Agencies tap Army's expertise on electronic health records

The Army's suite of computer hardware used by the Medical Communications for Combat Casualty Care (MC4) to manage battlefield electronic health records has attracted the attention of Air Force medical evacuation squadrons, the Navy, NASA and the State Department, according to MC4 commander Lt. Col. Edward Clayson.

These organizations approached MC4 because "they would love to switch over to electronic health records" and they wanted to tap its expertise in deploying and supporting such systems, Clayson said at a Government Executive webinar on Thursday.

MC4 has fielded 22,000 handheld, laptop and server computer systems to more than 250 Army medical units operating in Afghanistan, Iraq, Europe and Asia. Combat medical personnel transmit 4.5 million electronic files from the battlefield to the Defense Department's global Armed Forces Health Longitudinal Technology Application (AHLTA) record system.

Recent tweaks in Theater Medical Information Program-Joint software, developed by the Military Health System to run on MC4 hardware, allow medics to download electronic health records from AHLTA to battlefield systems, Clayson said. The MC4 systems can send data with narrowband connections equivalent to a 56Kbps dial-up modem, but they require a broadband connection to pull records in from AHTA, he said.

The Navy and Air Force expressed an interest in MC4 hardware when the Army started developing it in 1999. Since then, operations in Afghanistan and Iraq have driven demand for battlefield electronic health record systems, Clayson said. "It's not that we did it faster," he said, "it's because we did it first."

In October 2007, MC4 equipped the Expeditionary Medical Support Group's Air Force Theater Hospital at Balad Air Base with 200 computer systems, the largest single fielding of MC4 equipment to date.

Maj. Gen. Charles Green, the Air Force's deputy surgeon general, said MC4 equipment and TMIP-J software ensured that clinicians in Balad could share electronic health information at all stages of treatment, from the air base to stateside hospitals.

The one disconnect in the electronic continuum of care, Clayson said, is medical evacuation flights from the field to the Army's Landstuhl Regional Medical Center in Germany and then to hospitals in the United States. He is working with the Air Force to plug that gap with MC4 hardware and allow critical care air transport teams to provide the same level of intensive care found in a hospital.

MC4 also is in discussions with the Navy's Bureau of Medicine to supply computers to a field hospital in Djibouti and with NASA to support manned space flight operations on the space shuttle and the International Space Station. In December 2005, MC4 provided systems to the U.S. Embassy clinic in Baghdad and is consulting with the State Department on how to equip other embassies.

Talks with these agencies are preliminary, Clayson said, adding that MC4 is quite willing to share its expertise, even if other agencies decide to field their own systems.