Difference between revisions of "Armed Forces Health Longitudinal Technology Application (AHLTA)"

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According to the Military Health System website, AHLTA seemingly had its birth in the State of the Union speech given by President George W. Bush in 2004, when he expressed a goal to have most Americans have their own electronic health record by 2014(http://www.ha.osd.mil/AHLTA/). The Department of Defense (DoD) set their target for the military for 2011. Others suggest the effort to build a military EMR began as far back as 1997, and the military has invested up to $20 billion to do so (http://www.motherjones.com/news/update/2008/09/another-walter-reed-scandal-medical-records.html). Many observers have questioned why the DoD chose to build their own system instead of adopting the VA system, VistA. User satisfaction with AHLTA is reportedly low (http://www.healthbeatblog.org/2008/09/ahlta-textbook.html), and there are ongoing attempts to address user issues.
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The '''Armed Forces Health Longitudinal Technology Application (AHLTA)''' is an [[EMR|electronic medical record]] used by the [[U.S. Department of Defense (DoD) Initiatives|Department of Defense (DoD)]].
  
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== History ==
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In 1997 President Bill Clinton issue directives to reinforced the need for a centralized, longitudinal patient record for military personnel and their beneficiaries accessible across the department of defense. AHLTA was born in the State of the Union speech given by President George W. Bush in 2004, when he expressed a goal to have most Americans have their own electronic health record by 2014. The Department of Defense (DoD) set their target for the military for 2011. It is estimated that the department of defense invested up to $20 billion in this project. AHLTA, previously known as the Composite Health Care System II, was developed by the Clinical Information Technology Program Office (CITPO), an acquisitions office for centrally managed Military Health System clinical information technology systems supporting the U.S. military. In 2008, CITPO was combined with the TMIP-J Program Office to form the Defense Health Information Management System, or DHIMS. It began worldwide deployment in January 2004 to treatment test pilot Military Treatment Facilities. Unique to AHLTA was the entry of more than 2 years of historical health information for each beneficiary upon the creation of their EHR. This information, transferred from legacy systems, facilitated continuity of care. Many observers have questioned why the DoD chose to build their own system instead of adopting the VA system, VistA. User satisfaction with AHLTA is reportedly low, and there are ongoing attempts to address user issues.
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(Staggers, Jennings and Lasome, 2010) concluded that “The study supports providers’ anecdotal information about usability issues: Limited use of AHLTA during patient encounters, difficulties achieving situational awareness, necessary work-arounds, and structured documentation” (p.523). <ref> Staggers, N., Jennings, B.M. & Lasome, C.E. (2010). A usability assessment of AHLTA in ambulatory clinics at a military medical center. Military Medicine; 175(7):518-24. </ref>
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On May 23, 2013, the Department of Defense (DoD) Secretary, Chuck Hagel announced that an assessment of other managements softwares would occur to replace the AHLTA. In additon, Hagel wanted to see that this primary priority should be in concert with Veteran’s Affairs (VA) in order to “develop data federation, presentation and enhanced operability” [5]. Hagel sought a competitive process to assess various replacement options. He acknowledges that although VistA is the primary legacy system for the VA, he believes the DoD requires a system that meets its specific needs, which are, to some degree different to the VA. [5]
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http://www.globalsecurity.org/military/library/budget/fy2009/dot-e/dod/2009ahlta.pdf
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http://www.usmedicine.com/2010-issues/june-2010/ahlta-record-defended-at-conference/
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http://www.health.mil/dhcs
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5. http://www.himss.org/News/NewsDetail.aspx?ItemNumber=18612
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== Features ==
  
 
AHLTA is both knowledgeable and proactive. Health care personnel receive wellness reminders for their patients.  The system also proactively provides critical information that alerts clinicians of possible medical outbreaks so that they may better prepare for these scenarios. Another important aspect that this product brought onto a worldwide scale was the ability to capture data on handheld devices in the battlefield.  It has also allowed the extremely mobile military force to have medical information available worldwide.
 
