U.S. ARMY MEDICAL RESEARCH

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U.S. ARMY MEDICAL RESEARCH MATERIEL COMMAND
MG Lester Martinez-Lopez,
Commanding
Telemedicine Advanced Technology Research
Center Cutting Edge Medical Technology
Battlefield Medical Information
System-Telemedicine (Patent Pending)
Deputy, Advanced Technologies Colonel (Dr)
Jeffrey Roller, MC, USAF, Director, Mr. Tommy
Morris, Telemedicine Project Manager, Telemedicin
e Advanced Technology Research Center (TATRC)

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Battlefield Medical Information
System-Telemedicine
OPTIMIZING PATIENT CARE BMIST is a point-of-care
hand-held assistant that enables military
veterinary providers to record, store, retrieve
and transmit the essential elements of patient
encounters in an operational setting. Reference
materials, diagnostic and treatment decision
aids, and logistic support software can also be
included, facilitating patient care, skill
sustainment training, and mission planning.
Initially designed for Special Forces medics and
other first responders, BMIST can be used by
providers at all echelons along the healthcare
continuum. As medical practice evolves, BMIST has
the flexibility to incorporate new procedures and
protocols, medical databases, and mission
requirements.
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BMIS-T Product Portfolio
Veterinary Food
COSCWARS Behavioral Health
Research Tool RCQ/WRAIR NIH
BMIS-T HQ USSOCOM WHMU DCDD
Veterinary Animal SVC
Logistics PM DMLSS USAMMA
Hospital Locator
Preventive Medicine
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BMIS-T Interfaces/Inputs
Veterinary Food
Hands Free Speech Input
Research Tool RCQ/WRAIR NIH
COSCWARS USACHPPM
BMIS-T Core Product
USAMMA URL/DMLLS
TMIP/CHCSII
OFW Medic WPSM
USSOCOM HSS
LSTAT?
Hospital Locator
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Health Surveillance and Policy Drivers

• Public Law
• 10 U.S.C. 1074f, 18 Nov 97
• Pre-deployment med exam
• Post-deployment med exam
• Medical recordkeeping during deployment
• Centralized repository
• Presidential Directive, 8 Nov 1997
• DoD Policy
• DoD Directive 6490.2, 30 Aug 97
• DoD Instruction 6490.3, 7 Aug 97
• DoD ASD-Health Affairs Memorandum, 30 Sep 99
• Joint Staff Memorandum MCM-0006-02, 1 Feb 02

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Goals

• To optimize Patient care
• To establish a true longitudinal Patient record
• To maximize the amount of medical data available
  for medical health surveillance
• To develop a Point of Care hand-held device and
  support architecture to improve military health
  care by improving medical decision making and
  reducing errors beginning at the first responder
  level

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Personal Information Carrier
Theatre Medical Information Program (TMIP) DOD HA
(TMIP/CHCS II) provides Software.

• Data Requirements
• Medical Histories
• Readiness data immunizations, prescriptions,
• Summary data master problem list, allergies
• All clinical encounter data

• Presidential Review Directive 5 Develop a
  standardized, integrated seamless system of
  medical C2 for the military medical community
  within GCCS, to include an individually carried
  device

Electronic Medical Record PIC Worn by Individual
and issued to all for data connectivity when
nonexistent, unreliable or not available and as a
redundant system for all Levels of Care
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Screen Shots
Readiness
SF 600
DD 1380

• Electronic References
• SOFMH
• Handbook of Veterinary Care
• Mosby Rx/Ix
• Medical NBC Battlebook
• MEDIC, Medical Environmental
• Disease Intelligence Countermeasures
• Field Operators Guide

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Veterinary Application
DD 1380/Trauma Flow Form
Veterinary References

• Electronic References
• SOFMH
• Handbook of Veterinary Care
• Mosby Rx/Ix
• Medical NBC Battlebook
• MEDIC, Medical Environmental
• Disease Intelligence Countermeasures
• Field Operators Guide

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Clinical Workflow
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Patient-Centric Infosphere

• Provides
• More effective medical care
• Better medical information
• Heightened Vigilance for Public Health Threats
• Bioterrorism preparedness

Medical Care
Improved Healthcare Quality
Longitudinal Medical Record
Medical Surveillance
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Systems Interoperability
Space Network
Wideband Gateway
Advanced EHF
Narrowband Gateway
Air Network
Ground Network
Commercial ACNs
Airborne Communications Nodes
CONUS Fiber
MTW
High CapacityGateways
MSE, WIN/T
SSC/NEO
In-theater fiberentry points
JTRS
Global Fiber Network
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Project Schedule
Meetings
Pre-implementation Strategy
Recommendations Demonstration
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Status

• Prototype July 2001
• Iterative RD
• Provisional Patent Filed 15 May 2002
• Accepted as TMIP Block I for Army
• Accepted as TMIP Block II Jointly
• Transition to TMIP Aug 2003
• Utility and international Patents Pending
• Trademark Pending on BMIS-T name
• 5 License Applications

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Organization StructureAcceptance Decision Process
Local and Service Activities
Central Program Activities
Services
IMPC
PEO
Services IM
TFWG/TFSC
Execute
Approve
Prioritize
Coordinate
Endorse

• Central Deployment
• Central Maintenance

• Central testing
• Accepted as enterprise program

• Local development funding
• Central Architecture
• Standardized data rules

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Deployed

• TMIP
• PEO HA
• 21 WHMU
• 605 HQ USSOCOM
• US Army Veterinary Corps
• 37 -325th AIR
• 12 MAMC
• 137 MC4
• 15-600 USAF
• DCDD
• AMEDD CS
• USACHPPM
• USMC

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Electronic Data Capture Versus Standard Paper
Method for BMIS-T/SOF

• USSOCOM Deployment Health Surveillance Study
  Found
• 6 Documentation/Retention Rate (paper and pen
  method)
• 82 Documentation/Retention Rate (electronic
  capture method)
• Data Capture at the point-of-care is essential
  it is foundation of medical surveillance,
  documentation, and recordkeeping
• Electronic point-of-care removes the medical
  recordkeeping burden from the beneficiary and
  puts it on the health care system

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Summary
New technologies revolutionize the way we learn,
work and play - all while improving quality of
our medical care. Medical handheld technologies
allow faster adaptation to changing conditions
and increase responsiveness to medical situations
while reducing clinical errors