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Theater Medical Information Program – Maritime (TMIP-M) Overview and Status Update 24 June 2008

AHLTA Clinical Advisory Board. Theater Medical Information Program – Maritime (TMIP-M) Overview and Status Update 24 June 2008. Claudia Kiefer, TMIP-M Program Manager. Introduction. Theater Medical Information Program – Joint (TMIP-J) is the DoD-wide solution to multiple legislative mandates:

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Theater Medical Information Program – Maritime (TMIP-M) Overview and Status Update 24 June 2008

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  1. AHLTA Clinical Advisory Board Theater Medical Information Program –Maritime (TMIP-M)Overview and Status Update24 June 2008 Claudia Kiefer, TMIP-M Program Manager

  2. Introduction • Theater Medical Information Program – Joint (TMIP-J) is the DoD-wide solution to multiple legislative mandates: “…every Soldier, Sailor, Airman and Marine will have a comprehensive, life-long medical record…” Source: Special report of the Presidential Advisory Committee on Gulf War Veterans’ Illness, 1997 “The Secretary of Defense shall establish a system to assess the medical condition of members of the armed forces…who are deployed.” Title 10; Section 1074f (1997): Medical tracking system for members deployed overseas “Effective immediately, the Services will implement and use the approved TMIP-J application suite to capture healthcare-related data.” ASD(HA) draft memo; 2008; Policy on World-wide Use of the Theater Medical Information Program-Joint (TMIP-J)

  3. TMIP-J Operational View OV-1 Interoperability across the Continuum

  4. TMIP-J Software Applications Suite DCAM PMITS DMLSS T-DBSS AHLTA- Mobile TeleHealth TRAVAX EIC TMDS JMeWS MAT/JMAT JTTR JPTA BHIE-T SAMS GEMS MEDIC GCSS AHLTA-Theater AHLTA Warrior TMIP CHCS Caché (TC2) DOEHRS - IH TRAC2ES Mobile Electronic Health Record Patient Movement Command & Control Medical Logistics Mission Pillars

  5. Joint Military Needs • Expanding worldwide medical visibility requirements • Integration over: - Time & Space - Organizations (Levels of Care, Functions, Agencies, Coalitions) • A broad view of medical information to support operational and strategic decisions • Analytical tools and decision support systems • Visualization tools to display spatial and temporal relationship of information

  6. Defense Health Information ManagementSystem (DHIMS) • Clinical Information Technology Program Office (CITPO) and Theater Medical Information Program - Joint (TMIP-J) were consolidated on 2 June 2008 to form DHIMS • CITPO developed and deployed clinical applications such as AHLTA, the MHS electronic health record • TMIP-J developed and/or adapted solutions to support the Theater clinical business practice to include AHLTA-Theater • Benefits • Develops solutions that are scalable across the enterprise • Aligns objectives and goals for a seamless electronic health record • Eliminates communication gaps from a functional, technical and operational perspective • Eliminates redundancies and increase efficiencies

  7. Defense Health InformationManagement System (DHIMS) Vision & Mission Vision Provide a world class health information management system to supportthe military’s Electronic Health Record (EHR) for our Warriors and their families Mission Provide a suite of health information solutions to capture, manage and share health data

  8. Current TMIP Capabilities (Block 1) • AHLTA-Theater • Version 301.3 • Outpatient Treatment Documentation • AHLTA Mobile • Version 1.9.8 • First Responder Application • Electronic Field Medical Card • Joint Medical Work Station (JMeWS) • Version 2.2.3.1 • Command and Control • Medical Surveillance • Classified/SIPR • TMIP CHCS Caché (TC2) • Version 1.0.0.0 • Technical Refresh of CHCS-NT • Inpatient Treatment Documentation • Pharmacy, Laboratory, Radiology Support • Theater Medical Data Store (TMDS) • Version 2.2.3.2 • Individual Theater Medical Encounters • BHIE-T Interface • Unclassified/NIPR

  9. Current Logistics Capabilities in Theater • DMLSS Customer Assistance Module (DCAM) Version 1.1.39.0 • Stand alone MEDLOG application that enables users to electronically download catalog data, place orders, and obtain status information from their supply activity • Can be used by all medical personnel • Operates in austere communication environments • Capability to feed data to Joint Medical Asset Repository (JMAR) • Patient Movement Item Tracking System (PMITS) PlexusD Version 1.0.2.0 • Tracks air certifiable medical equipment evacuated with the patient • Facilitates the management and distribution of PMI assets • Stand-alone application which requires a modem to communicate • Utilizes bar-coding and scanning technologies

