Summary

GAO completed a survey of the Automated Military Outpatient System (AMOSIST). This program uses enlisted medical corpsmen to provide health care service to adult dependent, military retiree, and active duty outpatients at certain Army hospitals. These corpsmen have limited medical training and are not supposed to exercise medical judgment and are expected to strictly adhere to medical algorithms which are step-by-step directions for diagnosing and treating certain minor illnesses.

GAO found that required process audits are not being conducted at two of the three hospitals GAO visited and are not complete at the third hospital. Army physicians who spoke to GAO did not believe that the audits are necessary, and hospital commanders to whom GAO spoke assumed that the audits were being conducted. GAO also found that the AMOSIST programs at these hospitals frequently do not adhere to the prescribed diagnostic algorithms. As a result, potentially serious cases were not referred to physicians, correct drugs were not prescribed, patients were not given appropriate followup instructions, and key medical information that could have materially affected the handling of a case was not obtained. Although three Health Service Command organizations have reported that the AMOSIST program was insufficiently controlled, the Army has not taken appropriate action to improve the program.