Defense portal to add medical data-sharing

Consistent e-health records expected to improve care

RESCUE: U.S. Army medics load a wounded Iraqi man into a medical helicopter at Forward Operating Base Danger, Iraq.

Courtesy of DEFENSELINK Spc. Brandi Marshall, U.S. Army

When a soldier injured on the battlefield receives emergency medical attention, that care is recorded in the soldier's health care file, which then stays with him during his treatment.

That might seem an ordinary bit of record-keeping, but the realities of war have made it difficult; during the first Gulf War in 1991, the management of military health care records was inconsistent.

When moving from deployment to deployment, soldiers carried two-inch-thick folders of paper medical records. Information on surgeries performed and vaccines or drugs given on the battlefield was often missing.

As a result, when soldiers were diagnosed with Gulf War syndrome, good-quality data wasn't available to link drugs with the symptoms, said Edward Clayson, an Army medical communications expert. Because of missing data, many soldiers underwent repetitive and unnecessary procedures, while others, with no documentation to back up their claims, were denied benefits for service-related injuries.

In response to these problems, a presidential advisory commission in 1997 called for the creation of lifelong electronic medical records for military-service members. Congress later passed legislation requiring the Defense Department to create and maintain electronic medical records.

The Army responded with the Medical Communications for Combat Casualty Care program. Clayson is project manager of this information management system for Army tactical medical forces, which uses electronic records for all service members and provides medical data to operational commanders.

'We're capturing all the health care that's being done on the battlefield,' Clayson said. Nearly 250,000 medical encounters have been entered into the database and are available to physicians worldwide, he said.

The combat casualty care program is one of several using IT to move DOD toward network-centric operations and warfare. Together with other recent IT programs and system deployments, it is an effort to cut down on duplicative records and processing, consolidate systems and share information agencywide.

Although the Defense Logistics Agency and the Defense Information Systems Agency use multiple medical systems, intranet portals and databases, DOD wants a single entry point for information for soldiers and commanders. The goal is to create the Defense Knowledge Online portal, a departmentwide, integrated, data-sharing environment.

At this summer's Management of Change Conference in Hilton Head, S.C., Clayson and Larry Wilson, executive director of enterprise solutions in information operations at the logistics agency, were part of a panel discussion on IT's impact on the battlefield.

'There's never been a period of transformation like this one: widespread, massive and persistent, and going pretty well overall,' Wilson said.

The Army Knowledge Online portal, which gives employees, retirees and their families secure access to the Army's Web tools and services, will be the foundation for the Defense Knowledge Online portal. It will offer a secured network for deployed soldiers as well as their families.

The first rollout of DKO will combine Army Knowledge Online and DISA databases and the Joint Forces Command portals, said Kevin Carroll, program executive officer for enterprise information systems.

To get DKO started, the Army and DISA will use a contract the Army awarded last year to Lockheed Martin Corp. to refresh and expand Army Knowledge Online's technology. Subcontractors on the seven-year, $152 million contract include Computer Sciences Corp., Internosis Inc. of Greenbelt, Md., Roundarch Inc. of Chicago and Science Applications International Corp. of San Diego.

To bring DKO to fruition, the military and other defense agencies have set up a board of directors comprising chief information officers from all military services and DISA's commander, said Skip Harborth, chief of future operations for Army Knowledge Online. They also have set up a technical board of representatives from various military intranet portals.

'We're going to take the best of whatever portal is out there in developing DKO ... rather than getting a single solution that's just been developed by a single agency,' Harborth said.

Roseanne Gerin is a staff writer for GCN's sister publication Washington Technology.

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