  10. Block 2 Release FY07 (Formerly B2R1) Originally Planned: Development Added to Block 1: Other Products: • AHLTA-Mobile 2.0* • AHLTA-Theater 301.9* • JMeWS 2.2.3.4* • Business Objects (Ad Hoc Reporting) 6.5.1 • * Newer Version Than Planned • TMIP Composite Health Care System Caché (TC2) 1.0.0.0 • TMDS with JPTA functionality 2.2.4.0 • DMLSS Customer Assistance Module (DCAM) 1.1.106.0 • TRANSCOM Regulating and Command & Control Evacuation System (TRAC2ES) Interface • Patient Movement Items Tracking System (PMITS) 1.0.2.0 • Shipboard Non-tactical Automated Data Processing Program (SNAP) Automated Medical System (SAMS) 9.02.00 Environment: Windows XP Professional/Server 2003 Oracle 10g Sustain Block 1 until the Services migrate to Block 2 OT completed 5 February 2008/ FDDR planned for August 2008 To be released to Service Infrastructure Program Offices in July 2008

  11. Block 2 Release FY07 Highlights • AHLTA-Theater • Alternate Input Methods (AIMS) Forms • Includes 111 standard templates • MACE Forms • SAMS demographic interface • Limited inpatient capability for Forward Resuscitative (Level II) • Off-line demographic verification • AHLTA Warrior (Phase 2) • Reachback to the CDR for Patient History • Clinical Encounter • Allergies • Laboratory • Radiology • Pharmacy • Single Sign On (SSO) with TMDS • Eliminates multiple passwords • Reduces multiple login screens to one

  12. Theater Medical Data Integration (TMDI): Today

  13. TMDS-BHIE ViewLab Data Sharing TMDS View AHLTA - BHIE Data Viewer

  14. TMDS-BHIERadiology Data Sharing TMDS View AHLTA - BHIE Data Viewer

  15. TMDS-BHIEMedication Data Sharing TMDS View AHLTA - BHIE Data Viewer

  16. TMDS-BHIEInpatient Data Sharing TMDS View AHLTA - BHIE Data Viewer

  17. TMDS-AHLTA ViewCDR Records TMDS View AHLTA CDR view

  18. TMDS-VISTA CPRS BHIETheater Clinical Data Sharing TMDS View VISTA CPRS BHIE

  19. TMDS-TRAC2ES InterfacePatient Movement Data TMDS View TRAC2ES PMR

  20. TMIP Outpatient DATA Outpatient Statistics (1 Jan 05 – 30 Apr 08) 1,748,051 Total Encounters

  21. Access to TMDS (NIPRnet) • https://fhp.osd.mil/registration.jsp The Theater Medical Data Store (TMDS) provides web-based access to service member information collected at theater based medical treatment facilities (MTFs) using AHLTA-Theater, Shipboard Automated Medical System (SAMS), Global Expeditionary Medical System (GEMS), and Caché TC2. Individuals seeking access to this data must request a TMDS user account by filling out this registration form. Account requests must be reviewed and validated before user accounts are created. User accounts are usually validated and activated within 48 hours of the request. Questions about this web site should be directed to tmds.help@deploymenthealth.osd.mil. Register for a TMDS account.

  22. Access to JMEWS (SIPRnet) • https://www.mc4.army.mil/mc4newsletter/2007_7/ask.asp To acquire a JMeWS account from a SIPR computer, go to the URL: https://JMeWS.fhp.smil.mil. Click on the “Need Access” link. Fill in the requested information and select “Register.” After you complete and submit the registration process, you will receive an e-mail stating that you are now a registered user of JMeWS. You can also contact the JMeWS Help Desk via e-mail (jmews.help@deploymenthealth.osd.mil) or call 703 578-8553.

  23. Access to AHLTA Warrior • https://warrior-sa.lrmc.amedd.army.mil • AHLTA Warrior is currently available only in theater. It features a Virtual private network (VPN) access to a CITRIX server allowing read-only access into the central data repository (CDR), which stores Service members’ permanent medical records. • Provides deployed medical professionals with access to past medical histories, from which they base current and future treatment plans for injured Service members • Prevents redundant tests and treatments on the battlefield • Assures Service members do not have to remember and recite their complete medical history to medical staff when being treated in the combat zone • Request an AHLTA Warrior account by completing the request form at https://www.mc4.army.mil/help/AHLTA_Warrior.asp,and e-mailing it Mr. Daniel Armstrong, Daniel.Armstrong2@amedd.army.mil

  24. Block 2 Release FY08 • Products Brought • Forward From • Block 2 Release FY07 • AHLTA-Mobile • TMIP Composite Health Care System Caché (TC2) • Patient Movement Items Tracking System (PMITS) • Expeditionary Framework (EF) • Defense Occupational & Environmental Health Readiness System - Industrial Health (DOEHRS-IH) Web • AHLTA Reachback • JPTA merge with TMDS • TMDS to BHIE-T • TRAC2ES Interface with TMDS • New Development • AHLTA-Theater Convergence • Defense Medical Logistics Standard Support (DMLSS) Oracle Technical Refresh (OTR) • DMLSS, Customer Assistance Module (DCAM) Upgrade • TRAC2ES Mobile - Non-Integrated with Expeditionary Framework • Shipboard Non-tactical Automated Data Processing Program (SNAP) Automated Medical System (SAMS) – Interface Demographics • Public Key Infrastructure (PKI) and Internet Protocol version 6 (IPv6) – Address requirements applicable to Theater • Joint Medical Work Station (JMeWS) Upgrade • Business Objects Upgrade Environment: Windows XP Professional/Server 2003 Oracle 10g Sustain Block 1 and Block 2 Release FY07 including COTS Licenses and Upgrades

