Defining a New Electronic Healthcare Records System for the Military

May 2015
Topics: Health Services Administration , Systems Modernization, Government Acquisition, Systems Engineering-General
The U.S. military pioneered the use of electronic healthcare records decades ago. Recently, the Defense Healthcare Management System tapped MITRE to help keep its patients' records paperless—while benefiting from the latest strides in health IT.
Tom Neal discussing new healthcare records system with Ron Backus.

"For years and years, soldiers, sailors, airmen, and marines would physically carry their medical records with them from location to location," says MITRE's Dr. Tom Neal. "Then in the late 80s, realizing that a paperless system would be easier and more efficient, the Department of Defense converted to an electronic healthcare records system."

Neal, a former DoD operational medicine doctor, is now a MITRE health information systems subject matter expert with an insider's perspective on the DoD's health IT processes.

Since introducing its initial electronic healthcare records system, the Composite Health Care System (CHCS), the Department of Defense has added components and features to CHCS to address emerging needs. But years of augmenting CHCS with more advanced technologies has left its core systems inefficient and difficult to use. The military needs a modern system that will provide sustainability, flexibility, and interoperability.

MITRE is aiding the Defense Healthcare Management System (DHMS) efforts to procure a new electronic healthcare records system. This system will feature the latest advances in electronic healthcare records technology: clinical decision support for providers, robust billing engines, and the ability to synchronize ancillary services like pharmacology, laboratory work, and radiology. It will ensure that the DoD, the Veterans Administration, and private care providers can adequately and effectively exchange healthcare patient information.

Taking a Fresh Approach

In acquiring a replacement, the DoD is trying a fresh approach. When adopting the CHCS, the military worked with a number of contractors to design and deploy the core system from the bottom up. For the new system, it will seek to purchase technology that already exists in the marketplace.

"With the CHCS, the military needed an electronic healthcare records system that would meet what were, at the time, its unique needs," Neal says. "But now the healthcare marketplace has caught up to, and in many cases exceeded, the military's original paperless vision. There are now advanced marketplace solutions for a paperless, efficient DoD healthcare system."

Lending a Hand in the Transition

On August 25, 2014, the DHMS issued a solicitation requesting proposals for an electronic healthcare records system solution, including related services, due by October 31, 2014. MITRE assisted the military in defining the capabilities that the new system would have to meet. "The military is looking for an open architecture so that they won’t be tied to a particular vendor’s approach," Neal says. "And they want something off-the-shelf and highly configurable so that they can bring it into their environment and make it work quickly for them."

Once the military chooses a new electronic healthcare records system, MITRE will be on hand to assist in the transition from CHCS. MITRE is also assisting the DHMS in adopting and maintaining health data standards. “We’re helping provide secure portability of medical data by making the best use of currently deployed technology," says Ron Backus, one of the project leads for MITRE’s collaboration with DHMS.

Consistent use of standardized data will ensure that the patient information DHMS collects and houses can be shared smoothly with the Veterans Administration and with the private-sector medical providers who provide 60% of the DoD's beneficiary healthcare. Standardized health data will enhance treatment accuracy and clinical decision-making.

Expertise from Acquisitions to Health IT

"This project demonstrates all the expertise MITRE has under one roof," says Backus. "In a given day, I could attend a meeting with the cost-estimation team and then go upstairs to get a briefing on safeguarding medical records from the IT team and then stop in the hallway on my way back to my office to talk shop with someone from the instructional systems development team."

As the military prepares to adopt DHMSM, MITRE will apply its systems-of-systems expertise to help CHCS evolve. MITRE will assist DHMS to implement new system capabilities, make those capabilities available worldwide, and position the military to transition smoothly from the old system to the new. As the military healthcare system marches further and further from its paper-based past, MITRE's systems engineering expertise will continue to help it keep its stride.

—by Christopher Lockheardt


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