Medical system fits the bill

Medical system fits the bill

Now DOD wants to improve protection of data and training of users

By Bill Murray

GCN Staff

The Military Health Service, pleased with the success of an outpatient billing system, now wants to improve system training and security.

MHS deployed the Third-Party Outpatient Collection System in 1993. Through fiscal 1999, the service used TPOCS to collect $160 million in fees for outpatient visits at Defense Department hospitals, said Edward Leo Welsh III, the service's TPOCS project officer. Last year, TPOCS collected $40 million.

MHS has spent about $20 million on TPOCS, which means it has collected $8 for every $1 it has spent on the system, said Richard Lehosky, project manager for TPOCS contractor Impact Innovations Group Inc. of Columbia, Md.

The service has installed systems at 122 Defense medical facilities to run TPOCS. The sites host the system on Dell dual-processor PowerEdge 4200 and 4300 servers running SunSoft Solaris 2.5.1 and Oracle7 Release 7.3.3 databases, Lehosky said.

End users access the system from PCs running Microsoft Windows 95 or Windows NT Workstation 4.0.

Collections via TPOCS have increased from $13 million to $40 million a year over the past five years as more facilities have deployed it.

Building a system that used both Unix and Windows operating systems was not easy, Lehosky said. 'It took a little finagling, but we got it to work,' he said.

MHS soon might upgrade to Solaris 7.0 or 8.0 because Dell's controller configuration for RAID storage subsystems no longer supports Solaris 2.5.1, Lehosky said.

There are no commercial systems running in private hospitals that do what TPOCS does, said Air Force Maj. Rose Layman, manager of the service's DOD Uniform Business Office.

When MHS officials in the early 1990s began making plans for the fee-collection system, they could find no suitable systems for their needs, Layman said.

So they combined products, she said.

Data clerks at local Defense clinics and hospitals are the chief users of TPOCS.

The turnover among employees at that level makes training a challenge, Layman said.

'Sometimes new people who are there don't know about using the system' unless they have someone on-site to help them, she said. 'We're working to get people up to speed,' using a technical support Web site, at

The service also has set up training visits at military treatment facilities.'Sometimes, lapses of two or three years occur between an initial TPOCS deployment at a facility and retraining, Lehosky said.

'One-half of our help desk calls are due to lack of user knowledge,' such as not knowing how to make ad hoc queries using Structured Query Language, he said. The SQL queries are the chief mechanism for searching the TPOCS databases.

Besides TPOCS software development, Impact Innovations has six employees who do nothing but answer help desk calls, he said. The contractor runs the desk 50 hours a week.

Check it out

To help new users, MHS and Impact Innovations post responses to frequently asked questions on the Web site. They also are distributing questionnaires to determine what re-fresher training is needed in particular regions or at specific medical centers, Lehosky said.

Another issue for MHS is the security of TPOCS data. Because the system contains medical records for individual patients, TPOCS must have good security, Layman said.

'We have an interim security certification' from the Defense Information Systems Agency, she said. The service is working with the Office of the Assistant Secretary of Defense for Health Affairs and DISA to make sure the system meets the department's security standards, Layman said.


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