  25. AHLTA-Theater Convergence • Same look and feel as AHLTA in garrison • Dental • Spectacle Request Transmission System (SRTS) • Post-Deployment Health Reassessment (PDHRA) • Individual medical readiness: immunizations, profiles • Alternate Input Method (AIM) forms • Battle/Non-battle categorization (e.g., BI/DNBI) • Off-line demographic verification • Able to transfer encounters via removable media • GEMS and SAMS Patient Encounter Module (PEM) functionality • Duties Not Including Flying (DNIF) • Undersea Medicine • Personnel Reliability Program (PRP)

  26. Near Term Initiatives: FY08 Release • TC2 • Improve usability with a user friendly Graphical User Interface • Remote access for outlying Theater medical facilities • Allows providers to leverage clinical capabilities from off-site locations • Improved interoperability between Theater hospital systems • Laboratory • Radiology • Consultations • Automatically access data for a single patient across multiple applications • Extend Single Sign On across the TMIP Suite of software • Technical analysis to determine best solution to support Theater business practice for Psychological Health and Traumatic Brain Injury

  27. TC2 Graphical User Interface Enhancement

  28. TMDS: Mid Term (FY10)

  29. Transforming business processes and driving organization-wide benefits Enterprise Visibility Make it simple to manage medical information Individual Impact Increase accuracy,self-sufficiency and effectiveness Discovery Make the right information available to the right people Collaboration Keep providers in sync Mobile Solutions Applications with workflow interoperability Fundamentals Make it secure, user friendly and reliable Long-Term Strategy: Service Oriented Architecture

  30. Future Capability: Medical Situational Awareness in Theater (MSAT) Provide commanders and their staffs actionable knowledge and enhanced medical situational awareness for critical decision making • Services Oriented Architecture • Mapping Tools • Decision Support / Business Intelligence Medical Situational Awareness • Joint Medical Information Systems • Global Combat Support System • Net-Centric Enterprise Services Support Decision Making Leveraging existing success and emerging capabilities Empower commanders with Actionable Knowledge by to

  31. TMIP-M Program Maritime Version of the Joint Acquisition Program responsible for: • Naval Capabilities Advocate to the TMIP-J program • Formal documentation and routing of Naval Capability requirements through the TMIP-J Requirements Management process • Coordination with Navy Communications and Hardware Infrastructure Programs of Record (ISNS) • DT/OT Support • Deployment of TMIP-J software applications • Training • Sustainment Support

  32. Parallel Efforts in Transition Notionally, all Navy capabilities may be transitioned to TMIP-J applications by Q2FY12

  33. Current TMIP-M Concept of Employment • Primarily designed for Navy Operational Commands in the Fleet Environment • Large Deck • SAMS 9.0 • AHLTA T for Patient Encounters • JMEWS II • MICROMEDEX • Medium/Small Deck • SAMS 9.0 • AHLTA T for Patient Encounters • MICROMEDEX • Expeditionary Medicine • SAMS 9.0 Medical Materials and Environmental Health Modules • AHLTA T Patient Encounters • AHLTA Mobile (BMIST J) • MICROMEDEX • MTF • SAMS 9.0 Health Services and Radiation Health Modules

  34. Recent Milestones; Upcoming Targets • Successful OT onboard USS RONALD REAGAN (Feb 08) • First DoD-wide permanent implementation of TMIP Block 2 (Apr 08) • Participating in Trident Warrior ’08 (Jun 08) • USS BONHOMME RICHARD (LHD 6) • USS MILIUS (DDG 69) • Planning TMIP implementation at EMF Djibouti, Africa Q4FY08 • Planning NECC implementations Q1FY09 • Planning Block 2 migrations for EMF Kuwait sites in FY09

  35. TMIP Deployment Planning • Planned FY09-FY11 deployment schedule • Hardware assumed to be installed and available for TMIP software implementation • DT/OT events planned upon Navy’s receipt of each TMIP release • External software release approvals for Navy installs require 6-8 months, and are mandated for every release • (DIACAP/ATO, NMCI testing, SHIPMAIN, etc.) • All sites (except aircraft squadrons) will have to be revisited to turn-off SAMS 9 capability once all Navy Capabilities are transitioned to TMIP

  36. Summary • TMIP-M PMO is working to deliver Navy Medical capabilities to the Fleet • Focused on the Fleet Customer • Providing formal requirements management process for operational Navy Medicine • Creating communication forums for Navy Medicine stakeholders • Infusing Project Management Discipline

  37. Questions? Claudia J. Kiefer TMIP-M Program Manager Space and Naval Warfare Systems Center Norfolk (757) 443-0698 (757) 831-2683 claudia.kiefer@navy.mil

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