Army fields upgrade to MC4 electronic medical record system

By J.D. LeipoldMarch 10, 2014

MC4 Upgrade
1 / 2 Show Caption + Hide Caption – (Photo Credit: U.S. Army) VIEW ORIGINAL
Patient Information Being Entered into MC4
2 / 2 Show Caption + Hide Caption – Col. Rebecca Douglas, chief nurse of the 115th Combat Support Hospital and Spc. Bryan Draeger, a signal officer, verify that notional patient information is flowing through the Army's MC4 electronic medical record system during a mass casualty exerci... (Photo Credit: U.S. Army) VIEW ORIGINAL

WASHINGTON (Army News Service, March 4, 2014) -- The Army is fielding a major software upgrade to its electronic medical record system to ensure Soldiers wounded on the battlefield will have detailed permanent accounts of the scenario and treatment received.

A new suite of the Medical Communications for Combat Casualty Care, commonly known as the MC4 system, is being fielded through April.

"What's important for Soldiers to know about the upgrade is that they will continue to receive improved documentation of their care," said Lt. Col. Keith Harley, assistant product manager for MC4, during a bloggers roundtable, Feb. 26, 2014. "And, that gives reassurance to them when they leave the Army and are filing a claim with the Veterans Administration that their care has been documented."

The most significant change MC4 customers will notice is an upgraded operating system, Windows 7. Under the upgraded system, each MC4 standalone system and server will require Public Key Infrastructure -- Equipment, or PKI-E certificates. The PKI-E certificates will enhance security and assure the integrity of information transmitted through networks, officials said.

The MC4 update also includes an improvement to patient safety as it relates to allergies and medication history.

"When that laptop is connected to the Internet, the documentation becomes available to any provider in the world with access to the system," Harley said. "In theater, we capture data in a repository known as the theater medical data store. That allows all information to be available to providers anywhere in the treatment of that Soldier from the time of point-of-injury all the way to the time he's evacuated to places like Walter Reed or San Antonio."

Harley said eventually all medical information moves to a clinical data repository which contains all medical care from the time a Soldier enters the service until discharged from the Army.

Mark Gregory, who serves as MC4 technical management division director, said there weren't a lot of functional changes with the system because it was running Windows XP before upgrading to the Windows 7 platform and moving from Windows Server 2003 to Windows Server 2008.

"That was the major change from an engineering standpoint, making sure we had a secure system that meets information assurance requirements out on the battlefield," Gregory said. "Again it goes back to an engineering issue because when you change operating systems, there's a lot of work that has to be done. The most significant upgrade outside of the MC4 operating system was the GUI (graphic user interface)."

Beyond the technical changes that we made, there's also a certain amount of functional changes that happen within the software, whether it's the inpatient module, outpatient module, the medical supply ordering," said technical advisor Jeannie Winchester, MC4 information assurance manager. "The user wants to see changes, new functions, new features… maybe something is outdated and needs to go away… so there are always those types of changes as well."

The new MC4 software was tested by Army medical personnel last year.

MC4 has become the most widely used, comprehensive information management medical system on the battlefield, Harley said. He said the system has enabled the capture of nearly 22 million electronic patient encounters since it was first established by presidential and congressional mandate for all the services in 2003.

More than 500 active, National Guard and Army Reserve deployable medical units use the MC4 system in 16 countries. Combat medics or physician assistants record the scenario under which a Soldier was injured along with the treatment and patient care via a hand-held device which encrypts all information.

"After the patient is stabilized, the Soldier and medic move to the next level, such as combat support hospitals," Harley said. "The entire record is uploaded to an encrypted MC4 laptop to maintain privacy."

Once in a medical treatment facility, providers can use the MC4 system to its fullest potential, to document inpatient or outpatient care, facilitate laboratory and radiology services and even pharmacy orders or medical supplies.

Related Links: Health News

Medical Communications for Combat Casualty Care (MC4) Part 1

Medical Communications for Combat Casualty Care (MC4) - Part 2

The Gateway: Army Tactical Health Information Systems Resource