FORT SAM HOUSTON, TEXAS - In an effort to streamline and ensure efficiency in maintaining Soldiers' medical records, the U.S. Army Medical Information Technology Center, in partnership with the U.S. Army Medical Command and the Military Health System, recently completed deployment of its Clinical Information System-the Essentris® Clinical Suite.

The Essentris® system is an Army Medical Department inpatient electronic health record system which allows for standardized usage across all Army medical treatment facilities, for all beneficiaries. This includes active duty, National Guard, reserves, dependents and retirees. Essentris® is the counterpart of the Armed Forces Health Longitudinal Technology Application (AHLTA) which is the MHS electronic health record solution.

"Although the Essentris® system had been around for years, the war in Iraq helped to increase the rate of the deployment," said James Hickey, USAMITC's Project Director Branch Chief and Project Manager for the AMEDD Essentris® deployment. "The U.S. started receiving a greater number of casualties, and sent them to Landstuhl [Germany] first before bringing them to the U.S.," he said. "The health care team needed an improved way to track patient care, because it was difficult to ascertain conditions and render follow-on care from paperwork attached to patients, which was how it was done before," he mentioned. This provision of the patient's electronic medical record is what made the difference. "After the deployment of the Essentris® system in Landstuhl, it was clear the system worked," Hickey added.

"The deployment of Essentris® at Landstuhl in Germany was in fiscal year 2007," said Laura Smith, an Essentris® Project Management Support Specialist. She said this was followed throughout fiscal years 2007 and 2008 by deployments to medical treatment facilities at Fort Campbell, Ky.; Fort Gordon, Ga.; Fort Stewart, Ga.; Fort Carson, Colo.; Fort Jackson, S.C.; Fort Sill, Okla.; Seoul, Korea and Fort Leonard Wood, Mo. "Fiscal Year 2009 brought about deployments to MTFs at Fort Riley, Kan.; Fort Knox, Ky.; Fort Wainwright, Ala.; Fort Polk, La.; [U.S. Military Academy at] West Point, N.Y.; and finally Vicenza, Italy, which completed the Essentris® deployment," she added.

The Veterans Administration also has access for when patients move between the Department of Defense and the VA via the Bidirectional Health Information Exchange. This is a secure, bidirectional, database system link with real time viewable electronic health information between the Department of Veterans Affairs and the DOD. The BHIE came about from a Congressional mandate which had to happen in calendar year 2007 as a way to move medical information from Landstuhl to the VA. Essentris® and BHIE are two separate database systems working together to benefit each other and support continuity in patient care.

Although Essentris® had been around for years as mentioned earlier, standardized deployment of Essentris® started at the deployment of Landstuhl for two reasons: as a way for Landstuhl to get information to the VA via BHIE as mentioned above, and to deploy a standardized baseline of Essentris® to the remaining MTFs, instead of each MTF being deployed separately. The reasons to deploy Essentris® in a standardized method were to assist the MTFs, support the MTFs and to share best practices - which means that well-established MTFs would share forms and processes with all MTFs across the AMEDD to provide better patient outcome and to improve support of clinical staff. "The same time the Essentris® deployment was going on," said Kathleen Sotello, Senior Analyst for the Office of the Chief Medical Information Officer for the Army, "the OCMIO has been working to standardize the database for the MTFs that were deployed earlier prior to the standardized deployment."

"The Army took the lead in completing this project," said Essentris® Project Manager Elaine Washington. "The Navy and Air Force are also deploying their Essentris® counterparts. All DoD Military will have an electronic medical record - this includes uniformed personnel, dependents and retirees in all branches," she stated. "USAMITC was asked by the Air Force to deploy [Essentris®] to Wilford Hall Medical Center because of the Base Realignment and Closure action resulting in shared patients and shared staff at the two facilities in San Antonio," she added, referring to Brooke Army Medical Center and WHMC.

"Some Essentris® deployments took 100 plus days and some took shorter periods of time, depending on the size of the MTF," said Washington. "USAMITC's Project Management Team worked with individual MTFs to stay within their missions and to make sure the vendors met the MTF needs."

"This was definitely a team effort," Hickey said. "We brought a team aboard and made sure everyone was brought up to speed on how and why we were deploying Essentris®," he concluded.