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Military Transforming Use of Medical Records

By Steven Donald Smith
American Forces Press Service

WASHINGTON, Oct. 13, 2006 – The U.S. military’s health care community is transforming its approach to capturing, archiving and accessing servicemembers’ medical records, a senior Defense Department official said here yesterday.

“We are working to bring about some pretty amazing things in the way we’re changing and revolutionizing the delivery of health care through technology. and specifically through information technology,” Dr. William Winkenwerder, assistant secretary of defense for health affairs, told an audience at a military health care exhibit.

He said private industry has contributed to the development of DoD’s electronic medical record keeping and health care information system. “We recognize that many of you have contributed in many different ways to the incredible capabilities that are before you and that are put forth for making this wonderful new system we call AHLTA,” he said.

AHLTA -- an acronym for the lengthy name “Armed Forces Health Longitudinal Technology Application” -- is a global, 24/7, secure and advanced electronic system of digitized medical records and information. “It is a system that supports the very unique missions of the United States armed forces,” he said. “Current, accurate and available patient information is an essential component in providing quality health care.”

In August, President Bush signed an executive order to promote federally led efforts to implement more transparent and high-quality health care. The executive order promotes quality and efficient health care for federal government-administered health care programs, including DoD’s TRICARE. “The executive order offered dynamic direction and real change in culture and the practice of health care in our country,” Winkenwerder said.

The executive order’s goal is to propel the business of health care and the practice of medicine into the Information Age, he said. This will allow health care information to become more transparent, so Americans and military personnel can make informed decisions about where to seek health care, he said.

One of these “transparencies” is in health care costs. DoD set up a Web site that specifically outlines military health care costs in order to help beneficiaries understand what TRICARE pays for medical procedures, visits and hospitalization.

DoD also holds health care summits and forums in which health care professionals come together to discuss ways to improve the military medical system.

AHLTA will soon be fully deployed to military facilities throughout the world. “This will allow our beneficiaries’ health records to be accessed worldwide at any military treatment facility in which our patients receive care,” he said.

The AHTLA system now holds 8.6 million clinical records out of its total of 9.2 million beneficiaries, he said.

Winkenwerder said AHLTA uses highly scalable and mobile software that can be linked to hand-held wireless devices. One of these wireless systems is the “Battlefield Medical Information System Tactical.”

BMIST generates electronic health records at the point of care. The hand-held wireless device enables military medical professionals to record, store, retrieve and transmit essential information from point of injury to health care facilities. Information can be entered onto electronic dog tags so medical folks at the next level of care have all the appropriate treatment information. This information then becomes a permanent part of the patient’s electronic health record.

DoD has about 30,000 hand-held BMIST devices in use worldwide, including many in Iraq and Afghanistan.

Other information technology initiatives that are improving troop care are the ESSENCE -- “Electronic Surveillance System for Early Notification of Community-based Epidemics” -- system and the “Military Health System Population Health Portal.”

ESSENCE, a Web-based medical surveillance application that analyzes DoD health care data worldwide for rapid or unusual increases in the occurrence of symptoms such as respiratory infection. ESSENCE enables DoD to better control and provide more timely care for those already infected.

Samuel Sturlson, project controller for ESSENCE, said the system provides epidemiologists and military health care providers with information about potential outbreaks of diseases or biological incidents. “Users are able to determine if there was a real outbreak at that local level or if it was a false positive,” he said.

The Military Health System Population Health Portal is a centralized, secure, Web-based population health-management system used by military health care providers to alert them to their patients who may need clinical preventive services, like immunization or mammograms, and assists with disease management for condition like diabetes or asthma.

DoD also works closely with Department of Veterans Affairs health care providers to come up with better methods of sharing important military medical information electronically, he said.

“Our goal ultimately is to involve our patients more deeply in managing their health care. We believe that those patient-provider partnerships serve to enhance the quality of health care,” Winkenwerder said. “Our nation’s heroes certainly deserve our very, very best.”

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Biographies:
Dr. William Winkenwerder

Related Sites:
Military Health System

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