Medical breakthrough

Three industry giants provide the hardware for the Army's combat casualty care system

In this report

Electronic medical records.

AGENCY: Army.

PARTNERS: Medical Communication for Combat Casualty Care, Hewlett-Packard Co., Motorola Inc.
and Panasonic Corp.

GOAL: To better capture and save medical information about soldiers throughout their careers and make that information available anywhere it is
needed.

OBSTACLES: Paper records make it harder to record information, and they are more easily lost.

SOLUTION: A fully digital system ensures the records are accurately
captured and makes it easier to access the records anywhere in the world.

PAYOFF: Soldiers are receiving better medical care throughout their careers.

During a routine foot patrol looking for insurgents
in Mosul, Iraq, Master Sgt. Wynton
Hodges broke his ankle in two places.
He was placed on a vehicle and brought
back to the Army's combat support hospital
for treatment. As soon as Hodges'
treatment began, every detail of
his care was recorded electronically in the
Medical Communication for Combat Casualty
Care (MC4) system.

Hodges was treated in theater and received
physical therapy in Iraq, all of which was
recorded in MC4.

When his 2006 deployment ended, Hodges
was stationed in San Antonio, where he started
having problems with the same leg.

Hodges went to the Brooke Army Medical
Center for follow-up care. A physical therapist
at the center peppered Hodges with
questions: When did you break your ankle?
Which bones were broken? What treatment
was rendered? What kind of physical therapy
did you undergo?

"I'm looking at him and trying to think,"
Hodges said. "It was 15 months ago, hundreds
of missions later. I had limited information.
I couldn't give him all the details."

However, Hodges knew all that information
was stored in MC4, and he asked the
therapist if he could access it.

The therapist could. "He was able to bring
up my treatments and everything I received
in Iraq, which led him to [send me] to an
orthopedic surgeon," Hodges said.

Hodges had successful surgery on both
legs. He said MC4 led him toward
the correct care.

RUGGED ENVIRONMENT

The MC4 program relies heavily on ruggedized
hardware from communications and
computing giants Hewlett-Packard Co.,
Motorola Inc. and Panasonic Corp. These
companies provide a wide variety of devices
for MC4, including handheld devices, laptop
PCs, servers and printers.

The handheld computers used for MC4 are
the HP iPaq 4700 and Motorola MC70. For
laptops, MC4 uses the Panasonic Toughbook
CF51 computer. In some instances, the
Panasonic Toughbook is used as a server
accessed by other Toughbooks.

The ability to record medical records electronically
and have those records accessible
from anywhere could be the model for other
health care systems, said Col. Kelly Wolgast,
deputy commander at the 14th Combat Support
Hospital.

Wolgast was deployed to Afghanistan,
where her unit used the MC4 system extensively
in treating patients. "With MC4, soldiers
never have to worry about their record
being lost," she said, "It is all archived and
saved for them in the future."

MC4 is used at all Army and Air Force
medical facilities, on the battlefield, and in the
Multinational Forces and Observers Effort in
Sinai, Egypt. Army Special Forces, Navy and
Marine health care providers throughout
Southwest Asia also use the system.

More than 5 million electronic medical records have been captured since MC4's
deployment in 2003.

The system gives soldiers better continuity
of care while giving providers up-to-date
information to avoid repeat procedures. It also
provides commanders with improved medical
situational awareness to better place medical
resources and personnel on the battlefield.

Important medical information about a
patient can be sent via MC4 from the battlefield
to any hospital or doctor's office with
access to the system.

"I don't think a lot of people realize that
when soldiers deploy, they don't deploy with
their medical records," Hodges said. "Having
this computer system and being able to go in
and query the system anywhere in the world
is a huge step forward."

Hodges worked as a medic and remembers
how the system helped a wounded soldier who
was hit by an improvised explosive device in
Iraq. As he was evacuated to the Green Zone
in Baghdad, doctors there were able to see the
details about his injuries and care so they
could be prepared to meet his specific needs.

Those kinds of electronic records were not
available in the recent past, said Hodges, who
also was a medic in Bosnia in the 1990s.

Hodges said he recalls being hospitalized
there, and all the charting and recordkeeping
was done by hand.

"I'm not sure the care I received in Bosnia
is in my permanent paper medical records,"
he said. "But I can tell you with certainty that
everything that happened to me in Iraq is in
the digital MC4 system."

Using the MC4 handhelds, even soldiers
who are wounded in remote parts of
Afghanistan start having their medical information
recorded automatically as soon as
care is provided so medical staff at Bagram
Air Base are able to monitor the care.

The system records a patient's injuries,
vital signs and treatments. All that information
wasn't necessarily recorded in the old
paper-based days, Wolgast said.

"In the old days, in the heat of taking care of
a soldier in a casualty situation where you
might have been taking enemy fire, you did
what you had to and then you recorded the
information by hand later," Wolgast said. Trying
to recall details after the fact occasionally led to
omissions or inaccuracies, she added.

With MC4, the information is recorded
automatically.

WIDE DEPLOYMENT

The Army's MC4 program has deployed more
than 24,000 systems to medical units in Iraq
and 13 other countries and has trained more
than 26,000 field medics, doctors, nurses and
commanders on use of the system in combat
support hospitals and battalion aid stations.

The system will even follow soldiers as they
enter the Veterans Health Administration.
Hodges said he expects it will benefit him
when he retires from the service.

"The VA doctor can either flip through the
paper record and hope that the information
he wants is there, or he can click a mouse and
use the MC4 system to see the details of my
injury and care," he said.

Doug Beizer (dbeizer@1105govinfo.com) is a staff
writer at Washington Technology.

About the Author

Doug Beizer is a staff writer for Washington Technology.

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