Electronic medical records go into combat

'You're tracking the entire medical record from the point of injury so they can get the appropriate care.'

'Former Army medic Tommy Morris

BMIST reduces errors, makes medics' job easier

As an Army medic responding to medical emergencies in Macedonia in the early 1990s, Sgt. Tommy Morris thought there had to be a better way to keep patients' records.

Morris lugged around thick medical reference manuals and a Leader's Book in which to jot down a patient's diagnosis and treatment. It was tough for medics to keep complete records of a soldier's medical history.

'Mostly that information wasn't captured until soldiers got evacuated to a hospital facility,' said Morris, who now serves in a civilian role as chief IT officer and director of mobile computing for the Telemedicine and Advanced Technology Research Center at Fort Detrick, Md. The center is part of the U.S. Army Medical Research and Materiel Command.

When he returned from Macedonia, Morris began researching ways to automate and simplify medical record-keeping. The result is the Battlefield Medical Information System-Tactical, which military medical personnel use to capture a patient's medical history on the battlefield. It has been so successful in making medical record-keeping more accurate and efficient that the Army is speeding rollout of the devices.

Three years ago, Morris and his division developed a prototype of BMIST based on Microsoft Windows Mobile software running on ruggedized Hewlett-Packard iPAQ Pocket PCs. The devices store data such as immunizations, dental and vision records, and drug allergies, which can also be transmitted to a central medical repository.

With BMIST, 'you're tracking the entire medical record from the point of injury so they can get the appropriate care,' Morris said.

Users also can download health care reference manuals via BMIST. The devices have a Simple Technologies Compact Flash Card with 128M of RAM, an iPAQ PC CARD Expansion and a Simple Technologies Compact Flash Adapter.

Last year, the Defense Department approved BMIST as the main handheld system supporting military health surveillance missions.

At the White House

Today, there are 5,000 BMIST devices in use, including by brigades of Army Stryker armored combat vehicles in Iraq and the White House Medical Unit. Recently, the Marine Corps has been devising plans to use BMIST in Iraq. The military expects to deploy 50,000 more of the units in the next three years.

Morris said the devices can 'save lives and reduce medical errors' while helping the government comply with the president's Health IT Plan, which requires federal agencies to begin keeping electronic health records of personnel and their families. The goal of the 10-year initiative is to move from paper to electronic medical records, which is expected to save money and reduce errors.

Morris said BMIST is making life easier for medics.

'We wanted to give them a more intuitive way to do their jobs and to provide them with decision support,' Morris said.

When a medic treats an injured soldier, he removes an electronic device that is worn around the soldier's neck, like a dog tag, and can store medical records for 20 years. The medic then enters the personal information carrier into BMIST to gain instant access to such data as the soldier's allergies and medications. 'The information goes with the patient, so when the patient gets to the next level of care, they can see what has been done for the patient to help reduce medical errors,' Morris explained.

BMIST, which is part of the joint Theater Medical Information Program, interfaces with the Defense Department's Composite Health Care System II program and the military's Clinical Data Repository.

Since the deployment of BMIST, other military units have expressed interest in applying the handheld devices to their own disciplines. For example, veterinarians envision using the devices to maintain medical records on military pets.

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