Database gives doctors global access

'Legibility is no longer a problem. There is a lot more patient safety.'

'Dr. Robert Wah, commander in the Navy Medical Corps

The Defense Department has approved limited deployment of a database that will eventually store the records of more than 8.5 million military personnel and their families, letting doctors retrieve medical histories and information on their patients at the click of a mouse.

In November, DOD's IT Acquisition Board approved use of the Composite Health Care System II at seven military hospitals, ending a test of the feasibility of the project at four East Coast hospitals. DOD officials next summer will begin a deployment of the system at more than 100 military hospitals around the world that is expected to take three years.

CHCS II lets medical personnel update and share files of any military patient. The system also allows physicians to place orders electronically and to conduct research and identify trends from stored records.

It will hold laboratory, radiology and enrollment information on all outpatient visits at more than 100 hospitals and 600 clinics worldwide.

'The new system expands the information we store electronically,' said Dr. Robert Wah, a Navy Medical Corps commander who specializes in obstetrics and gynecology and reproductive endocrinology. Wah was one of the doctors who took part in the CHCS II pilot program.

Information ranging from a patient's history to doctor assessments, X-ray results and vital signs will be stored at the Defense Information Systems Agency megacenter in Montgomery, Ala. As each medical center converts its data to electronic format, it will upload the information to the clinical data repository, making the information accessible anywhere in the world, officials said.

More than 1 million records have already been migrated to the repository, according to Larry Albert, senior vice president and health care practice leader at Integic Corp. of Chantilly, Va. Integic is the prime contractor and is serving as developer and systems integrator for CHCS II. Albert said the system uses commercial software such as the Care Innovation product suite from 3M Corp. of Santa Clara, Calif.

Before the development of CHCS II, medical personnel used CHCS I, which was more hospital-centric in scope than patient-centric, said Albert. CHCS I created more than 100 separate clinical information systems to keep track of military medical records.

A problem arose when patients moved from base to base, Albert said, and had to carry their medical records with them in a paper folder.

'While you had many digital systems, they were all restricted to the individual hospital,' Albert said. 'With a mobile work force, that created a real issue, from patient safety to the quality of care. CHCS II changed that paradigm.'

The new system standardizes the data at medical centers, Albert said. The system also lets doctors program wellness alerts that will notify them if a patient is due for any kind of health test, Albert said. The alerts will eventually be e-mailed to patients to remind them.

'We're going to all of the medical treatment facilities, and we're mapping their old information to our current data dictionary and migrating it,' Albert said.

CHCS II underwent Defense operational test and evaluation at the Portsmouth Naval Hospital in Portsmouth, Va.; Langley Air Force Base, Hampton, Va.; Fort Eustis, Va.; and Seymour Johnson Air Force Base, N.C., before the board signed off on it.

On your mark, get set

Ron Pace, deputy program executive officer for Military Health System IT, said every system function was tested to see how much time it took to execute. Defense officials also conducted user surveys and security tests, he said.

'The real issue was did the product meet the department's parameters for security and will the people who use this product get their job done,' Pace said.

The board was satisfied, Pace said.

Wah said the system is the long-awaited answer to the problems of paper records.

Doctors' handwriting "legibility is no longer a problem," Wah said. "There is a lot more patient safety."

Wah said the system lets doctors concentrate on their patients, leaving the computer to handle coding and documentation work.

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