Health Records System Has A Long Way To Go

Press Release

The electronic military health records system is so unreliable it may be reducing the number of patients seen by doctors and could be driving some health professionals to leave the services, according to key lawmakers.

At a Tuesday hearing where two House Armed Services Committee panels grilled defense and service officials about problems, lawmakers said they understand that building a computerized records system is complicated, but they are worried that it is taking so long and that so many problems remain.

The computerized system, Armed Forces Health Longitudinal Technology Application, or AHLTA, was first implemented in 2004 but has experienced several problems and remains unpopular with many users.
"The committee has heard from military doctors and nurses ... that it is unreliable, difficult to use, and has decreased the number of patients they can see each day," said Rep. Joseph Wilson of South Carolina, ranking Republican on the Armed Services subcommittee on military personnel "We have also heard that medical professionals leave the military because of their frustration with AHLTA."

"Our providers remain largely dissatisfied," acknowledged Navy Rear Adm. Thomas Cullison, the Navy's deputy surgeon general, one of several military officials questioned by the committee. Cullison said the computer system frequently goes down and takes time to reboot.

Cullison said nobody in military medicine wants to return to the days of paper records, but many are wondering when AHLTA is going to be more of a help than a burden. "They don't want to go back; they want us to fix the one we have," he said.

Air Force Maj. Gen. Charles Bruce Green, the Air Force deputy surgeon general, said general practitioners seem to be spending about 60 percent of their time treating patients and 40 percent working with AHLTA, which is not ideal.
Dr. S. Ward Casscells, the assistant defense secretary for health affairs, said the Defense Department's senior leadership "is committed to ensuring provider satisfaction with AHLTA and to resolving issues identified by providers in the health-care community."

"Improvements over this next year will answer urgent provider requests for improved usability, stability and reliability," Casscells said. Additional advancements over the next two to three years will address other problems, he said.
"We have to get this right," said Rep. Jeff Miller. "Four billion dollars later, it appears the system is not working as advertised."

Miller said he knows the program is important. "The use of an electronic medical record, allowing a patient's treatment history to follow him through the system, at all points of care is one way of improving beneficiary care," he said. "When one considers the speed with which combat casualties are removed from the battlefield to higher levels of care, the importance of ensuring the treating physicians have access to a patient's medical history becomes clearer."

Miller said he is concerned over the fact that AHLTA needs more work and that the military is using a different system than the Veterans Affairs Department.

Former Navy doctor Rep. John Fleming., said he remembers using paper records when he was in the military and the difficult of reading them, so he sees the benefit of the having an electronic system.

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