Department Of Defense Pushes Ahead With E-Health SystemDepartment Of Defense Pushes Ahead With E-Health System

A personal health records pilot test by the Department of Defense has been successful, and the military is now determining how to expand it more widely.

The service, called MiCare, is still in pilot mode at Madigan Army Medical Center in Tacoma, Wash. Plans call for it to be expanded to the Hampton Roads, Va., area and then beyond. Defense is also working with the Department of Veterans Affairs to determine how the two agencies can collaborate on the initiative. "We want to make sure functional and clinical experts help decide what to do next and when," said Chuck Campbell, CIO of the Military Health System, during a panel discussion at the Open Government and Innovations Conference.

MiCare will eventually give military members, their families, and veterans access to their personal health records via Internet services, including Microsoft HealthVault and Google Health. The military is also evaluating Relay Health.

The Defense Department opted to go with an online service for health records instead of an internally developed system largely due to cost and timing. "I could build all the servers, buy all the software to do that at probably a large cost and a long time, or I could do this," said Campbell.

Privacy was a primary concern during the pilot. Patients will have the ability to opt into the system, so their healthcare records won't go online unless they approve. Users will also be able to decide what information to share and with whom.

During the pilot, MHS had to manage security, determine how to share medical information from its own e-health records system with public systems from Google and Microsoft, and revise processes in hospitals and clinics, including educating healthcare workers in how to use the new systems.

Campbell said MHS has "special arrangements, involving penalties" with Google and Microsoft around security. The military also requires that information on Department of Defense employees must be stored only in the United States and that personal information is immediately deleted from vendors' servers if an employee opts out after entering information into the system.

In addition to the personal health records pilot, Defense is overhauling a back-end electronic medical records system that pre-dates the Google and Microsoft pilots, but has garnered significant criticism from users and observers. Campbell admitted that the system is slow, not user-friendly and unreliable. As part of the overhaul, MHS plans to redesign some elements of the system's user interface and add redundancy.

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