The proposed interoperability of Defense Department and Veterans Affairs Department electronic medical records will not solve one important challenge facing the military health care system: integrating purchased care — provided outside the military health system — and direct care.
“There will be difficulties in integrating purchased care and direct care so long as much of the outside purchased care is not using electronic medical records,” said Dr. David Walker, chair of pathology, University of Texas Medical Branch at Galveston and a member of the Defense Health Board.
Walker spoke at a DHB meeting in Washington Dec. 11. DHB is a federal advisory committee to the Secretary of Defense, the surgeons general and the assistant secretary of Defense for health affairs.
“This is probably an issue too big for DOD to resolve,” Walker said. “But it will be harder to get [purchased] care fully integrated, if they're not on the same information systems or at least interoperable information systems.” He said the private sector would ultimately have to solve this problem.
Walker’s comments came in response to a report by the Task Force on the Future of Military Health Care, a DHB subcommittee. The task force issued several recommendations for improving military health care. The first and overarching recommendation was to develop a strategy for integrating direct and purchased care.
“We understand the need for having flexibility and the desire for optimizing the delivery of health care to all DOD beneficiaries,” said Gail Wilensky, the task force co-chair, “and we think that it will be very difficult to have this function well without better integration at the local level where care is actually provided.”
The board also took up the question of providing better mental health care to service personnel. Ellen Embrey, deputy assistant secretary for force self- protection medical readiness, noted that DOD will be implementing an electronic mental health record as part of its overall health system record, “so it will be accessible to primary-care providers.”
From the battlefield to the home front: Managing medical data
Government Health IT presents Col. Claude Hines Jr., program manager for the Defense Health Information Management System, in this recent InSight eSeminar. Col. Hines discusses the health information technology and tactical challenges faced by the military medical community in Iraq, Afghanistan and other areas of conflict. In doing so, he describes the current information technology solutions for transferring clinical data between battlefield care givers to health care personnel at military treatment facilities worldwide.
