Aeromedical Evacuation EHR Operational Medicine



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Lt Col Justice Sakyi, Air Mobility Command Maj Jordan Lindeke, Air Mobility Command 2015 Defense Health Information Technology Symposium Aeromedical Evacuation EHR Operational Medicine 1

DHA Vision A joint, integrated, premier system of health, supporting those who serve in the defense of our country. 2

Learning Objectives Describe how the AE crew members utilize the EHR kits to document patient care, which increases patient safety Identify the different levels of the continuum of care Comprehend safe to fly and the futures plan for EHR 3

Agenda The Problem The Solution Lessons Learned Way Forward Discussion 4

Problem In 2007, the Capabilities Review and Risk Assessment process identified a gap in patient care documentation during patient movement (Aeromedical Evacuation and Critical Care Air Transport). Multi-tabbed patient documentation form; 3899 tabs A-L 5

Solution AHLTA-T with Alternate Input Method (AIM) Forms specifically designed for AE patient documentation Modernization Document submitted to Defense Health Information Management Systems (DHIMS) office for AE specific changes to AHLTA-T Unit Type Code and Allowance Standard developed for EHR specific equipment kits 6

Solution CDR Legend: Electronic Interface Manual Input and Data Exchange AHLTA CHCS TRAC2ES TMDS AHLTA-T CHCS TMIP MC4 TRAC2ES BMIS-T AE Medical Record AE Medical Record AE Medical Record AE Medical Record TRACES AE Medical Record Level IV Level V Level V Level IV Level II Level I Pacific Theater Redistribution COMMZ COMBAT ZONE FEBA 7

Implementation Phase I 86 CASF/10 EAEF Nov 10 100% in-flight electronic documentation Jul 11 Bagram CASF Oct 11 Ali Al Salem Oct 11 Phase II 86 AES Ramstein Feb 12 779 ASF Andrews Feb 12 59 CASF Lackland Mar 12 43 AES Pope Oct 12 375 AES Scott Oct 12 775 OL-A/B/C Andrews/Travis/Kelly Nov and Dec 12 8

System Improvements Strategic Pause instituted Dec 12; three areas of concern to address Wireless LAN capability in-flight Mi-Fi capability to transmit patient data to Theater Medical Data Store (TMDS) Policy and guidance from HQ AMC/SGK for implementation and use Successful in-flight Wireless/Mi-Fi capability assessments completed 19 May 13 on C-17 (Charleston); 13 June 13 on C-130 (Scott) 9

System Improvements Policy and Guidance (AFI 48-XXX, volume 3) written and coordinated by HQ AMC/SGK; currently staffed for USAF/SG signature Implementation resumed 1 Aug 13 Receiving provider can access in-flight patient care via TMDS before patient arrives at facility Medication Administration Record development completed; currently being deployed to worldwide AE sites CCATT patient documentation capability currently under development Incorporated Electronic Flight Bag ipads for patient documentation capability 10

Implementation PACAF - Jul 14 implemented Aeromedical Staging Facilities; Special considerations 86 AES, Kadena & Det 1 Hickam Phase III AFRC/ANG FY 16/17 11

Lessons Learned Difficult to procure equipment and implement while simultaneously integrating improved technology Technical knowledge/skill varies widely for AE crewmembers From an IT perspective, AE encompasses much more than care provided from on-load to off-load In-flight documentation capability is relatively easy to solve, transmission of data at patient on-load/off-load is difficult 12

Way Ahead Tactical Critical Care Evacuation Teams Critical Care Air Transport Teams Humanitarian Assistance/Disaster Response Burn/Lung Teams 13

Target Areas TCCET (Tactical Critical Care Evacuation Team) No documentation capability Utilize TCCC (Tactical Combat Casualty Care) Possible solution available; physiological monitoring CCATT (Critical Care Air Transport Team) Solution identified; SME approved $1.65M Unfunded Request for development Enhanced Technology Requirements Heads up display Voice Recognition Virtual Medicine/EHR 14

Evaluations Please complete your evaluations 15

Contact Information Lt Col Justice Sakyi Deputy Chief, Medical Modernization Division Air Mobility Command Justice.Sakyi@us.af.mil Maj Jordan Lindeke Chief, Business Operations Branch Air Mobility Command Jordan.Lindeke@us.af.mil 16

Questions? 17