This spring, the 7th Theater Tactical Signal Brigade and the Medical Communications for Combat Casualty Care (MC4) program completed the first successful migration of the Army's electronic medical record (EMR) system onto the Afghanistan enterprise network.

The transition enables remote maintenance of systems used to document patient care, restock medical supplies and conduct medical situational awareness. By adding the system to the Afghanistan network, staff can now easily monitor and repair more than 100 computer systems used throughout treatment facilities in Afghanistan.

Users benefit by way of improved functionality, strengthened security and greater customer service with less equipment and in-person support required. The effort marks the first time a standard Army management information system (STAMIS) has successfully migrated its system onto the Afghanistan theater enterprise network.

"Our partnership with the 7th Signal Brigade is a significant accomplishment and is almost as important as the initial deployment of the EMR systems in 2003," said Lt. Col. William Geesey, MC4 product manager. "MC4 systems are on the fielded enterprise infrastructure, similar to the network configuration at a garrison installation. The ability to remotely monitor and service computers takes our systems support to an entirely new level."

Joining the network not only streamlines MC4 technical support efforts, but it also eliminates excess equipment. The migration also reduces the coordination required by signal personnel to open firewalls, ports and Internet access on a system that typically resides outside a theater's domain.

"During a recent trip, I watched MC4 personnel remotely monitor the functionality of EMR systems in use at the various treatment facilities," said Tracy Ellis, MC4 director of operations. "All were 100 percent operational, except for one MC4 computer that contained outdated antivirus software. With a couple clicks, an MC4 representative pushed the update to the laptop while the provider entered patient notes, without interruption."

Since MC4 systems joined the Afghanistan network, health care providers can complete tasks using one laptop as opposed to multiple machines. They can also access their terminals via a common access card, providing single access to their military e-mail account and to shared document repositories to better coordinate patient care.

"The functionality added to MC4 computers helps to promote the use of EMR systems throughout the clinics," Ellis said. "Providers no longer view the computer as a separate entity to use for a specific task. It's now worked into their daily routine."

The migration of EMR systems to the enterprise network offers improved security measures and "the move is win-win for both MC4 and the 7th Signal Brigade," according to Chief Warrant Officer Patrick Quenga, network security engineer and information assurance officer for the Joint Network Control Center-Afghanistan.

"MC4 benefits from the network's robust architecture and automated sensors in place to pick up and eliminate viruses and other malicious activity throughout the enterprise," Chief Warrant Officer Quenga said. "The network is now stronger with the addition of the EMR systems. Systems that reside outside of the domain typically operate with outdated security measures. With MC4 systems on the network, we can now perform automated scans for security issues and push software updates without inadvertently breaking the EMR system."

With the success of remote desktop maintenance and support, MC4 plans to expand the capability to additional forward operating bases. Development of policies and standard operating procedures will play a key role in this expansion.

"As we expand the new support model to other locations throughout Afghanistan, and potentially other parts of Southwest Asia, I expect that we'll be able to reduce the number of support personnel we have in theater," Lt. Col. Geesey said. "As such, we'll be able to reallocate resources to support other requirements and missions worldwide."

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