The Department of Defense is continuing to roll out an EMR system that has been in continuous development since the late 80s.
Serving almost 10 million military personnel and families, the implementation of and lessons learned from this project could provide some clues as to what lies ahead for the broader usage of electronic medical records in the United States.
Last year, the Bush administration said it will set the ball rolling so that a national electronic medical records system can be established within the next decade. But the path to reaching this ambitious target is still relatively obscure.
The Department of Defense has several advantages in implementing its electronic medical record system, in comparison to what will be required for a national EMR system.
First, the military has been working on electronic medical records for more than two decades.
In addition, it has a strong, hierarchical institutional structure that could make some of the necessary decision-making and implementation processes easier.
The first version of the EMR system, Composite Health Care System I, was an electronic medical record system limited specifically to individual hospitals.
Sharing data between health care facilities is a feature that came about with the initiation of the next phase of the project, CHCS II (Composite Health Care System II).
The ambulatory portion of CHCS II, which deals with outpatient interactions, is expected to be complete by the end of 2007.
"Currently we have the ambulatory portion of our electronic health record deployed about a third of the way across our enterprise," noted Dr. Robert Wah, a Navy captain and reproductive endocrinologist who serves as the director of information management for the Military Health System.
Already, 15,000 physician interactions are recorded daily into the system.
"Were currently rolling out the ambulatory care outpatient portion; thats 50 million encounters a year," according to Larry Albert senior vice president at Integic, a long-term contractor on the CHCS project that has been recently acquired by defense company Northrop Grumman Corporation.