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Witness Testimony of Brigadier General Douglas J. Robb, M.D., Keesler Air Force Base, Biloxi, MS, Commander, 81st Medical Group, Department of the Air Force, U.S. Department of Defense

INTRODUCTION

Mr. Chairman and members of this distinguished Subcommittee, thank you for inviting me here today. I am Brigadier General Douglas J. Robb and I served as the Command Surgeon, United States Central Command from 2004 to 2007. Currently I am serving as the Keesler Medical Center Commander and as the Senior Market Manager, Gulf Coast Multi-Service Market Office, Keesler Air Force Base, Biloxi, Mississippi. Thank you for the opportunity to express my advocacy for a Healthcare Information Systems platform and electronic medical record that supports the world class quality healthcare that our military and Department of Veterans Affairs veterans healthcare facilities provide to our DoD and VA beneficiaries.

HISTORICAL OVERVIEW

In my previous assignment as the CENTCOM Surgeon, I had the opportunity to witness the evolution of our deployed healthcare information systems platforms that support access to patient care data, as our wounded warriors move through the continuum of care: from our combat casualty care life savers, to our forward surgical teams, to our theater hospitals, and then onto our definitive care facilities at Landstuhl, Walter Reed, Bethesda, Wilford Hall, and VA Polytrauma Centers.

On 16 March 2006, Spc. Channing Moss was severely injured in an attack in southeastern Afghanistan. The lifesaving care performed by the combat lifesavers in his unit and the subsequent surgical stabilization by the forward surgical team and the Bagram Theater Hospital saved his life. What was also lifesaving was the ability of the surgeons at Landstuhl Hospital, Germany, who would receive Spc. Moss less than 24 hours after his initial injury, and the surgeons at Walter Reed to be able to view his operative notes and x-rays, before the patient arrived at their hospitals. This was accomplished via the Joint Patient Tracking Application, part of the DoD’s deployed healthcare information systems platform.

Earlier that year, again in Afghanistan, a general surgeon and commander of one of the forward surgical teams, commented on his excitement when he was able to send completely digital trauma resuscitation and operative reports to the Bagram Combat Support Hospital, again before the patient arrived. This is something that had been his vision for our forward surgical teams for a long time. During his previous assignment, he had been a surgeon at Landstuhl, Germany, and was frustrated by the lack of medical data from the forward surgical teams’ initial surgical resuscitation.

CURRENT ACTIVITIES

In my current position as the Senior Market Manager, Gulf Coast Multi-Service Market Manager, through collaborative and joint DoD and VA initiatives, we are entrusted with the in-garrison care of our DoD and VA beneficiaries. In this capacity, we also require a healthcare information system platform that supports access to real-time patient care data for our shared patient population. Our patients from the Gulf Coast Multi-Service Market are treated in DoD and VA hospitals and clinics that are often located in close proximity anywhere from Biloxi, to Pensacola, and continuing along the Florida Panhandle to Panama City. Our goal is provide quality services in a seamless manner. This requires an integrated healthcare information systems platform that is user friendly for our jointly operating DoD and VA healthcare facilities.  Significant progress has been made in the past few years to bridge the gap of electronic information flow.  Just last month, our staffs were excited when the bi-directional health information (BDHI) system became available at some of our facilities. Although not at its full capability yet, it is a very positive step in the right direction in our ability to view patient care data from both VA and DoD facilities.

  CONCLUSION

In conclusion, as a former Combatant Command Surgeon and currently as the Senior Market Manager for the Gulf Coast Multi-Service Market Office, I continue to be a strong advocate for a healthcare information systems platform and electronic medical record that provides real time access to patient care data for our DoD and VA beneficiaries, heroes like Spc. Canning Moss, as they move through our deployed and garrison based continuum of care: combat casualty care, forward surgical resuscitation, in-theater hospitalization and finally our DoD and VA medical centers and clinics. The current capability has already proven itself in contributing to the quality of care for our beneficiaries. And with your support I believe we can continue to improve upon our already existing and evolving capability to further share and make available the full spectrum of electronic health information between the Department of Defense and the Department of Veterans Affairs. Mr. Chairman, Committee Members, thank you again for allowing me the opportunity to appear before you.