Composite Health Care System

From Wikipedia, the free encyclopedia

This article may require cleanup to meet Wikipedia's quality standards. Please improve this article if you can. (February 2007)

The Composite Health Care System (CHCS) is a VMS-based relational database designed by Science Applications International Corporation (SAIC) and used by all United States and OCONUS military health care centers. In 1988, SAIC won a competition for the original $1.01 billion contract to design, develop, and implement CHCS.^[1]

CHCS is module based: RAD (radiology), LAB (Laboratory), PHR (Pharmacy), PAS (Patient Appointing & Scheduling), MCP (Managed Care Program; used to support TRICARE enrollees by enrolling them to Primary Care Managers), PAD (Patient Administration): MRT (Medical Records Tracking), MSA (Medical Service Accounting) medical billing, WAM (Workload Assignment Module), DTS (Dietetics), CLN (CLinical: Nursing, Physician, and Allied Health), DAA (Database Administration), ADM (Ambulatory Data Module) Medical Coding of outpatient visits and TOOLS (FileMan).

Currently all appointments are booked in CHCS, except for Walk-Ins and Telephone Consults, which can now be booked in AHLTA. CHCS is a text based BBS/ANSI like display accessed via DEC VT320 terminal emulation.

CHCS shares its original codebase with the VA's VistA system. Since its inception it has been customized for supporting the Military and their family members.

Security in CHCS works by concept of least privilege. You are assigned the minimum needed for your work duties. This limits your access to sensitive data both protected by the Privacy Act 1974 and PHI protected under HIPAA.

AdHoc reports can be written using the FileMan tools and can be quite powerful, if the files are designed with that in mind. Many CHCS files are now more easily accessed with MUMPS routinues that can make more efficient use of the internal datastructures.

CITPO began the implementation of AHLTA, the DoD's electronic health record (EHR), in January 2004. It is a "next generation" system that links the 481 Military Treatment Facilities (MTF) world-wide as well as service members deployed abroad to the EHR, ultimately supporting 9.2 million MHS beneficiaries. The introduction of AHLTA, previously known as the Composite Health Care System II, marks a significant new era in health care for the MHS and the nation. AHLTA is a powerful, potentially life-saving tool that provides around the clock access to a single data repository of all treatment. It provides MHS providers with efficient, secure access to health-sustaining information. AHLTA is the most expansive EHR system in the nation, yet it can also be scaled to the health information requirements of tracking a single sick or injured service member in the field environment. AHLTA is being deployed in phases, or "blocks" of increasing functionality that allows the MHS to build a system that is easily adapted to meet evolving requirements and to incorporate the latest available technology. Block 1 provides the foundation of system performance through a graphical user interface for real-time ambulatory encounter documentation. It enables retrieval of a beneficiary's health record at the point of care.

Block 2 will integrate robust dental documentation and optometry orders management capabilities.

Subsequent blocks will modernize legacy system ancillary services (laboratory, pharmacy, and radiology), order entry and results retrieval, inpatient documentation, and interface exchange with other MHS information support systems. Unique to AHLTA is the entry of more than 2 years of historical health information for each beneficiary upon the creation of their EHR. This information, transferred from legacy systems, facilitates continuity of care. As of December 2006, AHLTA Block 1 has been fully deployed and is in use by more than 55,000 MHS care providers in 481 Army, Navy and Air Force treatment facilities worldwide, including Combat Support Hospitals and Battalion Aid Stations in the combat zones.

AHLTA CHARACTERISTICS Creates a life-long health record for TRICARE beneficiaries Offers an intuitive, graphical user interface designed by military providers to support clinical workflow Leverages structured documentation to maintain integrity of patient data and optimize data standardization Enables symptom-based medical surveillance Uses templates to simplify workflow Provides 24 hour, 7 day a week access to beneficiary EHR Eliminates health record legibility issues Enables population health and wellness reporting Provides clinical functionality used in support of deployed service members, ensuring a “train as we fight” approach Ensures costly tests, labs and scans aren’t lost and needlessly duplicated Interoperability ensures records can be accessed at any MTF world-wide Prevents unauthorized access and protects from loss due to natural or man-made disasters

AHLTA Capabilities Encounter Documentation and Coding Problem List Generation Order Entry Results Retrieval Consult Tracking Allergies Warning Medical Alerts Immunization Documentation Wellness Reminders Self Reporting Tools I use CHCS. It's the greatest.

[edit] References