leping, millega muudetakse teist korda partnerluslepingut ühelt poolt Aafrika, Kariibi mere ja Vaikse ookeani piirkonna riikide rühma ning teiselt poolt Euroopa Ühenduse ja selle liikmesriikide vahel, millele on alla kirjutatud 23. juunil 2000 Cotonous ja mida on muudetud esimest korda 25. juunil 2005 Luxembourgis (ELT L 287, 4.11.2010, lk 3).
 (4) ELT L 309, 19.11.2013, lk 50.
 (5) ELT L 278, 23.10.2015, lk 26.