AHLTA is both knowledgeable and proactive. Health care personnel receive wellness reminders for their patients.  The system also proactively provides critical information that alerts clinicians of possible medical outbreaks so that they may better prepare for these scenarios. Another important aspect that this product brought onto a worldwide scale was the ability to capture data on handheld devices in the battlefield.  It has also allowed the extremely mobile military force to have medical information available worldwide.
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== CHCS: Composite health Care System ==
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The introduction of AHLTA, previously known as the Composite Health Care System II, marks a significant new era in health care for the MHS and the nation.CITPO began the implementation of AHLTA, the DoD's electronic health record (EHR), in January 2004. It is a "next generation" system that links the 481 Military Treatment Facilities (MTF) world-wide as well as service members deployed abroad to the EHR, ultimately supporting 9.2 million MHS beneficiaries. [http://en.wikipedia.org/wiki/Composite_Health_Care_System]
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== AHLTA 3.3 ==
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A major enhancement to Block 1, is the newest version of AHLTA. As with other releases, AHLTA 3.3 consolidates data into a single database and continues to support the delivery of advanced medical care in hospital and clinical settings worldwide. Completed in December 2008 and currently in deployment, AHLTA 3.3 offers software enhancements that focus on system performance and speed. It also features new modules that are key to providing service men and women, along with their beneficiaries, the finest health technology service in the world [http://dhims.health.mil/userSupport/ahlta/sysInfo.aspx]
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== AHLTA-T ==
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AHLTA-T enables deployable medical staff to digitally document and update outpatient care and simple inpatient hold capabilities for forward resuscitative medical units via an MC4 laptop. AHLTA-T may operate in a stand-alone or networked configuration. On an MC4 laptop or client-server environment, AHLTA-T will support documentation of clinical care regardless of network or Internet connectivity. Several laptops running AHLTA-T may be linked to form a local electronic health record (EHR) network. On an MC4 laptop, AHLTA-T’s store-and-forward capability enables medical data to be initially stored in a local database and, when Internet connectivity is available, forwards information to the Theater Medical Data Store (TMDS) and to the DOD’s Clinical Data Repository (CDR), accessible to authorized personnel worldwide. The MC4 program doesn’t create the software. Instead, the MC4 system is comprised of joint software, commercial and government-off-the-shelf products, including Theater Medical Information Program-Joint (TMIP-J) applications provided by Deployment & Readiness Systems (D&RS) Program Management Office of the Defense Health Clinical Systems (DHCS), formerly Defense Health Information Management System (DHIMS). <ref name=”AHLTA-T - 2015”>The Gateway Army Tactical Health Information System Resource. http://www.mc4.army.mil/apps/AHLTA-T</ref>
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== AHLTA-Mobile ==
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As the first responder's hand-held data application, AHLTA-Mobile enables users to immediately document injury, illness and care at the point of injury. It stores medical data until it can be transferred to AHLTA-T. Once AHLTA-Mobile encounters are signed and synchronized with AHLTA-T, information is distributed to the Medical Situational Awareness in the Theater (MSAT) application for medical surveillance, as well as to the Theater Medical Data Store (TMDS) where the data becomes part of a patient's longitudinal electronic health record (EHR).  The MC4 program doesn’t create the software. Instead, the MC4 system is comprised of joint software, commercial and government-off-the-shelf products, including Theater Medical Information Program-Joint (TMIP-J) applications provided by Deployment & Readiness Systems (D&RS) Program Management Office of the Defense Health Clinical Systems (DHCS), formerly Defense Health Information Management System (DHIMS). <ref name=”AHLTA-Mobile - 2015”>The Gateway Army Tactical Health Information System Resource. http://www.mc4.army.mil/apps/AHLTA-Mobile </ref>
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== AHLTA Warrior /AVHE ==
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AHLTA Warrior / Application Virtualization Hosting Environment (AVHE) provides military health care providers read-only access to patients' comprehensive electronic health record (EHR) from all points of care, whether worldwide, stateside or a military theater of operations.  AHLTA Warrior / AVHE utilizes the familiar AHLTA display to view relevant data, including patient demographics, laboratory results, radiology reports, medication and allergy lists, and clinical encounters. Additionally, AHLTA Warrior / AVHE allows theater-based health care providers to view patient's clinical data via the AHLTA Clinical Data Repository (CDR) and provides health history from garrison back to the theater environment.  The MC4 program doesn’t create the software. Instead, the MC4 system is comprised of joint software, commercial and government-off-the-shelf products, including Theater Medical Information Program-Joint (TMIP-J) applications provided by Deployment & Readiness Systems (D&RS) Program Management Office of the Defense Health Clinical Systems (DHCS), formerly Defense Health Information Management System (DHIMS). <ref name=”AHLTA Warrior/AVHE - 2015”>The Gateway Army Tactical Health Information System Resource. http://www.mc4.army.mil/apps/AHLTA_Warrior_AVHE </ref>
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[[Category: EHR]]
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[[Category: UT-SHIS SP09]]
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==References==
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<references/>

