DOD e-health record system halfway through installation

The Defense Department announced today that it was halfway through the implementation of its Web-based electronic health record to DOD facilities around the world.

The Defense Department announced today that it was halfway through the implementation of its Web-based electronic health record to DOD facilities around the world.

It also gave the system a new name: the Armed Forces Health Longitudinal Technology Application (AHLTA).

'We are digitizing the entire military health care system'from the battlefield to military clinics and hospitals to the Veterans Health Administration,' said William Winkenwerder, assistant Defense secretary for health affairs, at a briefing at the National Naval Medical Center in Bethesda, Md. 'We've reached the tipping point and we're expanding it rapidly,' he added.

AHLTA replaces the Composite Health Care System (CHCS I). Initially referred to as CHCS II, the AHLTA system is more than another version. It is global, available 24 hours a day, seven days a week and has the ability to move data across DOD's entire health care system, according to Winkenwerder. DOD should complete the system installation in December 2006.

Among its improvements, AHLTA enables structured document data, meaning that data entered into the system adheres to standard definitions, enabling it to be repeated, shared and moved. For example, DOD will be able to automatically aggregate and mine patient data for disease surveillance, such as tracking foodborne illnesses or symptoms of biological warfare that may befall soldiers.

AHLTA'which DOD has installed at 80 of 139 department facilities'has cost $1.2 billion to date; it will cost $100 million a year to finish the implementation and maintain the system. Despite the large expense, the cost of the new system works out to $130 per beneficiary and $28 per year per beneficiary to maintain the system, said Carl Hendricks, CIO of the Military Health System. There are 9.2 million military beneficiaries, including families and retirees.

DOD will share lessons it learns with the Health and Human Services Department about implementing a modernized, scalable system to assist in HHS' health IT initiatives. Structured document data could be useful in reducing Medicare and Medicaid fraud, said Navy Capt. Robert Wah, who was director of information management for the Military Health System and now is on detail as acting deputy national coordinator for health IT at HHS.

Structured data enables a computer to read patient information and code it correctly for claims payment from HHS, which would eliminate human error or fraudulent intent in upcoding, or claiming more treatment for a patient than was provided, Wah said.

HHS will also consider the architecture of how the Military Health System exchanges data to inform prototypes for its nationwide health information network and how it encouraged health IT adoption among physicians serving the military.

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