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U.S. military halts rollout of electronic dental record
By Kathy Kincade, Editor in Chief

November 23, 2009 -- The highly anticipated rollout of the U.S. Military Health System's (MHS) first integrated electronic medical and dental record has hit a snag.

Deployment of AHLTA Dental, the dental component of the military's electronic health record known as AHLTA (Armed Forces Health Longitudinal Technology Application), is undergoing a "strategic pause" to enable the MHS to "further analyze some existing functions within other systems," according to Charles Campbell, MHS Chief Information Officer.

"MHS is initiating a pause to do a pulse check of where we are with the process and make modifications based on the needs of our healthcare providers," Campbell said. "We need to make sure we can keep pace with the dental community's evolving needs, so I would rather take time to examine those needs and make adjustments now rather than replacing the system later."

“We need to make sure we can keep pace with the dental community's evolving needs.”
— Charles Campbell, Chief Information
     Officer, U.S. Military Health System

The AHLTA electronic health record is designed to integrate all dental and medical information in the MHS Clinical Data Repository, which maintains records on more than nine million active-duty and retired military personnel and their families.

MHS launched the dental module of AHLTA in March of this year. MHS had originally planned to deploy AHLTA Dental to nearly 400 Army, Air Force, and Navy dental clinics worldwide by the end of 2010, with the Army scheduled to begin rolling it out to 18 clinics this month. But on November 3, news reports indicated that the Army was pulling out of the deployment, opting to use its own dental record application instead.

In reality, all branches of the military are delaying the AHLTA Dental rollout, according to Michael Kilpatrick, M.D., MHS Director of Strategic Communications.

"This schedule delay is the result of an MHS agreement with all three Services to review existing options prior to making a decision to complete the remaining deployment," Dr. Kilpatrick told DrBicuspid.com in an e-mail.

Reviewing their options

In addition, while the Army's Corporate Dental Application (CDA) provides some capabilities that are not in the AHLTA Dental module, it was not developed to be an electronic dental record, Dr. Kilpatrick said.

"The CDA is a modular, Web-based application that meets several of the required dental capabilities other than the sustaining base electronic dental record capability," he said. "As it progressed, however, it acquired many robust features that allowed users to manage day-to-day dental activities."

In June 2008 the Army awarded Harris Corporation an $11.6 million contract to maintain and enhance the CDA.

"As we work to improve our electronic health record, we need to put the tools in the hands of our providers that can best support their needs for rapid documentation and access to their patient's health information," said Jack Smith, M.D., acting Deputy Assistant Secretary of Defense (Health Affairs) Clinical and Program Policy. "While we're still evaluating the business case for a change, the CDA appears to provide a reasonable alternate to address many of the current needs of our dental providers."

Because the CDA is currently available at Army and Air Force dental clinics, including remote locations in Theater, "it makes sense to review our options," Campbell added.

Despite the delay, Kilpatrick emphasized the MHS's objective to deploy a comprehensive electronic dental and medical record.

"The most important aspect of an electronic medical record is to be able to render accurate, secure patient information to the medical provider at the point of care," he said. "That goal has not changed."

Copyright © 2009 DrBicuspid.com

U.S. military launches integrated EHR, April 24, 2009

Electronic health records: Part II -- Patient privacy and ROI, January 6, 2009

Electronic health records: Part I -- Boon or boondoggle?, December 31, 2008


Last Updated np 11/22/2009 10:42:47 PM

9 comments so far ...
11/23/2009 9:08:06 AM
glenp
While the military works pretty well as a GOVT entity, we can see what a SNAFU true GOVT CONTROLLED health care will end up with the entire US population under BIG BROTHER'S thumb.
 
Left hand doesn'tknow what the right hand is doing and heaven forbid, as this article indicates, never use a ROBUST HIGHLY FUNCTIONAL product while there is a less than adequate alternative that doesn't meet needs well.
11/23/2009 9:31:13 AM
rw
Another perfect example of when Government run Healthcare (rubber) hitting the reality road. Road rash... We have seen example after example but very few of our collegues have the guts to stand up to stop it. If we don't stop it NOW there will be no PROFESSION of dentistry. I have heard these liberals that are pushing Healthcare Reform say that Doctors and Dentists should be put on the city payroll and paid the same as a police officer or firemen. If you continue to sit on your butts and not fight for the profession you will be sitting on your butts without a practice in the next few years. WAKE UP and STAND UP NOW before it is too late!!!
11/23/2009 9:31:50 AM
quabity_assurance
Hey glenp,

Are you in the military?  Are you a commander that is familiar with CDA and running clinic operations?  Why don't you spare us your political tirades and comment on something you know about.  This transition is no different than would occur in any large civilian organization making a strategic decision about information systems. 

I've struggled with CDA's somewhat clunky interface for a long time and would be happy to see something a little more modern, but I can also understand that a lot of important administrative features have been built into it.  If I were a DENTAC commander I'd want to have all those functions ironed out before the switch was flipped.

Mark M.
11/23/2009 10:58:02 AM
10thMTNdds
As a deployed dentist I can attest to how cumbersome CDA can be, especially now with the narrative we now have to enter while in theatre. And I really wish we had a better program to track completed treatment and planned treatment so I don't have to redo exams on soldiers before treating them. But I still think CDA is far superior to AHLTA after completing the AHLTA training. AHLTA just seems to add more hoops to jump through. I think my last DENTAC commander said it best-computers should work for us, we shouldn't have to work for them. I really hope the final AHLTA dental is a product that accurately captures our workload, allows us to look at past treatment, planned treatment, and gives us better access to the patient's health record. All in a package that can be accessed anywhere in the world. Our current health history form is a joke and in theatre I have no real access to a patient's past drug history and medical history without asking a physician to log me onto their system.

And I totally agree that the failure to roll this package out has nothing to do with Big Brother run healthcare. In fact, it is the opposite. It seems to me the dental corps realizes the product is flawed and won't accept it in it's current state. I personally think that's pretty responsible.
11/23/2009 6:57:49 PM
Sea Dentist
As a military dentist who served 2.5 years on a deployed warship with sailors and marines 2007-late 2009 with the US Navy.  the alta record does not work on deployed units and it is very cumbersome (limited bandwidth in the field or at sea), just like my fellow dds with the mt division stated.  the military does do one thing right our military paper records are more accurate and more complete than anything you can find in private practice.  as a doc who has looked at several practices to purchase, I am appalled at the errors in the private practitioners' dental record, regardless of a paperless record or paper record, records in private practice are a disaster.  before you blame the government for its short comings look at your own records first and your own short falls.
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