The Gateway

There are four things that all nurses who use the MC4 system need to know.

• All patient care, inpatient care and short term problems such as viral illnesses, should be documented in the MC4 system. Information documented in the EMR system will become part of the Soldier’s permanent medical record. This allows a complete past medical picture to be viewable for yourself and any other medical personnel.

• AHLTA-T is used by nurses in outpatient clinics, the ER and some level II holding facilities. This application is organized in the subjective/objective and assessment/plan (SOAP) format and is fairly easy to use. At level III’s, TC2 is used for documenting inpatient care. This application is almost the same as Composite Health Care System (CHCS) with the same flow and navigation. In theater, however; TC2 is used to document the complete medical record, which is different than how CHCS is used in garrison.

• The applications within the MC4 EMR system are not nurse-friendly and require some workarounds. Nursing typically documents in a flow sheet format and these are not available in the system.

• There are AHLTA-T templates/AIM forms and TC2 templates that will help in mimicking a nursing documentation work flow. The TC2 templates replicate the flow sheets nurses are comfortable using. The templates/AIM forms for AHLTA-T pull all the nursing documentation together in an easy to use format, but do not have a flow sheet look and feel.

  I recommend reading the Tips and FAQs on AHLTA-T and TC2 for more information.

MC4 is always looking for feedback and nursing advocates within the military nursing community that affect change and improve the system from a nursing perspective. If you have feedback to share and/or are willing to be an advocate, please contact the MC4 Clinical Operations Office.