Faults in DoD's EHR cripple drug abuse tracking efforts

Medication documentation issues with the Department of Defense's electronic health record system are keeping doctors from successfully tracking drug use by soldiers, hindering their efforts to crack down on abuse, according to an article in Nextgov.

The Composite Health Care System electronic medical record module in the Defense Armed Forces Health Longitudinal Technology Application (AHLTA)--the EHR used by Naval Hospital Camp Lejune (N.C.)--doesn't allow DoD providers to keep track of prescription medication orders by non-DoD doctors, a problem outlined in a report released late last month by the Department Inspector General. One Army provider who asked Nextgov for anonymity, called the system "a mess," and added that doctors instead find themselves manually searching for such information.

"This is time consuming and is a reversion to the free-text note format that [Defense Health Affairs] has been unsuccessfully trying to wean physicians from with the failed AHLTA architecture," the doctor told Nextgov.

The doctor continued, saying that he believes AHLTA broke down due to too many systems feeding into the interface. "While the system used to work reasonably well when AHLTA was being fed only by local CHCS hosts at [military hospitals], now it appears that it is getting fed by some civilian pharmacy feeds, VA and possibly some theater data," he told Nextgov.

According to the report, efforts to remedy the system likely won't be made until Fiscal Year 2014, when funding has been allocated to do so. Such efforts include:

  • Adding functionality for providers to mark "Taking/Not Taking" for their patients' medications, regardless of source system.
  • Allowing providers to change medication status to "Taking/Not Taking" when users marks whether or not they are using over-the-counter medications.

To learn more:
- read the full Nextgov article
- here's the DoD IG report (.pdf)

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