The Military Health System has set up a version of its AHLTA <a href="/directory/electronic-health-record-ehr" target="_blank" class="directory-item-link"><a href="/directory/electronic-health-record-ehr" target="_blank" class="directory-item-link">electronic health record system for use in the White House.

MHS chief information officer Charles Campbell talked about the initiative at the recent Health Information and Management Systems Society's annual conference in Atlanta.

The system, which was set up in just two months, is based on AHLTA Theater, the Defense department's electronic health records system designed for rugged uses in war zones.

The White House EHR would be used in the residence's clinic, in Camp David, as well as on Air Force One and Marine One, the president's airplane and helicopter, Campbell said.

AHLTA Theater has a store and forward capability that allows it to preserve digital health records under conditions where no signals are available to transmit records to forward care stations.

That was appropriate for the White House system, which would be needed on the presidential planes and in remote sites that also potentially lack connectivity, Campbell said.

Based on SOA

AHTLA Theater is based on a Service Oriented Architecture, which enabled the rapid development of the White House EHR, Campbell said.

"We're very proud of that and the White House is extremely happy with what we've done," Campbell said. The White House is expected to sign off on the system soon, another official said.

The State Department is also considering turning to an MHS-derived EHR system, according to an agency health IT executive, who said it is seeking an EHR for its employees in the United States and around the world.

Priorities for 2010

In other remarks, Campbell gave an upbeat assessment of MHS's work in 2009 and sketched out the organization's priorities for the coming year.

MHS is about halfway finished upgrading AHLTA, its flagship EHR, to its latest version, 3.3, he said.

The upgrade has been criticized for taking too long but Campbell explained that not only does the new version have to be loaded onto massive central systems such as DOD's Clinical Data Repository but on every one of 110,000 end user devices around the globe.

"That's why it takes so long - but that's not where we're headed," Campbell said.

Instead MHS will focus on modernizing its EHR and information infrastructure, two goals at the top of a list of 10 initiatives in a strategic plan approved in January 2010.

"We have to build and rebuild and modernize the infrastructure so that we can be more agile, flexible and stable," Campbell said.

He vowed to make the EHR virtually unbreakable.

"What we have now is a difficult way of traversing the information and getting that information to the provider," he said. "It's kind of cumbersome but that's how it was designed 11 years ago based on the technology at the time.

"But times have changed," he added. "We have to modernize it in such a way so that the system from the end users' perspective cannot go down," he said. "The information always has to be available - always - and all the information complete, accurate, secure."

Campbell said by the end of March, MHS would be able to unveil specific plans and timetables for meeting these goals.

Then, "folks (will) know exactly where we are going. And what we're trying to do, and when we're trying to do it," he said.

"We can't continue to just put band-aids on things; we're going to fix them systemically and get it done," he said.