Military, Veterans Communities on Right Path with Paperless Medical Records

The military and veterans healthcare communities are on the right track with how they document patient medical records, slowly transitioning into a near-paperless environment, officials said last week.

Speaking at a June 11 electronic health records open house held in Arlington, Va., Army Maj. Frank Tucker, a physician’s assistant and chief systems architect for the Military Health Systems’ Joint Medical Information System, said there was a time when “we didn’t have anything really electronic.”

“But we’ve evolved from there with 100 percent deployment of our outpatient electronic records … [and] are now on a path toward completing [inpatient electronic records] deployment,” he said.

Tucker participated in a panel discussion on progress and plans the Department of Defense and the Department of Veterans Affairs have achieved in EHRs. The open house showcased some of the latest tools the military uses to digitally enter and track troops’ medical information. For example, first responders on the ground in Afghanistan can now process troop health information from the heat of battle to a theater-level hospital in real time. Data can be exchanged and updated all the way up the chain to regional facilities, such as Landstuhl Regional Medical Center in Germany, and to Walter Reed Army Medical Center in Washington, D.C., before troops arrive for treatment.

The military first deployed what it considered basic EHRs in 1996 under the Composite Health Care System. Everything from laboratory blood work, prescription medications, X-rays and appointment scheduling were available for outpatient documentation.

Through technologies, the military relied on paper to document patient records. Troops injured in battle were transported with their hard-copy medical records, which sometimes were outdated. That method often left healthcare providers with many unanswered questions as troops transitioned through different levels of care, Tucker said.

Troops severely injured in Iraq, for example, transition to several facilities during their treatment and recovery. Injured troops likely are seen at their unit aid station, then at a field hospital and moved to a larger facility, such as in Landstuhl. Service members then could move to Walter Reed, and then would transition to the VA healthcare system if they separate from the military.

Tucker said it can be difficult to keep a perfect record of every laboratory result by the time they are seen at a VA hospital, which could delay the care and benefits process.

But today, the VA health system receives only electronic records for service members from the DoD, Dr. Ross Fletcher, chief of staff for the VA Medical Center in Washington, D.C., said.

Because of the technologies and integrated electronic records system the DoD and VA share, Fletcher said, the VA will never again file paper records. He explained some electronic documents he sees may be scanned from paper files, but they are electronic by the time they are passed to VA.