Medical Records Go High Tech
WASHINGTON, March 9, 2000 (GulfLINK) - Individual medical records for U.S. service members are going high tech. In addition to the standard military metal identification tag, service members will be issued another tag - approximately the same size as the dog tag - bearing computerized medical records to wear around their necks. The Pentagon selected the Army last fall as the first service to test the device, after trial studies were completed in 1998. Testing began in December, 1999.
Personal Information Carriers - known as PICs - provide computerized information of the service member's shot record and data on allergies and surgical history to field medical personnel. The PIC is part of the Composite Health Care System II, a computer system designed to allow providers to track health care services delivered to service members.
"Computerized medical records are a vision of the future," said Army Col. Frank O'Donnell, M.D., director of medical outreach and issues for the Office of the Special Assistant for Gulf War Illnesses. "As military forces deploy overseas in support of operational missions, PICs would be a portable, convenient method of record keeping. We would no longer depend on conventional paper-based documents. One focus of force health protection is improving medical record management, and PICs could support that mission."
A data storage device, the PIC uses flash memory; the same as that found in disks which store images in digital computers. This technology is five to 10 times more durable and reliable than most disk drives. Currently, the new tag can store up to eight megabytes of data, such as text, images, audio, and so on. Future versions of the PIC will provide higher capacities to enable the storage of large files such as X-rays and MRIs. The PICs could replace paper medical records, analog audio/visual recordings and film images.
The PIC is an extension of the Force Health Protection initiatives resulting from lessons learned from the Gulf War. Pentagon officials began working on the project after redeployment, when service members' battlefield medical records were unavailable, and incomplete medical records complicated investigations into the Gulf War illnesses. Defense Department officials found differing medical record keeping practices and policies between the services. For example, the Army and the Air Force deployed their personnel with abbreviated versions of their medical records while Navy and Marine Corps personnel deployed with their complete individual health record.
While the traditional metal "dog tag" - worn by service members since 1906 - will still serve as the primary means of identification on the battlefield, the PIC will give medical personnel access to the soldier's medical history via laptop computers at battlefield aid stations. Later, information about treatment received in the field can be transmitted and recorded to a central database. This central database guarantees, if the PIC becomes damaged or destroyed, that the data is still available and retrievable.
Another added benefit from the PIC is that the central database could be valuable for future epidemiological studies and offer a way to methodically evaluate if suspected events such as environmental exposures or immunizations are associated with subsequent health problems in service members. Medical support is provided on a required basis and some records - such as hospitalization records - stay with the treatment facility, not the individual's outpatient record.
Following the Gulf War, investigators found that medical treatment or services such as routine immunizations given to service members deployed to the region were often not entered into the individual's permanent health record back at their home installation. Some Gulf War veterans have experienced difficulty locating their medical records or finding documentation of all care received in the Gulf. The PIC may solve some of the problems associated with medical recordkeeping during contingencies.
"The PIC brings an opportunity to document exposures or treatments in the field," said O'Donnell, "and will facilitate the periodic updating of such information to a soldier's medical record throughout an entire career."
DoD is currently looking at technology for meeting many of its medical record-keeping challenges. The PIC is a major cornerstone of future military recordkeeping. This new technology, however, will require substantial time and effort to acquire, deploy, and fully integrate into the existing military records systems. Contracts were awarded to SanDisk Corp., and Informatech, Inc, a subsidiary of Kaneb Services, in October 1999 to deliver 2.5 million digital dog tags over the next five years.