The Gateway

Army Medicine has revolutionized the standard of care for Soldiers on the battlefield and has set precedence for us at MC4. We strive to continually improve the electronic medical record for providers and patients alike because the system does more than empower the provider who documents patient care or the commander who wants to know the status of their unit’s readiness. The system ultimately impacts the Soldier who returns home with an injury or a few aches and pains that requires follow-up medical care.

With Memorial Day behind us and Independence Day just around the corner, I want to thank all Army medical units, commanders and medical logisticians for the important medical functions they are serving in garrison and in theater. You do more than support or provide medical care, you are ensuring Soldiers can tell their medical stories. By doing so, they can get the right type of care they need based on their unique experiences.

I’ve met wounded warriors whose medical records, fortunately, were maintained electronically while they were deployed. When they returned home, the information captured during their deployment was accessible to stateside health care providers who were able to offer the appropriate continuity of care. That’s what we’re here for: MC4 exists to train, field and sustain the EMR so Army medical personnel can effectively care for our wounded warriors.

My focus as the product manager is to ensure the upgrades to applications and new tools that are fielded continue to improve the patient care documentation process and the EMR. We are currently partnering with organizations that have similar goals in mind and have a few projects underway. As we reach milestones on these endeavors, we’ll keep you posted on The Gateway.

Since millions of people a year make outlandish resolutions they never intend to meet, why can't I? Actually, I'm not shy to brag that we met many of our resolutions from last year and we’re looking to build upon them in 2012. Here’s what we have in store for the new year, at a glance:

Offer more training that aligns with the Army Force Generation (ARFORGEN) Cycle
Over the past few months, we've made significant progress in institutionalizing MC4, that is, in Army-speak, getting MC4 training engrained in school houses at the ground level. Last year we got our foot in the door at the CONUS Replacement Center (CRC) and expanded training at the Army Medical Department Center and School (AMEDDC&S), but we want to institutionalize MC4 in other areas so we can continue to assist with unit readiness. Step one was to publish our MC4 Training Strategy and then create this flashy graphic to show we're lining up the strategy with the Army Force Generation (ARFORGEN) framework. Now it's time to execute the tactics.

Continue fielding new technologies
Telehealth is a proven and hot commodity that deserves to be explored further. Recently, we worked with the Telemedicine and Advanced Technology Research Center to expand the telehealth footprint in Afghanistan. In addition to bringing this capability to some types of deployed units as an enduring capability, we want to explore ways to provide high resolution cameras and other tools to health care providers and Soldiers to enhance the quality of virtual consultations.

Additionally, it's important we continue to field improvements to MC4 systems to help providers streamline patient care and manage medical supplies. We are still fielding EMR 2.1.3.1 and look to have that completed in early 2012. We'll also begin fielding a new version of Defense Medical Logistics Standard Support (DMLSS) to combat support hospitals and medical logistics companies in theater next month through the summer. This will enhance the capability of those units and provide them with improved medical maintenance and work order management processes. There will also be a new version of DMLSS Customer Assistance Module (DCAM) coming your way this year.

Pursue new technologies
We didn't make it into NIE 12.2, but we will try for participation in 13.1. We want to continue our Telehealth enduring capability efforts as well as stay on the Army's leading edge when it comes to mobile electronic devices (MEDs). As the Army moves forward with MEDs, we want AHLTA-Mobile and other medical applications on these devices as they are fielded to Soldiers. PEO Soldier is the Army lead for hand-held devices and we are participating in a number of forums to ensure medical requirements are met. Hands-free, point-of-injury and MEDEVAC documentation are still goals we are exploring.

The Army is hopefully months away from releasing a secure, battle-ready smartphone. We're looking forward to this announcement so we can field apps to connect remote customers to the MC4 system. Having the ability to access information on a mobile electronic device will improve point-of-injury documentation and open the door for us to explore other capabilities we can offer MC4 customers on the go.

The Commander's Guide to MC4 was updated and re-released in summer 2011 and is now available on ATN2GO and accessible to customers via their iPhone, iPod Touch, iPad or Android device. I encourage you to read the Commander's Guide blog series and provide feedback on what improvements you would like to see in future iterations of this resource. In the coming year we hope to repackage the guide so each annex can be downloaded or shared individually.

There are other initiatives we have planned for 2012, including enhancements to the MC4 garrison use support system within the continental United States. We will continue to mirror the MC4 support structure we have overseas and establish a similar framework stateside to assist units who use the EMR system. New capabilities and improvements in our exercise support simulation tools for the Medical Situational Awareness in the Theater (MSAT) will be rolled out during Key Resolve in Korea early this year.

Tell us what resolutions you’re committed to or recommend MC4 pursue this year!

As 2011 comes to a close and the holiday nears, I can’t help but feel privileged and thankful for what’s been accomplished. I almost feel like Santa came early and often in 2011.

This year alone, MC4 helped field 8,000 systems and train 10,000 users, which resulted in more than 2 million electronic patient encounters being captured via MC4. As with any technology, the MC4 system requires some upkeep. Earlier this year, we completed fielding of the Electronic Medical Record (EMR) version 2.1.2.1 to all operational Army medical forces, and did so three weeks ahead of schedule and under budget. The upgrade provided enhanced traumatic brain injury reporting and documentation capabilities.

The upgrades also made it easier for deployed facilities to digitally manage their medical supplies and better track in-transit patients and equipment. Technology moves so fast that we’re already fielding EMR 2.1.3.1 and hope to have that finalized this upcoming spring.

