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DHA Form 116: Pediatric and Adult Influenza Screening and Immunization Documentation

Form/Template
9/14/2022

A form for screening both children and adults for contraindications to receiving influenza vaccine. (v3, September 2022)

Recommended Content:

Immunizations | Influenza, Northern Hemisphere | Influenza, Southern Hemisphere

DHA Form 207: COVID-19 Vaccine Screening and Immunization Document v22

Form/Template
9/9/2022

The purpose of this form is to determine if the COVID-19 vaccine can be administered to the patient. (v22, Sept. 2022)

Recommended Content:

Coronavirus and the COVID-19 Vaccine | Immunization Healthcare Division | COVID-19 Vaccine Efforts | COVID-19 Information for Military Treatment Facility Directors | Coronavirus

Access Controls June 2022

Form/Template
8/31/2022

Access Controls Information Paper, updated June 2022

Administrative Safeguards June 2022

Form/Template
8/31/2022

Administrative Safeguards Information Paper, updated June 2022

Best Practices for Verification of Identity June 2022

Form/Template
8/31/2022

Best Practices for Verification of Identity Information Paper, updated June 2022

Best Practices for Safeguarding Laptops June 2022

Form/Template
8/31/2022

Information Paper on Best Practices for Safeguarding Laptops, updated June 2022

Military Health System Information Platform PIA

Form/Template
8/23/2022

The Military Health Systems (MHS) Information Platform (MIP) is a system containing multiple dashboards and databases that deliver enterprise clinical data capabilities. The capabilities provided by MIP are: Program Management; Data Warehousing; Application Portal; Infrastructure and Operations; Application Support; Business Intelligence; Analytics; Predictive Analytics; Legacy Data Consolidation Service; Defense Medical Surveillance System; and Corporate Executive Information System. Types of projects enabled by MIP include clinical dashboards, reports, data feeds, ad-hoc data requests, a data mart, medical history tracking of individual service members, and identification of service members at elevate risk of injury or mental health illness.

Composite Health Care System (CHCS)

Form/Template
8/12/2022

Composite Health care System (CHCS) is a fully integrated health care information system used in Department of Defense (DOD) Military Treatment Facilities (MTFs) and clinics. It is used to automate and integrate the functions performed by the hospital staff and to facilitate the delivery of health care and MTF's administration. Data elements include beneficiary information collected and used to support the delivery of health care to Defense Health Agency's (DHA) beneficiaries.

Naval Hospital Jacksonville (NHJAX) Enclave

Form/Template
8/12/2022

Complete this form for DOD information systems or electronic collections of information that collect, maintain, use, and/or disseminate PII about members of the public, Federal employees, contractors, or foreign nationals employed at U.S. military facilities internationally.

Enterprise Patient Queuing and Notification System (ePQNS)

Form/Template
7/21/2022

The Enterprise Patient Queuing Notification System (ePQNS) automates patient check-in during visits to Military Treatment Facilities (MTFs) and clinics. ePQNS provides real-time information to leadership to manage assets as wait-times increase or the situation dictates. It also allows MTFs to determine inefficiencies, identify best practices, and optimize clinic resources to improve each patient’s overall experience and reduce wait times.

Enterprise Blood Management System (EBMS) - Transfusion

Form/Template
7/12/2022

The purpose of Enterprise Blood Management System (EBMS)-Transfusion, formerly known as Blood Management Blood Bank Transfusion Service (BMBB/TS), is managing the blood transfusion aspect of the Armed Services Blood Program (ASBP), including blood records, blood orders, and transfusion patient information in the Continental United States and Outside Continental United States.

Steps to take for Potentially Compromised Vaccine Event

Form/Template
7/7/2022

Recommended Content:

Vaccine Storage and Handling | Potential Vaccine Compromise Reporting

DHA Form 249: Pharmacy Data Warehouse Data Report Request Form

Form/Template
6/21/2022

Recommended Content:

DHA Pharmacy Operations Support Contract Data Management Team | CD-MART | D-MART | WTU P-MART

TRICARE Online (TOL) System

Form/Template
5/3/2022

TRICARE Online (TOL) is a Department of Defense (DOD) Online Patient Portal (PP) which provides eligible beneficiaries with the following: access to Military Treatment Facilities' (MTFs) appointments, new prescription (Rx) fill and refills, health record data, service separation/retirement information as well as access to secure messaging (SM), and the Nurse Advice Line (NAL).

Centralized Credentials Quality Assurance System (CCQAS)

Form/Template
4/18/2022

This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the Centralized Credentials Quality Assurance System (CCQAS) system.

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Last Updated: September 13, 2022

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