Latest revision as of 19:17, 9 September 2015

The Armed Forces Health Longitudinal Technology Application (AHLTA) is an electronic medical record used by the Department of Defense (DoD).

History

In 1997 President Bill Clinton issue directives to reinforced the need for a centralized, longitudinal patient record for military personnel and their beneficiaries accessible across the department of defense. AHLTA was born in the State of the Union speech given by President George W. Bush in 2004, when he expressed a goal to have most Americans have their own electronic health record by 2014. The Department of Defense (DoD) set their target for the military for 2011. It is estimated that the department of defense invested up to $20 billion in this project. AHLTA, previously known as the Composite Health Care System II, was developed by the Clinical Information Technology Program Office (CITPO), an acquisitions office for centrally managed Military Health System clinical information technology systems supporting the U.S. military. In 2008, CITPO was combined with the TMIP-J Program Office to form the Defense Health Information Management System, or DHIMS. It began worldwide deployment in January 2004 to treatment test pilot Military Treatment Facilities. Unique to AHLTA was the entry of more than 2 years of historical health information for each beneficiary upon the creation of their EHR. This information, transferred from legacy systems, facilitated continuity of care. Many observers have questioned why the DoD chose to build their own system instead of adopting the VA system, VistA. User satisfaction with AHLTA is reportedly low, and there are ongoing attempts to address user issues.

(Staggers, Jennings and Lasome, 2010) concluded that “The study supports providers’ anecdotal information about usability issues: Limited use of AHLTA during patient encounters, difficulties achieving situational awareness, necessary work-arounds, and structured documentation” (p.523). [1]

On May 23, 2013, the Department of Defense (DoD) Secretary, Chuck Hagel announced that an assessment of other managements softwares would occur to replace the AHLTA. In additon, Hagel wanted to see that this primary priority should be in concert with Veteran’s Affairs (VA) in order to “develop data federation, presentation and enhanced operability” [5]. Hagel sought a competitive process to assess various replacement options. He acknowledges that although VistA is the primary legacy system for the VA, he believes the DoD requires a system that meets its specific needs, which are, to some degree different to the VA. [5]


http://www.globalsecurity.org/military/library/budget/fy2009/dot-e/dod/2009ahlta.pdf http://www.usmedicine.com/2010-issues/june-2010/ahlta-record-defended-at-conference/ http://www.health.mil/dhcs 5. http://www.himss.org/News/NewsDetail.aspx?ItemNumber=18612

Features

AHLTA is both knowledgeable and proactive. Health care personnel receive wellness reminders for their patients. The system also proactively provides critical information that alerts clinicians of possible medical outbreaks so that they may better prepare for these scenarios. Another important aspect that this product brought onto a worldwide scale was the ability to capture data on handheld devices in the battlefield. It has also allowed the extremely mobile military force to have medical information available worldwide.