In just six weeks earlier this year, we rapidly fielded telehealth tools to Iraq and Afghanistan to help connect remote Soldiers with behavioral health care providers for private, virtual medical consultations. The Office of the Surgeon General estimated that 70 percent of the Soldiers seen through this telehealth capability would not have received services otherwise. As a result, Army Vice Chief of Staff Gen. Peter Chiarelli directed rapid expansion of this capability in Afghanistan. We are indeed expanding the telebehavioral health footprint there and have even been looking into ways we can provide high resolution, real-time video feeds to the Soldier and provider.

Some other highlights from this year include:

• Launched The Gateway, an interactive website for all MC4 stakeholders
• Continued our support of garrison use with our Train as you Fight Initiative, better preparing units via exercises and supplanting 85 aid stations’ paper-based systems with MC4
• Supplied MEDLOG support to U.S. Army Medical Materiel Center-Southwest Asia (USAMMC-SWA) and U.S. Army Medical Research Unit (USAMRU- Kenya) for a streamlined class VIII ordering process
• Published the new and improved “encyclopedia” for MC4, a.k.a the Commander's Guide to MC4 and made it available on mobile devices via ATN2GO
• Institutionalized MC4 training at CRC and at the AMEDDC&S
• Closed the RSOI office in Kuwait and opened new ones in Afghanistan
• Withdrew all MC4 support personnel from Iraq

This year we also got to sit at the big person table—demonstrating the viability of MC4 in the Army’s Network Integration Evaluation at White Sands Missile Range.

To boot, we landed some rockin’ stocking stuffers. We unwrapped three team awards, including the InformationWeek Top 15 Government Information Technology (IT) Innovators award and the 2011 Association of Military Surgeons of the United States (AMSUS) Top Information IT Team of the Year Award. For the third time, we won the 2011 DOD Chief Information Officer Award, placing second. I was also honored to be named a finalist for the Secretary of the Army Product Manager of the Year Award.

Most importantly, thank you to all of the men and women in uniformed service working steadfastly through the holidays to protect our freedom. I feel very lucky and thankful…and ready to give back. Stay tuned for my hefty list of New Year’s resolutions aimed at delivering top-notch IT to enable improved health care for deployable Soldiers.

Happy holidays!

This Friday is Veteran's Day and we will nationally recognize all the men and women who are currently serving and have served in uniform for our country. To support the Soldier and veteran alike, MC4 merely provides the means to tell their medical story. This is what motivates us. The work being done to ensure a lifelong electronic medical record (EMR) for every member in uniform is truly a team effort—a partnership between medical staff, commanders and support personnel.

But EMRs go beyond providing Soldier’s and veterans with appropriate care. These records help ensure veterans have the information they need to file disability claims or be aptly recognized for their service - like the Purple Heart. I encourage every MC4 user to remember that everything they do to support a patient's EMR really does have an impact on that Soldier or veteran's future. To those of you who value the deployable electronic medical record, I thank you for your time and efforts. Collectively we're a link in the chain to ensure Soldiers receive the greatest level of continuity of care they so aptly deserve.

Goblins, witches and werewolves will be roaming the streets tonight, but these monsters don't give me the chills. In fact, the only thing that scares me is when I find out medical units aren't using the numerous MC4 resources that have been developed and fielded in support of the electronic medical record (EMR), medical logistics (MEDLOG) and mission command missions.

It always scares me to hear that units aren't using MC4 in exercises or in garrison aid stations. Health care providers downrange are expected to use the system, so it only makes sense to become familiar with it as much as possible before deploying. We've launched the Train as You Fight Initiative to help Soldiers gain confidence and proficiency in MC4 prior to deploying. It's never too late to contact the appropriate region support office to find out how to ready up on the system as soon as possible.

I also get spooked when I learn that medical units aren't taking advantage of other opportunities to train up on the apps and hardware; units don't have to wait for exercises or garrison to learn how to use the system. A bevy of school houses and institutions have MC4 blocks of instruction. I recently announced that MC4 training is now available at the CONUS Replacement Center (CRC) for deploying professional filler system (PROFIS) personnel. One-on-one training is always available to end users upon request and it was also recently announced that MC4 training for physician assistants will be available as part of the Basic Officer Leader's Course beginning this December. For those with no time to spare, our distributed learning products offer on-the-go apps, tutorials and reference materials.

I was afraid that users weren't aware that we published the all-encompassing encyclopedia on MC4 use. The voluminous Commander's Guide to MC4 covers all of the basics, plus best practices and checklists that address everything end users and commanders would need to know about MC4. Because it's so enormous, last month we started out "Commander's Guide" minis—a blog series about the guide aimed to deliver bite size portions to make the guide easier to digest. The guide remains vital for units looking to develop a training plan and identify ways to brush up on their MC4 skill set.

It's frightening to think that once individuals are trained up and deploy with MC4 they don't think they need training again later down the road. Things are constantly changing, system updates are fielded regularly and someone somewhere is always finding a new and better way of managing tasks. Collaboration is why MC4 has been so successful; end users are sharing their lessons learned and providing feedback to help improve the system.

All of this information is published online in the form of Tech blogs and tips and FAQs on The Gateway. The website is a great conduit to provide feedback and be part of the continuous conversations of how we can train, field and implement processes to improve EMRs throughout the Army. I strongly encourage that every MC4 user subscribe to The Gateway to receive monthly updates on what's new with MC4; it's like going trick-or-treating every month!