The Army is planning to upgrade its electronic medical record system to ensure soldiers wounded on the battlefield will have detailed permanent accounts of the scenario and treatment received.
A new suite of the Medical Communications for Combat Casualty Care, commonly known as the MC4 system, is being fielded through April, according to a U.S. Army news release.
"What's important for soldiers to know about the upgrade is that they will continue to receive improved documentation of their care," said Lt. Col. Keith Harley, assistant product manager for MC4, during a bloggers roundtable, Feb. 26. "And that gives reassurance to them when they leave the Army and are filing a claim with the Veterans Administration that their care has been documented."
[See also: Q&A: Telemedicine in the Theater of War.]
The most significant change MC4 customers will notice, officials say, is an upgraded operating system, EMR 2.2.0.0. With the upgraded system, each MC4 standalone system and server will require public key infrastructure -- equipment, or PKI-E certificates. The PKI-E certificates will enhance security and assure the integrity of information transmitted through networks, according to officials.
The MC4 update also includes an improvement to patient safety as it relates to allergies and medication history.
"When that laptop is connected to the Internet, the documentation becomes available to any provider in the world with access to the system," Harley added. "In theater, we capture data in a repository known as the theater medical data store. That allows all information to be available to providers anywhere in the treatment of that soldier from the time of point-of-injury all the way to the time he's evacuated to places like Walter Reed or San Antonio."
Harley said eventually all medical information moves to a clinical data repository that contains all medical care from the time a soldier enters the service until discharged from the Army.
[See also: Military CIOs give frank talk about EHRs.]
Mark Gregory, who serves as MC4 technical management division director, said in a statement there weren't a lot of functional changes with the system because it was running Windows XP before upgrading to the Windows 7 platform and moving from Windows Server 2003 to Windows Server 2008.
"That was the major change from an engineering standpoint, making sure we had a secure system that meets information assurance requirements out on the battlefield," Gregory added, "Again it goes back to an engineering issue because when you change operating systems, there's a lot of work that has to be done. The most significant upgrade outside of the MC4 operating system was the GUI (graphic user interface)."
Beyond the technical changes that we made, there's also a certain amount of functional changes that happen within the software, whether it's the inpatient module, outpatient module, the medical supply ordering," said technical advisor Jeannie Winchester, MC4 information assurance manager, in the news release. "The user wants to see changes, new functions, new features. Maybe something is outdated and needs to go away, so there are always those types of changes as well."
The new MC4 software was tested by Army medical personnel last year.
MC4 has become the most widely used, comprehensive information management medical system on the battlefield, Harley said, adding that the system has enabled the capture of nearly 22 million electronic patient encounters since it was first established by presidential and congressional mandate for all the services in 2003.
More than 500 active, National Guard and Army Reserve deployable medical units use the MC4 system in 16 countries, according to Army officials. Combat medics or physician assistants record the scenario under which a soldier was injured along with the treatment and patient care via a hand-held device which encrypts all information.
"After the patient is stabilized, the soldier and medic move to the next level, such as combat support hospitals," Harley said. "The entire record is uploaded to an encrypted MC4 laptop to maintain privacy."
Once in a medical treatment facility, providers can use the MC4 system to document inpatient or outpatient care, facilitate laboratory and radiology services and pharmacy orders or medical supplies.
