A gusher of online complaints concerning an electronic health-record system used by the Military Health System is unlikely to lead the system to discontinue its use.
Long-held and pent-up user frustrations with the system, which is known as AHLTA and dates back to 1999 through a precursor, can be found in more than 200 comments posted on a special Military Health System Web page. The page had been set up for a global electronic town hall meeting in June called by S. Ward Casscells, assistant secretary of defense for health affairs.
An overwhelming majority of comments posted about AHLTA were negative, and some were vitriolic. One user called AHLTA an embarrassment, while another noted the system is slow at its baseline operational status, but when it goes into fail mode, which occurs on a weekly basis, it is intolerable. Multiple posters compared AHLTAalmost always unfavorablywith the Veterans Health Information Systems and Technology Architecture, or VistA clinical IT system at the Veterans Affairs Department.
Others called for AHLTA to be replaced. According to one commentator, I strongly believe that AHLTA is grossly inadequate and is not able to be repaired. My only real question about AHLTA is: When will the DoD scrap it and find a functioning system?
Switching to a different system is not likely to happen, however, according to Terry Jones, a Defense Department spokesman. Dr. Casscells has made this point very clearly as nearly as yesterday (July 21); were not scrapping AHLTA, Jones said. Thats not part of the equation. What theyre talking about doing is taking AHLTA and VistA and making the two systems better.
According to Jones, that is not to imply the Military Health System is whitewashing the problems or that Casscells is ignoring the complaints.
He was not surprised by the tenor of comments, Jones said. Dr. Casscells has said that AHLTA is difficult to learn, and once you do, its cumbersome and difficult to navigate. A big challenge to making it more user-friendly is making it more interoperable with the VAs system, VistA. He added that Defense Department responses would be made by this week.
Not that AHLTA had no supporters at the comment session, as some said many of the problems can be attributed to poor change management, a problem that also has afflicted many IT system deployments in the private sector.
Since its inception in 1999, defense, intelligence, aerospace and information technology contractor Northrop Grumman Corp. has been the primary systems integrator and developer of AHLTA.
George Peach Taylor Jr., vice president of its health and human services divisionin a written statement provided by a Northrop spokesmansaid the company, along with many other contractors, continues to work closely with MHS to improve performance and enhance the functionality of its AHLTA EHR. Taylor said a new version of AHLTA being beta-tested provides long-awaited, substantial improvements to the users, including several enhancements that attempt to address many of the concerns discussed in the Web meeting with Dr. Casscells. As with any large, complex IT system operating across 24 time zones and serving a transient patient population and staff, improvements in performance must be tackled systemwide.