Much military health care is not delivered in garrison, but in theater, so the military electronic health record must support the global information flow that happens from recruitment through deployed care.

“The EHR is the critical tool for supporting the continuum of care,” said Navy Capt. Michael S. Weiner, director of the EHR Way Ahead Planning Office, in his presentation to attendees of the 2011 Health Information and Management Systems Society Conference in Orlando, Fla.

Weiner and his team have a challenging task ahead as they plan for the next-generation EHR.  He noted that in 2010 the military EHR, known as the Armed Forces Health Longitudinal Technology Application, supported more than 53 million out-patient encounters—more than any other system. Applying lessons learned from other global EHR deployments has been critical in the planning process, including those from the departments of Veterans Affairs and Health and Human Services and private-sector partners.

One lesson learned comes from the medical mantra “See One, Do One, Teach One.” This has been applied in developing an iterative approach that employs a mix of classroom, one-on-one, over-the shoulder and computer-based training.

Weiner discussed some aspects of the acquisition process involved in EHR Way Ahead and addressed the engineers in the room, citing a need for service-oriented architecture that is scalable, extensive and integrated. 

“At the basis of the EHR is the data, and we want that information readily available and usable,” he said. For example, when blood pressure data is automatically tracked via a clinical support tool, the tool can alert the doctor to problems that should be addressed at certain times. However, the EHR Way Ahead is not just a tool.

“As with any large EHR initiative, we tend to focus a lot on the technical side of it,” Weiner said.  “It’s really a giant organizational change, and so we have parsed out significant time and effort into change management and communications. The change has to be communicated well and everyone has to be empowered along the way.”

Weiner’s presentation, “Lessons Learned for the Deployment of the Electronic Health Record,” can be downloaded at http://www.himssconference.org/docs/sphandouts/45.pdf.

The Health Information and Management Systems Society Conference is an annual event bringing together health information technology industry leaders. Learn more about the conference at www.himssconference.org. Follow live coverage of the event at www.twitter.com/mhsocio.