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DHA IT helps beneficiaries, providers and workforce through pandemic

Several military personnel, wearing masks, filling out paperwork. One woman is giving the thumbs up sign Defense Health Agency (DHA) COVID-19-related updates to Military Health System health care information technology systems ensure MHS providers like Navy Seaman Norelle Dry, assigned to Naval Medical Center San Diego, California, can continue to deliver top-tier care to Service members and beneficiaries during the pandemic. DHA IT system updates also helped patients manage their health care virtually and provided Department of Defense leaders timely information on critical medical supplies and equipment. (U.S. Navy photo by Seaman Elisha Smith.)

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Defense Health Agency information technology (DHA IT) teams demonstrated their versatility and responsiveness ensuring Military Health System patients continued to receive high quality health care during the COVID-19 pandemic and throughout 2020. The IT teams also provided innovative tools to MHS health care providers and DHA employees to enable to function during the pandemic.

For patients, they established virtual COVID-19 screenings and appointments, allowing patients to manage their health care online rather than in person at military medical treatment facilities (MTFs) where they could place themselves and others at risk of infection. For providers, they established COVID-19 protocols within electronic health record (EHR) systems and other health care applications enabling them to identify and document infections.

“As soon as the pandemic hit, our teams quickly kicked into high gear to deliver some critical updates to our systems and applications,” said Army Col. Francisco Dominicci, chief, DHA Solution Delivery Division, which sustains more than 60 different MHS health care applications. 

“We made updates to the TRICARE Online Patient Portal (TOL PP) to allow patients to make virtual visits with their providers via the portal,” he explained. “Starting in March, TOL PP facilitated more than 160,000 virtual visit appointments.”

Among other COVID-19 relief efforts, Dominicci said the IT teams worked with DHA Medical Logistics (MEDLOG) to update MEDLOG IT applications to track MHS personal protective equipment (PPE) and other critical medical equipment in real time. They also mapped strategies for tracking vaccine distribution across the Department of Defense. 

“In February, our teams created a Novel Coronavirus query tab in the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) application,” he added. “The following month, they launched a COVID-19 dashboard in ESSENCE that allows users to monitor the number of COVID-19 lab results in real time.”

The IT teams also developed and released a progressive web-based application for Antimicrobial Stewardship with COVID-19 content in April to help providers with needed COVID-19 triage protocols, Dominicci said. 

In March, the IT teams expanded Enterprise Blood Management System-Transfusion (EBMS-T) blood availability reports to the Armed Services Blood Program to include greater inventory level details on all blood components maintained at MTFs. The teams also made configuration changes to EMBS-Donor, enabling donor sites to create labels to track COVID-19 convalescent plasma, which contains antibodies from COVID-19 survivors.   

Dominicci explained how the IT teams deployed a COVID-19 Sentinel Surveillance testing application using TOL PP in the fall. More than 250 users were provisioned across 35 military sites to use the application to gather information at the population level. Surveillance testing is used to monitor the community-level of a disease or to characterize its incidence and prevalence.

The DHA workforce was also able to transition to a telework environment after the IT teams ensured the networks could handle the heavy traffic. They also enabled multiple online collaboration tools, such as video conferencing, to keep the workforce connected.

Along with fighting COVID-19, the IT teams logged other impressive achievements last year. They completed major upgrades to in-patient EHR systems at 46 MTFs around the world in November, Dominicci added. 

In August, the DHA IT team launched the Defense Medical Logistics Standard Support (DMLSS) system at the joint DoD-Department of Veterans Affairs James A. Lovell Federal Health Care Center in North Chicago. The DMLSS launch came after several years of planning, coordination and preparation between the DHA, DOD and VA. 

“The launch represented a major step in replacing the VA’s supply chain IT infrastructure with DMLSS,” Dominicci said. “The end goal is to establish a single DoD-VA health care logistics system for acquiring medical and surgical supplies.”

IT teams also completed conversions of legacy funding systems to the General Fund Enterprise Business System (GFEBS) at 26 Navy MTFs in September, he said. The GFEBS conversions enable DHA financial and funding control of Navy, Army and DHA sites that use DMLSS. 

In December, the teams completed an initiative to migrate 140 public-facing MTF websites to TRICARE.mil. Dominicci said the IT teams worked closely with the MHS Communications office, the Defense Media Activity and MTF public affairs office on the initiative, which should ultimately reduce site sustainment and hosting costs. Returning website users experienced no disruptions, as they were automatically redirected to the new sites. 

“These are just a few of the milestones DHA IT teams achieved in 2020,” emphasized Dominicci . “The IT teams met the pandemic head on and delivered highly effective, innovative solutions across the DHA and MHS.”

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This Defense Health Agency-Interim Procedures Memorandum (DHA-IPM), based on the authority of References (a) and (b), and in accordance with the guidance of References (c) through (p): • Establishes the Defense Health Agency’s (DHA) procedures for the physical custody and control of DoD Health Records at all DoD Military Treatment Facilities (MTFs) and the management, monitoring, review, and evaluation of DoD Health Record availability at MTFs. • This DHA-IPM is effective immediately and will expire effective 12 months from the date of issue. It must be incorporated into the forthcoming DHA-Procedural Instruction, “Health Records Management”.

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This Defense Health Agency-Interim Procedures Memorandum (DHA-IPM), based on the authority of References (a) through (c), and in accordance with the guidance of References (d) through (v), establishes Defense Health Agency’s (DHA) procedures to: • Establish the overarching guidance to implement policies and procedures for managing DHA Deputy Assistant Director, Information Operations (DAD IO)/J-6 Defense Health Program (DHP) IT resources. The DHA Investment Management Framework is used as an enabler for MHS leadership to make informed transparent financial decisions associated with the DHA DAD IO/J-6 systems, services, and capabilities and will continue to be used in the foreseeable future. • Provide full and total awareness of all IT across the enterprise ensuring all MHS healthcare-related IT investments are accounted for and integrated both operationally and financially. This includes all IT systems, applications, and devices and all their funding identified to manage a coherent and integrated healthcare capability across the enterprise. • Provide and supersede guidance and instructions previously provided through the Services. As Military Medical Treatment Facilities (MTFs) transition to DHA management and responsibility, procedures in this DHA-IPM will supersede IT systems guidance and instructions previously provided through the Services; including IT systems in all MTFs, clinics, and enterprise services provided to Other Lines-of-Business (OLB), such as training and research, etc. In addition, it supports a coherent and comprehensive catalog of IT capability investments encompassing all IT used to support the MHS mission. • Require that all funding sources, type and Budget Activity Group (BAG), purchasing or supporting any IT must be identified for inclusion in the DHA portfolio of IT capability investments. • Provide superseding guidance and instruction, through this DHA-IPM until a DHA-Procedural Instruction is issued previously provided by the Services in References (w) through (ad), for the MTFs as they are transitioned to DHA management and responsibility. • This DHA-IPM is effective immediately and it will be converted into a DHA-Procedural Instruction. This DHA-IPM will expire effective 12 months from the date of issue.

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