Complaints about AHLTA"the U.S.military's health information system"are not uncommon, a fact that is not lost on one of the Pentagon's key health IT executives.
"Many people hate AHLTA," acknowledged Col. Claude Hines, the program manager at the Defense Health Information Management System (DHIMS), a unit of the Military Health System, during a presentation at MHS's annual conference in January.
That is why Hines presented a laundry list of improvements he intends to make to AHLTA over the next year.
Hines blamed many of AHLTA's problems on outmoded technologies. The Clinical Data Repository (CDR), for example, where health data is stored to be called up by the AHLTA application, was designed in 1999.
"That may have been the best way to do it then, but there are certainly some things we can do differently now," said Hines. "Sometimes it takes us six years to implement new technology but in the meantime technology has turned over three times."
In October 2009, MHS awarded a contract to Evolvent Technologies Inc. to stabilize the CDR and correct problems reported by the military healthcare community.
Another example of the antiquated technology at work involves the relationship between AHLTA and the Composite Healthcare System (CHCS), a predecessor to AHLTA which is still relied upon to store some AHLTA data and perform some of its functions. DHIMS is pursuing a strategy to consolidate the two systems.
"Even though you may not like everything about AHLTA, we are working to make it a system you can be proud of" maybe," Hines quipped.
Hines discussed several other AHLTA improvement initiatives on his agenda:
"¢ A neuro-cognitive assessment tool designed to quickly evaluate warfighters for traumatic brain injury;
"¢ The Health Artifact and Image Management Solution (HAIMS), which will enable a worldwide view of patient x-rays;
"¢ A disability case-management evaluation system, which would bring together medical, personnel, and benefits data to facilitate disability evaluations;
"¢ A universal immunization tracking tool which would disseminate immunization records to all military medical systems and prevent re-inoculation of service members;
"¢ A secure behavioral health record, which would restrict access to information on patient mental healthcare; and
"¢ A tool which would automate the process of consolidating and eliminating duplicate patient records.
Hines also plans on introducing a new graphical user interface (GUI) for AHLTA some time this year. "What makes VistA good?" he asked, referring to the Veterans Health Administration electronic health record. "It's that the GUI makes it look like its all one system."
MHS intends to do the same for AHLTA. "There will be a single sign-on," Hines said. "When you enter the patient name you will pull up the history in all systems," including inpatient and outpatient encounters.
Hines also intends to proceed with AHLTA virtualization, which would centralize processing and administration while delivering application functionality over the network.
"This will simplify the deployment of updates and make them a lot quicker," said Hines.
Also on the drawing board is the initiation of new development and testing environment to improve the performance of AHLTA upgrades and to promote compatibility with healthcare practices on base and in areas of military operations.
All the enhancements planned for AHLTA reflects the fact that there is plenty of room for improvement. "As long as you are not complaining about the same things you were last year," Hines told conference participants, "I know I am doing my job making improvements."
