Sharing medical data imperative for care

By Tom Philpott: Military Update

William Winkenwerder Jr., assistant secretary of defense for health affairs, took time during a teleconference with journalists last week to tout his department’s ability to transfer electronically the medical records of separating service members to the Department of Veterans Affairs.

In doing so, Winkenwerder ignored a rising chorus of critics who say AHLTA, the Department of Defense’s digitalized medical record system, is a problem for the VA and for veterans because, in fact, it doesn’t allow electronic record transfers outside the military network.

The critics include the Government Accountability Office, senior VA officials and, most recently, the chairmen of the both the House and Senate veterans’ affairs committees.

GAO reported last month that the biggest obstacle remaining for severely wounded troops to experience “seamless transition” from military care to VA trauma centers is the inability to transfer AHLTA records.

Sen. Larry Craig, R-Idaho, chairman of the Senate Veterans’ Affair Committee, told Government Health IT that the VA has an “award-winning, highly touted” electronic health records system while the DoD “is still talking about ‘requirements.’ ” This, said Craig, leaves him “to wonder whether DoD is just trying to justify … building its own system.”

Rep. Steve Buyer, R-Ind., Craig’s counterpart in the House, also complained to the IT industry newsletter. He said AHLTA is less capable than VISTA in its ability to share data between its own hospitals.

But Winkenwerder ignored these complaints and described how AHLTA’s electronic data transfers are helping patients transition to VA health care.

“We transmit electronically every month records on our separated service members so that when (they) show up for services in the VA their records are available to providers, which is very important,” Winkenwerder said. “Again, that is not something that existed a few years ago.”

His comments came in unveiling a new DoD instruction on deployment health. Winkenwerder said it’s a compilation of policy decisions taken over the last four years to enhance force health protection dramatically.

Two of the initiatives are new. First, DoD is committed, as capabilities allow, to collecting data daily on the location of every service member deployed. This will allow officials to link environmental monitoring data to individual deployments and, over time, correlate exposure data to veterans’ health. Also, DoD will extend all health protection measures to deployed DoD civilian employees and contractors as well as service members.

Regarding AHLTA, Winkenwerder volunteered only praise for the system despite GAO’s findings that VA complaints regarding limits on electronic transfer of military medical records are well founded.

Through June, more than 19,000 service members had been wounded in Iraq and Afghanistan. Sixty-five percent had blast injuries, which often result in trauma requiring comprehensive rehabilitation. GAO said nearly 200 severely wounded members, while still on active duty, have been transferred to VA poly-trauma centers for care and rehabilitation. Most of these cases involve brain injury, missing limbs and spinal cord injuries.

VA and DoD have strengthened procedures for transferring war-injured members and veterans, GAO said. Their joint programs have eased hassles for patients and families. VA social workers are assigned to large military treatment facilities to coordinate transfers. Military liaisons have been added to VA staff at poly-trauma centers to handle transition issues raised there.

Tom Philpott can be contacted at Military Update, P.O. Box 231111, Centreville, Va. 20120-1111, or by e-mail at: