Health IT Initiatives of the Military Health System

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Health IT Initiatives of the Military Health
System
Mr. Charles M. Campbell, SES Chief Information
Officer, Military Health System
December 2008
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Topics

• Military Health System (MHS) by the Numbers
• Filling the Information Gaps
• Theater Health Information
• Personal Health Record (PHR)
• Essentris (Inpatient EHR)
• DoD/VA Health Information Exchange
• Federal Health Care Centers
• Computer / Electronic Accommodations Program
• New Enterprise Architecture
• NHIN Federal Connector Initiative

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Military Health System (MHS) Direct Care by the
Numbers
63
Military hospitals
826
Medical dental clinics
940,000
Prescriptions filled weekly
980
4,800
664,000
Births weekly
Inpatient admissions weekly
Outpatient encounters weekly
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MHS Purchased Care by the Numbers
1.173 million
Prescriptions filled weekly at retail pharmacies
13,700
Inpatient admissions weekly
1,260
Births weekly
175,000
Prescriptions filled weekly through mail order
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Filling the Information Gaps
Longitudinal Electronic Health Record
Entrance Physical
Veterans Services
Ambulatory Health Care
Immunized
Deployed
Garrison
Garrison
Basic Training
Pre-Deployment
Post- Deployment
Separation/ Retirement
Veterans Health Care
Information Gaps(Medical Care Not Captured in
Longitudinal Record)
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Theater Health Information

• Theater Medical Data Store (TMDS) expansion
• VA direct access to TMDS
• Convergence of Theater / CONUS EHR
• Quality enhancements
• Reliability
• Accessibility
• Speed
• Bandwidth
• Connectivity

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Personal Health Record (PHR)

• Internal pilot -- Madigan AMC / McChord AFB (Dec
  08)
• External pilot -- Hampton Roads
• Collaborating with State of Virginia
• Sharing standardized EHR data with private sector
  providers
• Possibilities?
• Patient-entered data
• Data downloadable to disk or thumb drive (PDF?
  computable?)
• Data available in multiple languages

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Essentris (Inpatient EHR)

• Currently implemented at 21 sites, accounting for
  57 of all DoD inpatient beds
• By end of 2009, implemented at 47 sites,
  accounting for 92 of beds

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DoD/VA Health Information Exchange

• Federal Health Information Exchange (FHIE)
• Monthly, one-time transfer of historical
  electronic health information from DoD to VA at
  the point of a Service members separation
• Support for 4.5 million separated Service members
• Bidirectional Health Information Exchange (BHIE)
• Real-time sharing of readable electronic health
  information between DoD and VA for shared
  patients
• Support for 3.1 million shared patients

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Interoperability Across EHRs
In AHLTA, DoD providers can select BHIE Data
Viewer from the Folder List to view VA data.
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Clinical Data Types Exchanged

• Allergies and adverse reactions (2004)
• Medications (2004)
• Laboratory (chemistry, hematology, microbiology,
  serology, virology, toxicology, anatomical
  pathology) (2005)
• Radiology reports (2005)
• Pre-/post-deployment health assessment and
  reassessment forms

• Inpatient notes (discharge summary, operative
  report, history and physical, inpatient consult)
  (2006-2008)
• Problems and diagnoses (2007)
• Outpatient progress notes (2007)
• Radiological images (2008)
• Vital signs (2008)

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Federal Health Care Centers

• Great Lakes / North Chicago
• Integrated facility
• Integrated services
• One Finance and HR systems
• Seamless IT systems
• Additional sites

July 14, 2008 Representatives of the Department
of Defense, Department of Veterans Affairs, U.S.
Congress, and Navy Medicine break ground on the
final phase of constructing the first completely
integrated DoD/VA health care center.
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Computer / Electronic Accommodations Program (CAP)

• Supporting assistive technology needs for federal
  employees
• Opportunity for employees with disabilities to
  continue working
• 65 federal agencies eligible
• More than 60,000 accommodations since 1990
• Equipping and empowering wounded Service members
• From deployment to employment
• More than 4,000 accommodations
• Earning a Presidents Management Agenda Award

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New Enterprise Architecture

• Service-oriented, standards-based architecture
• Enhanced interoperability among systems,
  enterprises
• Focus on stability, speed, security
• Support for expanded sharing of health
  information
• Reserve Component
• Private sector care
• Purchased care (TRICARE network) providers
• Other Federal agencies
• States

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NHIN Federal Connector Initiative
SECURE EXCHANGE OF INTEROPERABLE HEALTH
INFORMATION
DoD
Patients
VA
Providers
SSA
Improved Outcomes
NHIN
Population Health
IHS
Nationwide Health Information CONNECT Solution
Others
Graphic adapted from presentation at the Dallas
NHIN Conference, 4/30/08
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Questions?