View stunning SlideShares in full-screen with the new iOS app!Introducing SlideShare for AndroidExplore all your favorite topics in the SlideShare appGet the SlideShare app to Save for Later — even offline
View stunning SlideShares in full-screen with the new Android app!View stunning SlideShares in full-screen with the new iOS app!
U.S. A RMY M EDICAL R ESEARCH & M ATERIEL C OMMAND MG Eric B. Schoomaker, Commanding Deputy for Advanced Technologies COL Karl Friedl, MC, USA Director, Telemedicine & Advanced Technology Research Center (TATRC) LTC (Dr) Hon Pak, MC, USA Chief, Advanced Information Technology Group M EDICAL M ATERIEL D EVELOPER Protect the Warrior… Sustain the Force!
Apply physiological and medical knowledge, advanced diagnostics, simulations, and effector systems integrated with information and telecommunications for the purposes of enhancing operational and medical decision-making , improving medical training , and delivering medical treatment across all barriers .
The program scope is to identify, explore , and demonstrate key technologies and biomedical principles required to overcome technology barriers that are both medically and militarily unique.
Department of Defense, Joint Warfighting Science and Technology Plan, Chapter IX, Joint Readiness and Logistics, 1999
NAVY MEDCENS SERMC DDEAMC GPRMC BAMC PRMC TAMC Air Force MEDCENS WRMC MAMC 18 th MEDCOM 121 st General Hospital NARMC WAMC WRAMC Iraq Kuwait Afghanistan Balad ( Army & Air Force ) Baghdad Mosul Arifjan TMC ( Army & Navy ) Beuhring Ali Al Salem ( Air Force ) Theater Teleradiology Business Process A Theater Approach to Soldier Health Care: Teleradiology ERMC LRMC Germany Bahrain ( Navy ) Cropper Bucca Talil Tikrit Baghram Kandahar Salerno Kabul (Projected) Exams Work over flow / Medevac Radiologist LEGEND
Western Ft. Irwin Ft. Lewis (MAMC) Ft. Wainwright Pacific Tripler (TAMC) 121st General Hospital GE PACS Ft. Monmouth Ft. Sill Ft. Drum West Point Ft. Carson Ft. Huachuca Ft. Hood Ft. Sam Houston (BAMC) Ft. Polk Ft. Knox WRAMC Ft. Leonard Wood Ft. Riley Ft. Leavenworth Ft. Eustis Ft. Lee Ft. Meade Ft. Belvoir WBAMC North Atlantic Great Plains Ft. Bragg Redstone Arsenal Landstuhl Heidelberg Wuerzberg Siemens PACS Europ e Ft. Jackson Ft. Campbell Ft. Stewart Ft. Gordon (DDEAMC) Ft. Rucker Ft. Benning Ft. McClellan Digital Radiology– Where are we today? Agfa PACS IBM PACS Southeast Ft Buchanan, PR JTF Bravo
Single Sign On (SSO) to MHS Applications under development
Linked to DEERs for eligibility checking
Primary Means To Support Consumer Empowerment
Can make appointments
Pharmacy refill under development
Health Content for Patient Reference
Deployment related links
Personal Health Manager (journal and tracker) and Personal Health Record (demographics, allergies, medication and appointment profiles) under development
Home Page being re-designed
TRICARE Online (TOL) Schema Beneficiaries Providers/ Staff External Support Contractors Single Sign-On Defense Medical Human Resources System – internet (DMHRSi) Patient Safety Reporting (PSR) CHCS Defense Enrollment and Eligibility Reporting System (DEERS) Current TOL Applications and Services Single Sign on to MHS Systems (in progress) 104 Military Treatment Facilities Health Content Deployment Related Links Secure Provider Access CHCS (SPAC) Portal to Portal Single Sign-On Services to TOL Others Health Assessment Centralized Credentials & Quality Assurance System (CCQAS) Deployment Related Medical Records Online (DRMROL) AHLTA/Clinical Data Repository Non Availability Statements (NAS) Composite Health Care System - CHCS Service Portals Appointing External Systems Military Health System (MHS) Portal SSO
View Purchased Care Data Electronic Document [Future] MTF PACS (Agfa Web) Broker for person Identifier (DEERS PIDS fetch) Indicates Scanning/Import Tool ECP 915 Indicates Digital Imaging ECP 920 Indicates View Purchased Care Data ECP 919 DFI Registry
DFI Registry Query Service
DFI Registration Service
Document Engine/AHLTA Integration System Architecture Legends: Available To Be Implemented Oracle HTTP Server Document Engine Server OC4J (J2EE) Container DE Application DE Web Services Transcription System LCS Server JDBC Transcribed docs HL7 Messages: ADT, SCH … HL7 Messages: ADT, SCH … Document Capture Driver AHLTA Client WS Document Capture Applet Integration B2B HL7 Engine System Print Services Port 443 Port 443 Listener Port (e.g. 1521) LGSFEP #2 Server Generic Interface Port 443 Pulmonary Function System Medical Records Printers CHCS AHLTA DE Web Services AHLTA DE Module ICD Core Module XML Proxy Listener Port (e.g. 1521) CWSFEP ICD Enc. Mapper CDR Enc. Mapper Encounter Mapper DE HL7 DE CDR
Long History of Development of CONOPS through Flag-led WIPT and negotiations with MCSCs on what is required
Enterprise Wide Referral and Authorization Module (EWRAM)
HIPAA R&A WIPT: HIPAA OIPT Referral & Authorization (R&A) WIPT Created to Address Direct Care Business Process & HIPAA R&A Transactions Between MTF and MCSC
EWRAS: Enterprise Wide Referral and Authorization System
NAS: Non Availability Statements : Permits TRICARE Non-enrolled Beneficiaries to Receive Inpatient Care in the Civilian Market (NDAA 2002 – Mental Health Care only); Europe Uses NAS System For Referrals
EWRM: Enterprise Wide Referral Management IPT
EWRAP: Enterprise Wide Referral and Authorization Process IPT
M-EWRAS: Modified-EWRAS as a CHCS II Module
EWRAM: Enterprise Wide Referral and Authorization Module
EWRAS Interfaces MCSC TOL CENTRAL SERVER (at DISA) REFERRING PROVIDER ENTERS REFERRAL INTO EWRAS MTF HUB DEERS CHCS Ref. Approved to Direct Care Appointment 271 270 HL7 278 Civ Net INTERFACE ENGINE Referral Request, Status Updates, & Results 271 270 INTERFACE ENGINE MCP Request, Appointment Specialty Provider or Transcriptionist Enters & Verifies result into EWRAS