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FCW : June 30, 2014
to deliver. I think we have a lot of really dedicated gov- ernment people, both active-duty as well as civilian, who really want to do a good job taking care of our people, but a lot of times, we get these tools that just don t meet our needs and we never get a chance to really be part of the solution." Information silos are a challenge for military health care. For example, service members primary health records are not integrated with the systems that handle health assess- ments before and after deployment. It is a challenge Janda is determined to address. During his time in the Army, he gained extensive experi- ence with the Defense Department s AHLTA electronic medi- cal record (EMR) system. When he came to the Coast Guard in 2008, he was initially tasked with integrating the Coast Guard into AHLTA, which DOD is now seeking to replace. "Once we started that process, then we realized it wasn t just the [EMR system] we were lacking," Janda said. "We were lacking a document management system. We were ialing system, and as we went along, we g old systems either that were missing or laced, and before long we ended up with d Health Information System." top there. Janda s team ultimately joined ate Department after he and one of State s rmation of cers realized they were looking ons. Both of igitize health age care pro- de organiza- cials signed greement to ir civilian and aries. set IHiS apart pts at military like AHLTA, by an agency. ard and State Epic Systems ctors, includ- AIC, to create n on which d build. They se compa- ies that have worked with HMOs and ther large nstitutions. "Given that he Coast Guard s pretty small, if they re successful at such a large enterprise, then our risk is pretty low," Janda said. Second, the type of care the Coast Guard and State pro- vide differs from what the Army, Navy and Air Force pro- vide. Whereas DOD has specialists and resources to perform inpatient care, the Coast Guard focuses on primary care and refers bene ciaries for most other medical services. "We have a good percentage of people who never come into our facility who use their Tricare bene t...and they see a private physician," Janda said. "But we still pay for that care, and we re still responsible for their well-being." Likewise, the State Department mainly coordinates rather than provides care for its bene ciaries abroad. For instance, roughly 30 percent of State s overseas employees are active military members who are responsible for security at U.S. embassies. Coordinating that care is complicated by the fact that the health records of those military members and other State bene ciaries, such as Foreign Service of cers and their families, are still maintained as paper documents. After IHiS starts its piecemeal launch in July --- and Wil- liams said he hopes it will be fully deployed in the next year --- users will be able to access their health records and communicate with their doctors from any location. And all the relevant agencies will be better able to manage their employees medical care. By capturing all that information and sharing it with DOD and the Department of Veterans Affairs, "it s a virtual lifetime electronic record," Janda said. "We re all contributing to the same electronic record." So although it might be unclear whether to address Janda as doctor, captain or one of several other current job titles, he is undoubtedly the driving force behind IHiS, said Dan Fielden, a project manager at Leidos. "This whole thing is really Dr. Janda s vision, and we re just helping him realize it," Fielden said. "He s always think- ing ahead [to] what is the best technology we can use, which is both a blessing and a curse. Sometimes [we] start out think- ing we re going to go down this path and then we discover a new piece of technology that will be more effective and more ef cient." ■ lacking a credenti kept on identifyin needed to be repl this big Integrated But he didn t st forces with the Sta chief medical infor for similar solutio them needed to di records and mana vided by outsid tions. In 2011, of an interagency a share IHiS for thei military bene cia Two elements s from other attemp EMRs. First, unl IHiS was not built b Instead, Coast Gua of cials tapped E and other contrac ing Leidos and SA a foundation they could chos ni w H o in th In 2009, the Coast Guard planned to overhaul its paper-centric health records system by upgrading to the Defense Department s AHLTA and Composite Health Care System. But when DOD of cials told the Coast Guard that they planned to discontinue those systems, creating a new electron- ic medical records program became the obvious choice. Five years and $50 million later, the Coast Guard s Integrated Health Infor- mation System will go live beginning at two clinics this summer and gradu- ally expanding to more. The system is expected to have 300,000 member and bene ciary records when fully deployed and an average projected growth rate of 10 percent. --- Reid Davenport IHiS in a nutshell June 30, 2014 FCW.COM 23 DRAGUTIN CVIJANOVIC
May 30, 2014
June 15, 2014