The hand-carried Government Personal Health Record (GPHR) (2nd Gen CAC).

How does the idea work? The GPHR enhances Continuity of Care for the Patient and the Provider by providing a current electronic record of care, medications, and medical history. The GPHR is a 2nd Gen Smart card, which can be read at any current MHS CAC Reader, today. The card provides includes data-at-rest & in-motion security (FPS 140). Providers can insert the card at the time of care delivery, when the care episode is complete the encounter is saved to AHLTA and to the GPHR at the same time. The card is always available to the patient. It can accompany the patient to each outpatient appointment, emergency visit, and would have a “break-glass” feature for out of network access in lifesaving situations. The 2nd Gen CAC, has [large capacity] currently 250MB (soon to be 1GB). HIPAA + security, portability, and can be read in any Government health facility using existing on the ground technology. How does it support the readiness of our troops and medical force? (see diagram below) During pre-deployment all Warriors receive updated CACs. The current personal information, training, immunizations, etc are all updated prior to deployment on a single 1st Gen CAC. The GPHR concept could integrate into the PRE process of pre-deployment. Each active duty member could receive an up-to-date medical record along with all the other PII and PHI information, loaded to a single 2nd Gen CAC. (This concept is a medical only suggestion) The 2nd Gen Smart card capacity and interoperability did not exist prior to FY12 Currently emerging medical and clinical test and lab results can be stored for each beneficiary in near-real time at both repositories, the CDR and the PHR CAC) Capacity will exist for near-future capture of imaging, nano-fluidic lab-on-a-chip systems new forms of genomic sensing such as chemical, optical, thermal, electrical, and biological, with analysis available anytime, anywhere. In theater, the card can be carried to sick-call, read on a laptop, updated with treatment rendered. Access offers bio-metric, (finger) includes is role-based Users authentication. Access is controlled by role-based authentication (QUAD-service CRUD matrix of MOS roles), expandable.
Inpatient admission. The card can travel with the Warrior; it can be updated along the “continuum of care”. Omnipresence Example: Administrative – demographics, Company Medic – Sick-call; Nurse Practitioner - Emergency Department, Physician (specialist). Sustainment Quad-Service updates capability: updated at deployment, PCS, or medical encounter.
What would a small pilot look like? How many pilot locations would be needed? What resources would be used? Proof-of-concept is summer 13 at Ft Dix; Network Modernization Ft Dix exercise is scheduled. Phase 1 pilot could run at any garrison military facility, NCA or power projection post preferred. Medically evaluate outpatient, inpatient, and emergency department. Administratively, include Patient Administration Division. Consider a personnel interface, minimum one site per Service. Cost estimates? The cost to demo the proposed system following the actual exercise Proof of concept summer 13, would make the assumption that all equipment, software, integration and PHR (CAC) cards could be re-purposed for a MHS Innovation demo. Cost Guesstamate is < $ 20,000 Therefore, cost would be reduced to site prep, staff transportation, validation (IATO) for network access, and two days to set-up on a laboratory environment followed by 1-hour to demonstrate. The MHS Pilot could leverage equipment from the Ft Dix NM-13 exercise. Laptops, hand-helds, cards, etc. (includes notional patients with notional (unique) DOD numbers) : Role 0 – Medic / Role 1 Battalion Aid Station / Role 2 Forward Surgical Team / Role 3 Hospital (include Patient Admission). Cards will cost ~$10 each / Galaxy Note II 5” phones $500 each x 4 / MC4 laptop $2500. Staff travel (4) and per-diem three days. Cost is $5,000 per demonstration site. Multiple sites times four Services, total $ 20,000 What does the implementation timeline look like for your pilot? Proof-of-concept is 3Q13, at Ft Dix, Network Modernization exercise. MHS review 4Q13. Prototyping FY14 for same year implementation If you have any supporting documents/models, (embed below) please include them with the submission.

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