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Witness Testimony of Lieutenant Commander James Lawrence Martin, Medical Service Corps, Department of the Navy, Regional Information Systems Officer, Navy Medicine East, U.S. Department of Defense

Mr. Chairman and members of this distinguished Subcommittee, thank you for inviting me to be here today.   I am LCDR James L. Martin and I serve as the Regional Information Systems Officer, Navy Medicine East.

Thank you for this opportunity to talk about my personal involvement in the design and implementation of the Composite Healthcare System (CHCS), CHCS II, AHLTA and the Electronic Medical Record Sharing between the Department of Defense and the Department of Veterans Affairs.

Status of Electronic Medical Record Sharing Naval Health Clinic Great Lakes

The present method of sharing electronic medical information at Naval Health Clinic, Great Lakes, is through the Bi-Directional Health Information Exchange (BHIE) and the Clinical Data Repository/Health Data Repository (CHDR).  The Veterans Affairs providers are granted read only access to the Department of Defense (DoD) Composite Health Care System (CHCS) and AHLTA.  The Department of Defense (DoD) Providers are granted read and write privileges to the Veterans Affairs Computerized Patient Record System (CPRS) which resides on the Veterans Health Information Systems and Technology Architecture (VistA).

Specifically, access to the Composite Health Care System, AHLTA and the Computerized Patient Record System in North Chicago is achieved through a single end user device with icons on the desk top representing each of these applications.  This allows for seamless patient flow from the Recruit Processing Center Clinic at Recruit Training Center, Great Lakes to the Emergency Room and Inpatient Facility at North Chicago Veterans Affairs Medical Center.  Laboratory Data Sharing Interoperability (LDSI) is used to share Laboratory information between these two systems.  The combination of these methods listed above allows complete sharing of all Clinical Information between the Veterans Affairs and Department of Defense Providers.

Regional Information Systems Officer Involvement in this process

My personal involvement in this process dates back to 1992 when I assisted in the design and implementation of the Infrastructure and End User Device placement in support of Composite Health Care System (CHCS Legacy) while serving as Assistant Department Head, Naval Medical Information Management Center, Bethesda.  My involvement included personally visiting each Naval Healthcare Treatment Facility prior to and during system implementation.

Thereafter, my role expanded in 1994 as the Head, Management Information Department, Naval Hospital Pensacola, where I managed the Composite Health Care System Host Site for the Hospital and its remote facilities.  In 1997, while serving as the Tricare Region II Regional Information Systems Officer, Naval Medical Center Portsmouth, one of our Commands was selected to be the Test Site for Composite Health Care System II, the predecessor to AHLTA.  From 2000 to 2004, I was the Information Systems Officer at Naval Medical Center Portsmouth overseeing the testing and implementation of the Composite Health Care System II.  It was during this tour that Naval Medical Center Portsmouth first populated the Clinical Data Repository (CDR) with a twenty five month data pull from Composite Health Care System (Legacy CHCS) placing demographic information and Laboratory, Pharmacy and Radiology results in the Clinical Data Repository.  From 2004 until 2006 I served as the Medical Liaison Officer, Space and Naval Warfare Systems Center, Norfolk, where I was in charge of the design and testing of the Theater Medical Information Program-Maritime (TMIP-M) the Navy Operational Version of Composite Health Care System II and AHLTA designated CHCS II-T and AHLTA-T.

Currently, as the Regional Information Systems Officer for Navy Medicine East, I oversee all Information Management and Technology for the Navy Military Healthcare Facilities that fall under Navy Medicine East. Naval Health Clinic Great Lakes is one of these Commands.

I have made five site visits in direct support of the DoD/VA initiative at Great Lakes.  During these visits I have surveyed the existing facilities and assisted in planning of the relocation of the IM/IT equipment to its new location at the Federal Healthcare Clinic.  I attend bi-weekly conference calls and engineering support meetings where the design and layout of the actual IM/IT spaces is discussed.

The other Commands under Navy Medicine East that I am presently assisting with DoD/VA IM/IT initiatives include Naval Health Clinic Charleston, Naval Hospital Pensacola, Naval Hospital Jacksonville and Naval Medical Center Portsmouth.  I am also a member of the National Information Management and Technology Task Group for the Department of Defense and Department of Veterans Affairs Electronic Health Information Sharing Initiative.  My responsibility as a member of this task force is to plan and oversee the acquisition and implementation of information systems that integrate VA and DoD health care processes at the North Chicago Federal Healthcare Clinic.

Future Activities

Our goal is to have an interoperable information system that supports clinical and business operations by June 2010.  We plan to create a single (main) computer room and a single (main) telecommunications room.  Additionally, an Information Management and Information Technology Network Trust between DoD and VA must be established, along with domain ownership and a single electronic email system.

We are presently gathering requirements from the functional users so that the determination can be made on whether a combination of information systems or a new information system is required to meet the functional user requirements.  The ultimate goal is to have a single point of entry to support the missions of both DoD and VA patient populations.  At present, this goal is met by providing access to CHCS, AHLTA and CPRS using multiple icons on a single end user device.  

In addition to the goal of a single point of entry we are also working on the consolidation of IM/IT systems for all of the functional areas in the Federal Healthcare Clinic. This involves managing the development of functional requirements, assisting with local site integration efforts, assisting with enterprise solutions and communicating the status.     

Conclusion

I would like to conclude by saying that one of our top priorities is to continue finding ways for Electronic Medical Data Sharing between DoD and VA.

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.