AHLTA-T in TRICARE Remote Locations

(1)PRESENT METHOD: In garrison, the AFMS utilizes the Armed Forces Health Longitudinal Technology Application (AHLTA) as its Electronic Health Record (EHR), to document treatment of its patients. In theater, the AFMS utilizes Armed Forces Health Longitudinal Technology Application - Theater (AHLTA-T) as its deployed EHR, to document treatment of its patients.
AHLTA-T is a modified version of AHLTA used on a stand-alone laptop computer or server-client based system in a deployed theater environment. All data captured in AHLTA and AHLTA-T resides within the Clinical Data Repository (CDR) thus allowing all electronic medical data to be stored in one central repository.
Currently, the AF has many remote assignment locations (not within the AOR) with no access to AHLTA whatsoever. DoDI 6040.43 restricts hand-carrying of the physical paper medical records. In order to meet the intent of the DoDI, most are required to procure a copy of their paper records and printed electronic encounter from the EHR prior to departure to these locations. Very few are authorized to hand-carry their records. Often, the original paper records are mailed to the remote location; however they are often lost or misrouted. Lost medical records are considered to be a breech under Federal HIPAA laws. Additionally, if lost, the ability of the member to file a claim with the VA upon retirement or separation is hindered. While a claim can be initiated with a copy of the medical record, it is not official or complete without the original records. Without the original record, the member’s claim will be left unfiled and the member will not receive their due compensation. These current limitations do not allow us to completely comply with Presidential and Congressional mandates: ▫ Special Report of the Presidential Advisory Committee on Gulf War Veterans' Illness, the President Directed: ▫ “…Every Soldier, Sailor, Airman and Marine will have a comprehensive, life-long medical record of all illnesses and injuries they suffer, the care and inoculations they receive and their exposure to different hazards.” ▫ TITLE 10; Section 1074f (1997): Medical Tracking System For Members Deployed Overseas… ▫ “The Secretary of Defense shall establish a system to assess the medical condition of members of the armed forces (including members of the reserve components) who are deployed…” ▫ ASD(HA) memo, dated 7 June 2005, SUBJ: Expanded use of Automated Medical Data Collection and Patient Tracking Applications ▫ When available, TMIP tools will be used to capture outpatient and inpatient encounters

(2)PROPOSED METHOD: Have the remote assignment locations (those with medical capabilities) utilize AHLTA-T (TMIP). If these locations had AHLTA access, there would be no need for the MTF to have to print the EHR encounters prior to departure.
Additionally, the original paper record would not have to travel with the patient or be mailed; it could stay in place with the losing MTF until requested by the gaining MTF at the member’s next (non-remote) duty station.

(3)EXPECTED BENEFITS: Benefits would affect all involved – the patient, the MTF, and the AF as a whole. The patient would benefit as out- processing will not require the burden of requesting a copy of their record prior to departure (current minimum is 30 days). The patient would not have to worry about misplacing or losing their records en-route or at the location. The MTF would benefit as they would not have to make a copy for the patient prior to departure – saving man-hours and resources. The patient’s records would not have to be mailed, thereby saving money on mailing and reducing the likelihood of them being lost, and consequently reducing the number of HIPAA breeches and Congressional complaints filed by members searching for their medical records to file a claim with the VA. If implemented, it will bring the AF as a whole that much closer to fulfilling Presidential and Congressional mandates, by bridging the gap until the Integrated Electronic Health Record is completely deployed.

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