Lt. Col. Robert Price is the group surgeon for the 10th Special Forces Group (Airborne), Fort Carson, Colo. He recently completed a 90-day rotation, augmenting the medical staff of the Combined Joint Special Operations Task Force – Arabian Peninsula (CJSOTF-AP) in Balad, Iraq.
During his short time in Iraq, Lt. Col. Price worked tirelessly to stress the importance of accurate electronic medical records (EMRs) to clinical staff. He also utilized AHLTA Warrior to view a patient’s medical history and often times enhanced the treatment.
- “I believe that medical personnel need to electronically document patient information as accurately as possible, in theater and in garrison.”
He also led the initiative to network a local pharmacy to the EMR systems, streamlining the process of ordering and dispensing medications, improving overall safety and accuracy.
Why did you become a proponent of the MC4 system during your deployment?
I believe that medical personnel must electronically document patient information as accurately as possible. It doesn’t matter if clinicians are in theater or in garrison. When I arrived in Balad, I worked with the staff to make sure we utilized the applications on the MC4 systems to the best of our ability.
AHLTA-T, Theater Medical Data Store (TMDS) and AHLTA Warrior are powerful tools and all three programs are very important to track and manage patient care downrange. Deployed providers utilize AHLTA Warrior to review and verify care administered in garrison.
Previously, providers had to call garrison facilities for medical records. The cumbersome process was not efficient. With AHLTA Warrior, I didn’t have to rely on anyone else. I could immediately access previous treatments, illnesses and magnetic resonance image (MRI) results.
How did garrison records help you treat patients?
On more than one occasion, garrison records enhanced and changed the management of care. Sometimes the data helped to save lives.
- “On more than one occasion, accessibility to garrison records enhanced and changed the management of care.”
In one instance, a Service member had a large cell tumor in his heel. Before his deployment, he underwent two surgeries to remove the tumor. He deployed to Iraq with the intention of having an MRI performed 90 days into his deployment. I'm not sure if the stateside doctors decided this course of action or if it was the patient. Either way, the parties involved didn't realize that the patient couldn't receive an MRI in theater.
The Service member entered the clinic suffering from heel pain. Upon review of his medical history in AHLTA Warrior, I saw that he was three months overdue for the MRI. At that moment, I realized that this person had to be transported to Landstuhl right away. Had I not looked up the patient’s medical history, I might have only treated the immediate pain.
In Germany, the MRI revealed a recurrence of the cancer; an aggressive osteosarcoma and not the benign large cell tumors providers thought to be in the heel.
The Service member now receives chemotherapy to treat the cancer. Unfortunately, he will also undergo an amputation below the knee to remove the malignancy in the heel bone.
How did your records help garrison providers administer follow-up care?
A female Service member entered our clinic for treatment of what she believed to be a cold. Her symptoms included a sore throat, runny nose and cough. During my exam, I heard a very loud heart murmur. When I mentioned my discovery to the patient, the Service member said that she didn’t have a history of heart problems. Her records confirmed it.
I recommended that she return to the U.S. for additional care. Providers in garrison performed an echocardiogram and the procedure uncovered a severe mitral regurgitation. After consulting a cardiothoracic surgeon, the Service member underwent a surgical procedure to fix the heart valve.
The notes from my exam helped doctors in the U.S. administer the additional care needed to help the patient without the need for redundant tests and procedures.
- “While streamlining our ability to dispense medications, the process is also safer and more accurate.”
During your short tour, you made it a goal of yours to connect a local pharmacy to the MC4 systems in your clinic. Why was this so important?
In Balad, a pharmacy dispensed medications next to the clinic where I worked. Typically, I would write out my prescriptions and hand it to the medics. The medics would then write out a label and place it on a small plastic bag with the prescription.
When MC4 refreshed the old computers in our clinic, I saw a system configuration with a label printer. I believed that the printer would improve our processes. I spoke to the MC4 staff about securing the printer and networking it to the laptops in the clinic.
After the installation of the printer, I ordered prescriptions with the MC4 system that automatically generated a label with the type and quantity of the medication. The medics can now take the label from the printer and dispense the orders.
While streamlining our ability to dispense medications, the process is also safer and more accurate. Additionally, the prescriptions populate Service members’ medical records, providing additional information about the care administered.