The U.S. Department of Defense is gearing up to implement a comprehensive electronic medical record that eventually will be available anywhere in the world a military patient is seen by military providers, according to a presentation at the annual HIMSS
The U.S. Department of Defense is gearing up to implement a comprehensive electronic medical record that eventually will be available anywhere in the world a military patient is seen by military providers, according to a presentation at the annual HIMSS meeting in New Orleans.
Worldwide functionality will come when the DoD rolls out the second release of its Composite Health Care System II, the militarys version of the computer-based patient record. Release 1 of CHCS II is already up and running at two locations, according to Capt. David Snyder, USN, program manager for the DoDs Clinical Information Technology Program Office.
The goal is to have the same product in use for clinical documentation in the continental U.S., at major overseas hospitals, and wherever our units are deployed so that when we send soldiers out to take care of casualties they dont have to relearn the entire system, Snyder said. Theyll know the systemits the same system they use every day.
Although the military has approximately 500,000 inpatient stays annually, the current version of CHCS II is available only for out-patient care. This is because the military health system does more than 50 million outpatient visits per year, 33 million of them in house, in military facilities.
Traditionally, that documentation is carried out with paper records carried from clinic to clinic, many times fragmented, occasionally lost, and frequently unavailable at the point of care, Snyder said. The coding is quite variable and that influences how we monitor the populations and also how we bill.
Snyder cited several lessons learned from test segments fielded over the past two years in a product called Increment I, a Web-based version of the clinical PDA NoteWriter program:
Performance, performance, performance. The fastest performance a doctor has ever seen is the slowest the doctor will accept from that time forward, Snyder said.
The product must be aligned with the way physicians actually perform their work. Increment I was a nice, elegant application, but it didnt line up with the way healthcare teams in the military process patients and document their care.
There is no silver bullet. No single product on the commercial market meets all the needs of the military, many of which are unique.
There arent too many folks besides us that are interested in when David Snyder had his last anthrax shot, what bottle it came from, and which immunization was in that bottle, Snyder said. Those are the kinds of unique requirements we have.
At least 10 releases are planned over CHCS IIs 20-year life cycle, according to Snyder. In Release 2, the project will identify a technical solution that will allow the application to go worldwide and possibly get all of the data into a single database, something that would yield enormous power in managing the population, studying it, and planning for it. Agencies such as the Centers for Disease Control and Prevention are rubbing their hands in anticipation of mining a data repository this large.
We can see fairly clearly whats going to be in Release 2 and Release 3, Snyder said. After that we have a broad variety of requirements laid out, but were not sure yet which will roll in when.
One feature certain to get plenty of attention will be robust dental functionality.
Dental is very important in the military because of its importance in readiness, Snyder said. Weve found many times when a troop is down in the field its not from appendicitis, its usually from a tooth.
Emerging AI Algorithm Shows Promise for Abbreviated Breast MRI in Multicenter Study
April 25th 2025An artificial intelligence algorithm for dynamic contrast-enhanced breast MRI offered a 93.9 percent AUC for breast cancer detection, and a 92.3 percent sensitivity in BI-RADS 3 cases, according to new research presented at the Society for Breast Imaging (SBI) conference.
The Reading Room Podcast: Current Perspectives on the Updated Appropriate Use Criteria for Brain PET
March 18th 2025In a new podcast, Satoshi Minoshima, M.D., Ph.D., and James Williams, Ph.D., share their insights on the recently updated appropriate use criteria for amyloid PET and tau PET in patients with mild cognitive impairment.
Can Abbreviated Breast MRI Have an Impact in Assessing Post-Neoadjuvant Chemotherapy Response?
April 24th 2025New research presented at the Society for Breast Imaging (SBI) conference suggests that abbreviated MRI is comparable to full MRI in assessing pathologic complete response to neoadjuvant chemotherapy for breast cancer.
Clarius Mobile Health Unveils Anterior Knee Feature for Handheld Ultrasound
April 23rd 2025The T-Mode Anterior Knee feature reportedly offers a combination of automated segmentation and real-time conversion of grayscale ultrasound images into color-coded visuals that bolster understanding for novice ultrasound users.