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Army Kicks Paper Records to the Curb
Wednesday, July 23, 2008
Army Kicks Paper Records to the Curb
With wounded warriors being shuttled from the battlefield to hospital rooms and back to their homes, the Military Health System has some very unique challenges to overcome in providing quality care for its injured patients. Thankfully, some new technologies implemented in Afghanistan and Iraq have ushered in an era of unprecedented continuity of military medical care. Now, in-theater medicine has never been more effective, both for patients and care-givers alike, thanks to the Army’s MC4 system—Medical Communications for Combat Casualty Care.
As recently as the first Gulf War, medical records were stored on paper. It was not uncommon for injured service members to travel with paperwork from the battlefield to stateside medical facilities.
“Oftentimes what would happen is that at the end of the patient visit, the patient would be handed the paper copy [of their medical encounter] and told to make sure you match this up with your medical record,” said Col. William B. Grimes, who commanded the Multifunctional Medical Battalion in Iraq. “And often what would happen is that paper would get lost in transit. The service member who receives health care would try their best to make sure it got matched to their medical records, but oftentimes it would just get lost.”
MC4 has changed things by capitalizing on the proliferation of computer networking and increasing portability of powerful computers. Through the exclusive use of MC4 laptops, handheld computers, and portable servers, the military now enjoys purely electronic medical record-keeping in the field.
“[MC4] completely replaces the paper,” said Grimes. “Paper is available in case the system goes down, but we had one clinic set up that was completely paperless. And this was in Iraq, in Taji…completely paperless.”
Those versed in military medical-speak will recognize MC4’s primary software: AHLTA-Tactical. AHLTA is a worldwide electronic health record (EHR) application that records outpatient military patient information across each service. Medical records captured in AHLTA can be accessed from every military medical facility so military doctors will always have a patient’s complete medical record, from Afghanistan all the way to Atlanta, and can update that record in real time. That means that records made in MC4 in theater, become part of a service member’s permanent EHR.
The benefits are numerous. For one, the patient doesn’t have to keep track of anything on his own.
“It provides an advantage for the military personnel because they can focus on getting better, not worrying about their records,” said Lt. Mary Miller, who cares for wounded soldiers in the Intermediate Care Ward at the 325th Combat Support Hospital in Al Asad, Iraq. “They’re traveling from one facility to the next depending on where they are stationed. And so that’s one less thing that they have to worry about.”
In addition, things are made easier for doctors and other care providers.
“The soldier can get wounded anywhere and the information is electronically transmitted from our forward surgical team,” said Col. Kelly Wolgast, whose 14th Combat Support Hospital cared for troops in Afghanistan.
Wolgast was one of the first providers to employ MC4 in Operation Enduring Freedom (OEF), using it during humanitarian relief efforts in New Orleans after Hurricane Katrina. After that experience she was happy to bring it to Afghanistan, where she discovered MC4’s awesome power to prepare combat zone doctors for incoming patients before they arrive at a treatment facility.
“We knew in Afghanistan exactly when those soldiers arrived because they were logged into the system…and we already knew what had happened when they got there,” Wolgast said. “[MC4] has certainly shortened the time to care and increased our survival rates—period.”
Enhanced trauma care is only one part of MC4’s total benefit. The system continues to be a boon to military health care back home, for service members who have returned from deployment.
Grimes recalls the dilemma and controversy over Gulf War Syndrome in the 1990s, where veterans of the Gulf War began suffering symptoms that doctors couldn’t positively link to their experiences in theater.
“That was a huge issue where a lot of the symptoms and other illnesses that the service members were exposed to weren’t really documented anywhere,” Grimes explained. “So there were lots of questions about what actually happened and what these soldiers presented to the clinics.”
Since medics on the battlefield can use MC4 computers and handhelds to document patient encounters from the point of injury, and since that data is constantly updated through their treatment process, Grimes says there will be no question about what a service member returned from Iraq or Afghanistan has been exposed to and what they were treated for.
“In a nutshell, MC4 has prevented another Gulf War Syndrome from happening,” Grimes said
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