DOD approves medical system

After a successful pilot project in four Defense Department hospitals, the Pentagon this week approved the rollout of a system that enables physicians to obtain and update a patient's complete medical record at any military health care facility worldwide.

Navy Cmdr. Robert Wah, deputy director of the information management directorate at the Tricare management activity, said the Composite Health Care System (CHCS) II merges at least three processes that physicians have used when treating patients:

* Viewing and updating a patient history, done on a paper chart.

* Ordering such things as drug prescriptions or X-rays, performed via a computer system.

* Making a diagnosis, or "coding the visit," which can be done on paper or on another automated system.

"CHCS II integrates all of these tasks on a single system," said Wah, who is board certified in obstetrics/gynecology and reproductive endocrinology and has used CHCS II in that capacity. "It's planning at a level we were never [before] able to do."

Because patients in the DOD health care system are so mobile, paper charts can get lost or be inaccessible to the doctor treating someone far away from home.

"For patients, there's no such thing as a lost chart anymore," Wah said. "They are available 24/7."

Physicians also can program "wellness reminder" alerts into the system that will notify the doctor if a patient is due for a mammogram, diabetes test or any other health test, he said.

"If a doctor has 1,500 patients they are responsible for, they 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."

CHCS II was tested at four hospitals: the Naval Medical Center, Portsmouth, Va.; the Langley Air Force Base, Va.; Fort Eustis, Va.; and Seymour Johnson Air Force Base, N.C. It was tested by about 100 users per week who were responsible for about 400 patient visits per day, Wah said.

DOD's Acquisition Board granted CHCS II a limited deployment Nov. 4. The board is chaired by John Stenbit, assistant secretary of Defense for command, control, communications and intelligence. At that meeting, Stenbit agreed to the limited deployment request, and that decision is expected to become official in about two weeks when an Acquisition Decision Memorandum is signed.

"I'm greatly enthusiastic about this," Stenbit told Federal Computer Week in an e-mail. "It's the right kind of business approach."

Integic Corp. is the prime CHCS II integrator, and the company's main mission has been making the system more user-friendly while integrating existing legacy systems with numerous commercial off-the-shelf offerings, said Ron Pace, CHCS II program manager in DOD's Clinical Information Technology Program Office.

Larry Albert, health care practice leader and senior vice president at Integic, said CHCS I was a "hospital-centric" system that did not enable physicians to share information, whereas CHCS II is "patient-centric."

Albert said the plan is to roll out the system at four more hospitals in the coming year, before launching a "more aggressive worldwide rollout" in late 2003.

Pace said CHCS II has cost $275 million so far, and the 18-year life cycle funding for the system is estimated to be just less than $4 billion.