DOD rolls out cradle-to-grave EMR system

The Department of Defense's premier healthcare system has moved to the ready ramp following approval by the Pentagon.

The Composite Health Care System II (CHCS II), an integrated information scheme that lets physicians access patients' medical records from any military medical center anywhere in the world, was successfully piloted at four DOD hospitals and will be put on active duty at facilities worldwide next year.

The computer-based patient record is believed to be the first cradle-to-grave automated healthcare record of either military or civilian design. Pentagon medical experts expect CHCS II to revolutionize the Military Health System by providing instantaneous patient information to healthcare providers worldwide.

An associated smart card designed to be carried by military personnel stores a subset of this information, thus enhancing combat effectiveness by expediting healthcare at all levels.

CHCS II integrates the features of the existing CHCS I, along with the functions of more than 40 DOD and service-unique systems in various stages of development, while also providing new capabilities. It can handle both medical and dental information, and is a key enabler for Force Health Protection and Population Health Improvement, two cornerstones of military medicine.

According to Navy Cmdr. Robert Wah, deputy director of the information management directorate at the Tricare management activity, CHCS II incorporates three processes used by clinicians when treating patients:

1.viewing and updating a patient history, done on a paper chart;
2.ordering imaging procedures and drug prescriptions performed via separate computer systems; and
3.coding the visit, which can be done either on a paper form or on yet another computer system.

"CHCS II integrates all of these tasks on a single system," said Wah, who uses CHCS II in his ob/gyn and reproductive endocrinology practice. "It's planning at a level we were never before able to do."

Clinics at three Virginia test sites - Portsmouth Naval Medical Center, Langley Air Force Base, and Fort Eustis - and at Seymour-Johnson AFB, NC, served as CHCS II proving grounds.

The system supports "wellness reminder" alerts that can be used to notify clinicians when a patient is due for a mammogram, diabetes test, or other procedure.

"A doctor responsible for 1500 patients can find out how many of those are overdue for mammograms and get their contact information," Wah said. "That's not available in a room full of paper charts."