CHCS: Composite health Care System

The introduction of AHLTA, previously known as the Composite Health Care System II, marks a significant new era in health care for the MHS and the nation.CITPO began the implementation of AHLTA, the DoD's electronic health record (EHR), in January 2004. It is a "next generation" system that links the 481 Military Treatment Facilities (MTF) world-wide as well as service members deployed abroad to the EHR, ultimately supporting 9.2 million MHS beneficiaries. [1]

AHLTA 3.3

A major enhancement to Block 1, is the newest version of AHLTA. As with other releases, AHLTA 3.3 consolidates data into a single database and continues to support the delivery of advanced medical care in hospital and clinical settings worldwide. Completed in December 2008 and currently in deployment, AHLTA 3.3 offers software enhancements that focus on system performance and speed. It also features new modules that are key to providing service men and women, along with their beneficiaries, the finest health technology service in the world [2]

AHLTA-T

AHLTA-T enables deployable medical staff to digitally document and update outpatient care and simple inpatient hold capabilities for forward resuscitative medical units via an MC4 laptop. AHLTA-T may operate in a stand-alone or networked configuration. On an MC4 laptop or client-server environment, AHLTA-T will support documentation of clinical care regardless of network or Internet connectivity. Several laptops running AHLTA-T may be linked to form a local electronic health record (EHR) network. On an MC4 laptop, AHLTA-T’s store-and-forward capability enables medical data to be initially stored in a local database and, when Internet connectivity is available, forwards information to the Theater Medical Data Store (TMDS) and to the DOD’s Clinical Data Repository (CDR), accessible to authorized personnel worldwide. The MC4 program doesn’t create the software. Instead, the MC4 system is comprised of joint software, commercial and government-off-the-shelf products, including Theater Medical Information Program-Joint (TMIP-J) applications provided by Deployment & Readiness Systems (D&RS) Program Management Office of the Defense Health Clinical Systems (DHCS), formerly Defense Health Information Management System (DHIMS). [2]

AHLTA-Mobile

As the first responder's hand-held data application, AHLTA-Mobile enables users to immediately document injury, illness and care at the point of injury. It stores medical data until it can be transferred to AHLTA-T. Once AHLTA-Mobile encounters are signed and synchronized with AHLTA-T, information is distributed to the Medical Situational Awareness in the Theater (MSAT) application for medical surveillance, as well as to the Theater Medical Data Store (TMDS) where the data becomes part of a patient's longitudinal electronic health record (EHR). The MC4 program doesn’t create the software. Instead, the MC4 system is comprised of joint software, commercial and government-off-the-shelf products, including Theater Medical Information Program-Joint (TMIP-J) applications provided by Deployment & Readiness Systems (D&RS) Program Management Office of the Defense Health Clinical Systems (DHCS), formerly Defense Health Information Management System (DHIMS). [3]

AHLTA Warrior /AVHE

AHLTA Warrior / Application Virtualization Hosting Environment (AVHE) provides military health care providers read-only access to patients' comprehensive electronic health record (EHR) from all points of care, whether worldwide, stateside or a military theater of operations. AHLTA Warrior / AVHE utilizes the familiar AHLTA display to view relevant data, including patient demographics, laboratory results, radiology reports, medication and allergy lists, and clinical encounters. Additionally, AHLTA Warrior / AVHE allows theater-based health care providers to view patient's clinical data via the AHLTA Clinical Data Repository (CDR) and provides health history from garrison back to the theater environment. The MC4 program doesn’t create the software. Instead, the MC4 system is comprised of joint software, commercial and government-off-the-shelf products, including Theater Medical Information Program-Joint (TMIP-J) applications provided by Deployment & Readiness Systems (D&RS) Program Management Office of the Defense Health Clinical Systems (DHCS), formerly Defense Health Information Management System (DHIMS). [4]


References

  1. Staggers, N., Jennings, B.M. & Lasome, C.E. (2010). A usability assessment of AHLTA in ambulatory clinics at a military medical center. Military Medicine; 175(7):518-24.
  2. The Gateway Army Tactical Health Information System Resource. http://www.mc4.army.mil/apps/AHLTA-T
  3. The Gateway Army Tactical Health Information System Resource. http://www.mc4.army.mil/apps/AHLTA-Mobile
  4. The Gateway Army Tactical Health Information System Resource. http://www.mc4.army.mil/apps/AHLTA_Warrior_AVHE