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Witness Testimony of Colonel Gregory Andre Marinkovich, M.D., Clinical Information Technology Program Office, Military Health System, Data Management Product Line Functional Manager, Medical Services, Corps, Department of the Army, U.S. Department of Defense

Introduction

Mr. Chairman and members of this distinguished Subcommittee, thank you for inviting me to be here today.  I am COL Gregory Andre Marinkovich and I serve as the Data Management Product Line Functional Manager in the Clinical Information Technology Program Office within the Military Health System (MHS). Thank you for this opportunity to talk about the military’s electronic health record, AHLTA, and the strides we are making in sharing information between the Department of Defense and the Department of Veterans Affairs.

Historical Overview

AHLTA, an enterprise-wide medical and dental outpatient clinical information system, is the military’s current outpatient Electronic Health Record (EHR).  It generates, stores, and provides secure online access to life-long patient healthcare records for more than 9.1 million MHS beneficiaries seen in military treatment facilities.  AHLTA ensures the continuity of the Department’s health information and patient-centered healthcare delivery with worldwide accessibility anytime, anywhere.

Worldwide deployment of AHLTA, which began January 2004, was successfully completed to all DoD military treatment facilities worldwide in November 2006.  Implementation support activities spanned 11 time zones and included training for over 55,000 users, to include more than 18,000 health care providers.  Current AHLTA functionality includes encounter documentation, order entry/results retrieval, encounter coding support, alerts and reminders, role-based security, health data dictionary, master patient index, and ad hoc query capability.

Current Activities

AHLTA use continues to grow at a significant pace. 

  • To date, AHLTA has processed over 45 million outpatient encounters.

  • AHLTA is currently processing approximately 112,000 outpatient encounters per workday.

DoD and VA also are taking the first steps towards a joint electronic health record system.  A contract to assess VA’s and DoD’s business and clinical processes, design features, and system constraints relevant to the inpatient component of an electronic health record has been awarded.  This assessment will determine and describe, in narrative and graphic format, the scope and elements of a joint inpatient electronic health record and identify those clinical and business capabilities and applications that interact with the joint inpatient electronic health record.  An analysis of alternatives will then be conducted to develop a recommendation for the best technical approach.  We will implement the solution in a manner that builds in data interoperability. 

Future Activities

Based on feedback from several AHLTA user conferences, we are making changes to the next version that will be more provider-friendly. This is scheduled to be released in December 2007.  Enhancements that are scheduled to begin deployment in December 2007 will include the ability for patients to provide their signatures electronically for medical forms, and multi-site user account access, which will enable “mobile” providers to use AHLTA from multiple locations.

Looking ahead to 2008, we plan to begin worldwide deployment of dental charting and documentation, and eyeglass ordering and management.

Conclusion

I would like to conclude by saying that one of our top priorities is to continue finding ways for AHLTA to seamlessly transfer information between DoD and VA, thereby ensuring continuity of quality care for returning wounded warriors.  With your support, we will continue building on our achievements in sharing electronic health information in support of the men and women who serve and have served this country. 

Mr. Chairman, Committee Members, thank you again for this opportunity to speak about our efforts.  At this time I would be pleased to answer any questions you may have.