MHS CIO Report
MMT 2010 Volume: 14 Issue: 4 (June)
Charles M. Campbell
Military Health System
Chief Information Officer
While innovative technology pops up in developing nations around the world, most American hospitals are still relying on information sharing technology from the 1980s.
Less than 1.5 percent of U.S.-based hospitals use a comprehensive electronic health record, according to the March 2009 issue of The New England Journal of Medicine. For decades, the Military Health System has relied on some form of an electronic health record to track and share health data with providers.
In contrast to our private industry counterparts, whose patients may only see a handful of providers throughout their lives, MHS has highly mobile patients and providers that are scattered across the world. My organization is dedicated to ensuring we are providing the right information, at the right time, to those who need it. We continue to do this by being innovative in our thinking, partnering with our federal, academic, private and contract partners, and taking our lessons learned and applying those to new innovations.
In 2004, we deployed a comprehensive EHR to better serve our now 9.6 million beneficiaries. The systems that make up our EHR serve our patients whether they are deployed to a hostile environment, stateside or transitioning to veteran status.
As a pioneer of EHRs, MHS didn’t have the benefit of learning from others, so we had to be innovative and learn as we went. We would like to share some of the lessons we learned to help others
First, an EHR has to easily incorporate into the current workflow, including everything from registration to nursing notes, clinical encounters and laboratory results. A system that meets your current workflow also needs to be usable in order to easily ensure computable data gets into patients’ medical records. This easily manipulated data helps the health care provider access information they need, when they need it, to provide the best possible care.
Another key component includes effective testing. In the MHS, testing environments that mimic the real world are vital to ensuring the system meets the needs of providers around the world without stopping care to try it out.
The hardware used to run an EHR is just as important as the software that is selected. Not only should testing the software repeatedly be a component, but anyone who will use the software solution should also test the ergonomics of the hardware it will run on. For example, nurses may want a laptop on a cart to be able to move from room to room, while physicians may want a wireless tablet to emulate paper charting.
The bottom line is that an EHR that is simple and intuitive to use will promote quick adoption and deliver immediate benefits. The goal of any EHR adoption is to leverage modern technologies for greater clinical efficiency, higher quality and safer delivery of care.
All of the right software and hardware will do nothing if your team isn’t properly trained. We learned in MHS that maximum success and rapid adoption are achievable with a hybrid mix of classroom, one-on-one, ‘over-the-shoulder’ and computer-based training.
Nothing is more effective than empowering staff from the beginning, so you achieve “buy in” and a desire for change. When users have a voice in what is acquired and how it is deployed, they are empowered and often support the decisions because they are part of it, instead having it forced upon them. For decades, the military and Department of Veterans Affairs have been using EHRs in some form. We keep our focus centered on the impact EHRs make to ultimately benefit both patients and clinicians in achieving the best treatment decisions and health care outcomes. The current military EHR is a system of systems in which health care providers are capturing vast amounts of computable data daily. This computable data is captured from the battlefield to the home front and is usable in austere environments around the world.
Over time, the Nationwide Health Information Network will evolve as the common thread in EHRs. As the NHIN, what I see as the next generation in our EHR evolution, develops, all health care organizations with EHRs will connect into this secure network. Through NHIN, the country will be able to meet the health care goals set forth by President Obama and his administration.
We are so passionate about sharing our EHR lessons learned that Defense Health Services Systems’ Navy Captain Michael Weiner has been blogging on the MHS Website, www.health.mil/ blog. There, he goes into more detail over a 10 week series. Please feel free to visit the blog and submit feedback or questions.
Visit health.mil to learn more about the Military Health System or the CIO’s efforts. ♦
Charles M. Campbell is the chief information officer for the Military Health System. Please direct any questions to director, MHS OCIO Communications, Karen Roberts at 703-681-8836.