Gateway to Medical Information for Deployed Forces

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Gateway to Medical Information for Deployed Forces
LTC William E. Geesey Product Manager, MC4
301-619-7858 William.Geesey_at_us.army.mil www.mc4.a
rmy.mil Date April 16, 2009
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Agenda

• Why MC4 exists
• What MC4 does
• How MC4 works
• Who benefits from MC4
• MC4s impact
• Way ahead
• Summary
• More information/QA

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Medical Information Management During Persian
Gulf War (1990-91)

• No electronic medical record systems available
• Fixed facilities paper records
• Tactical medical units no documentation
• IM systems were available to fixed facilities
  but,
• Software did not address health care
  documentation
• Software captured portions of healthcare (e.g.,
  lab results) often not included in patients
  health care record
• Facilities were independent and not networked
• IM systems were not available to tactical medical
  units
• Laptop computers emerging at that time
• Operating systems differed from main frames
  software not compatible

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Consequences of Lack of Healthcare Documentation

• Gulf War Veterans Illness
• Could not do scientific studies to rule out/
  rule in vaccines/drugs as
  potential cause
• Congressional testimonies
• Less than optimal healthcare
• Exploratory surgery
• Repeated tests, procedures/vaccinations
• Difficulties getting benefits from VA
• Incomplete medical picture for tactical
  commanders
• Inefficient management of medical supplies

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Why MC4 Exists
For the Soldier
Special Report of the Presidential Advisory
Committee on Gulf War Veterans' Illness, the
President Directed Every Soldier, Sailor,
Airman and Marine will have a comprehensive,
life-long medical record of all illnesses and
injuries they suffer, the care and inoculations
they receive and their exposure to different
hazards.
1997
TITLE 10 Section 1074f Medical tracking system
for members deployed overseas The Secretary of
Defense shall establish a system to assess the
medical condition of members of the armed forces
(including members of the reserve components) who
are deployed
1997
MC4 PMO chartered to address TMIP-Army and
emerging telemedicine requirements
1999
President Barack H. Obama To improve the quality
of our healthcare while lowering its costs, we
will make the immediate investments necessary to
ensure that within five years, all of America's
medical records are computerized. This will cut
waste, eliminate red tape and reduce the need to
repeat expensive medical tests. (January 2009)
2009
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Mission

• Medical Communications for Combat Casualty Care
  (MC4) integrates, fields and supports a
  comprehensive medical information system,
  enabling lifelong electronic medical records,
  streamlined medical logistics and enhanced
  situational awareness for Army tactical forces.

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What MC4 does
Slide 8
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Current System Capabilities

• Electronic Outpatient Medical Record AHLTA-T,
  AHLTA-Mobile
• Electronic Inpatient Documentation TMIP CHCS
  Cache (TC2)
• Laboratory, Radiology, and Pharmacy TMIP CHCS
  Cache (TC2)
• Retrieval of Previous Records TMDS, AHLTA
  Warrior
• Post Deployment Health Assessment (PDHA) ePDHA,
  Pocket PDHA
• Trauma Performance Improvement Database JTTR
• Patient Tracking TRAC2ES, TMDS
• Medical Logistics DCAM
• Medical References MICROMEDEX, MEDIC and more
• Medical Surveillance and Annex Q Reports JMeWS
  (via SIPRNET)

Slide 9
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MC4 Hardware

• Seven different hardware configurations approved
  by Army Medical Department Center School
• Approved configurations tailored to unit mission
• MC4 adjusts equipping levels dependent upon
  Theater Mission
• Hardware includes
• Servers
• Laptops
• Handhelds
• Printers
• Peripherals

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Training Technical Support

• Region Support Offices train and support
  deployable units
• CONUS - Ft. Bragg, Ft. Hood, Ft. Lewis
• OCONUS - Germany South Korea
• Helpdesk for worldwide assistance (24/7)
• 34,000 trained
• 28,000 systems fielded

• MC4 Technical Support Teams (OIF/OEF) provide
  support for 250 combat and medical units
• Army, Air Force, Navy Special Forces users in
  14 countries, including U.S.
• Iraq
• Kuwait
• Afghanistan
• Qatar

• Saudi Arabia
• Turkmenistan
• Kyrgyzstan
• UAE

Black MC4 core program funded
Red GWOT or unfunded
Slide 11
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How MC4 Fits Into the Big Picture
SUSTAINING BASE
THEATER
Accession
First Responder
Deployment
Training
Forward Resuscitative Surgery
CONUS Database
Theater Database
Enroute Care
Theater Hospitalization
Care Outside Theater
VA Care
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Who Benefits from MC4

• Deployed Medical Providers
• Quick, accurate access to patient histories and
  forward casualty resuscitation information
• Automation tools facilitating
• patient tracking
• medical reporting
• medical logistics support
• Combatant Commanders
• Medical surveillance information
• Theater-wide trend analysis capabilities
• Enhanced medical situational awareness
• Most importantly Service members
• Secure, accessible, lifelong electronic medical
  records
• Better-informed healthcare providers
• Easier access to VA medical benefits
• Peace of mind

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MC4 Impact

• 2008 - SPC John Doe visited Martin Army Community
  Hospital, Fort Benning, Ga. with leg pain
• Warrior transition unit case manager/nurse
  evaluated SPC Doe
• Nurse reviewed medical history on computer,
  accessing Soldiers battlefield medical records
  originally recorded via MC4 systems
• Case manager asked Soldier about his traumatic
  brain injury (TBI) and care received in theater
  and at Landstuhl Regional Medical Center
• SPC Doe did not recall injury or treatments
• Without access to this individuals electronic
  medical record, we would have never known about
  the previous blast injury, nurse said. The
  medical staff would have treated the leg injury
  and the Soldier would have walked out the door.
  Chances are, he would have never received the
  critical care he needed. The data captured by
  medical personnel in theater prevented him from
  slipping through the cracks here in the states.

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MC4s Way Ahead

• Enhance customer support
• Improve system application training
• Strengthen system support
• Facilitate best practices
• Manage system changes dynamically
• Rapidly implement new technologies(virtualization
  , thin clients, remote maintenance, mobile
  hardware, wireless)
• Implement CMMI LSS
• Broaden use of MC4 system
• Diversify system responsibilities

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Summary

• The MC4 System is fielded and operational in
  Theater
• MC4 is the most comprehensive IM/IT medical
  system on the battlefield
• Nearly 10 million electronic patient encounters
  captured using MC4 and stored in the DoD central
  data repository
• Industry will continue to help us meet new and
  emerging challenges
• Questions?

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More Information on the Web
Public Web site www.mc4.army.mil MC4 Program
Mission Overview News Background
Information Photos Videos
Users Monthly Newsletter The
Gateway www.mc4.army.mil/mc4newsletter System
Updates Unit User Stories from the Field System
Tips FAQs
Users Web site MC4 Helpdesk www.mc4.army.mil/he
lp Tips software downloads Get MC4 training and
support Technical information Give MC4 feedback
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