News from HIMSS: Largest integrated network takes IT to the next level

An insider's view of the world's largest integrated delivery network can be had for the price of admission this week at the Healthcare Information and Management Systems Society meeting in San Diego. The Department of Defense exhibit at HIMSS showcases the healthcare IT programs that consolidate and manage an IDN comprising 70 hospitals, 800 clinics, 60,000 medical professionals, and more than nine million patients.

Just as the DOD was among the first to deploy radiology PACS in its hospitals, it has also spearheaded implementation of comprehensive healthcare IT systems. The components of this IT management system have been organized in an easy to underestimate exhibit not to be missed by HIMSS attendees. The DOD's impressive patient tracking and mobile records management system could easily be adopted by civilian healthcare systems.

For example, electronic medical dog tags worn by soldiers hold vital statistics and have the ability to store a 20-year individual health record including diagnostic images. The contents can be downloaded into a wireless PDA with an easy user interface that allows medics to rapidly input information about injuries. The PDAs also contain handbooks for emergency medical care. When the medic reaches a medical facility with a computer, all the information is immediately downloaded and integrated with the soldier's electronic patient record. This triggers the preparation process for treatment by the medical facilities that will provide it, including exam planning and scheduling for diagnostic imaging procedures.

This is part of the DOD's Theatre Medical Information Program, which integrates components of various medical information systems to support rapid mobilization of battlefield patients. It includes a system for global blood tracking and deployment, provides disease and injury coding and analysis, and facilitates a sophisticated evaluation of the medical resources that have been utilized.

An integrated patient tracking system provides a way to track the type of care patients have received where, potentially throughout their lives. And as with the newly introduced DOD electronic patient record, known as AHLTA, the tracking system demonstrates levels of access security and permissions that are in rigid conformance with HIPAA rules. At HIMSS, the DOD announced that AHLTA (Armed Forces Longitudinal Technology Application) is replacing its aging Composite Health Care System II (CHCS II) electronic records system.

The Defense Medical Logistics Standard Support program provides timely access to medicine, medical supplies, hospital equipment, facilities, and services. The system has reduced procurement lead times from up to 45 days to two days or less, with 80% of items delivered where they are needed in under 24 hours, according to the DOD. The agency also claims that this system delivers cost savings valued at $6.40 for every $1 invested.

TriCare Online is a patient-centric Web portal to be used by military personnel and dependents to schedule appointments online and to obtain medical information. It collects patient information in advance that would be time consuming to collect at the point of care. It notifies users of recommended wellness checks.

One unexpected outcome of the Web-based system is that patients are more forthright about their medical problems and explain them in more detail, particularly when it comes to potentially embarrassing medical problems, according to a DOD representative on hand at HIMSS. TriCare Online is integrated with other programs to help plan for staff and resource utilization, budgeting, and cost-effective deployment.

These integrated systems represent the vision of the HIMSS meeting--except they are being used now. Perhaps the radiology community will get its own insider's peek at this exhibit if the DOD stages a similar, imaging-centric one at the 2006 RSNA meeting.

Ms. Keen is a PACS consultant and imaging technology analyst with i.t. Communications, headquartered in Palm Beach, FL. Her industry consulting includes engagements with Agfa Healthcare, Eastman Kodak, GE Healthcare, Imaging Dynamics, IDX, Merge-eFilm, Philips Medical Systems, Siemens Medical Systems, SmartPACS, Sorna Corporation, and Talk Technology.