Military officers cite problems with AHLTA at hearing

Part one of a two-part series (Access part two):

Three high-ranking officers of the Army, Navy and Air Force health services took turns before a House joint subcommittee hearing last week to criticize the Military Health System’s AHLTA outpatient electronic health-record system, but in their written and oral testimony, none called for scrapping the troubled system, at least not immediately.

Problems with what formerly was called the Armed Forces Health Longitudinal Technology Application but later officially shortened to AHLTA go way back, noted Rep. Susan Davis (D-Calif.), chairwoman of the Military Personnel Subcommittee of the House Armed Services Committee. Davis’ subcommittee co-hosted the joint hearing with the Armed Services Subcommittee on Terrorism, Unconventional Threats and Capabilities. Work began in 1999 on what is now called AHLTA by defense, intelligence, aerospace and information technology contractor Northrop Grumman Corp.

Davis said her personnel subcommittee held a previous hearing on growing discontent with AHLTA back in October 2007.

“Many promises were made about the plan to fix the system, and after the meeting a road map was provided to the members,” Davis said in her opening statement. “However, the committee was surprised when the former president’s (fiscal 2009) budget for the Department of Defense contained none of the initiatives from that road map.”

“One of our frustrations is that we keep hearing a fix is on the way, but it never comes,” Davis said.

Last summer, the Defense Department held a virtual “town hall” meeting of military health system providers to get feedback on AHLTA, and providers blasted the EHR in a majority of the more than 200 comments posted on the Web site of the AHLTA forum.

Rep. Joe Wilson (R-S.C.), the ranking member of personnel subcommittee, who has four sons serving in the military, said Congress is aware of military providers’ difficulties with AHLTA.

“While l applaud the department for the tremendous effort it has taken to deploy this system, I have serious concerns about the state of the system today,” Wilson said. “The committee has heard from military doctors and nurses who use AHLTA that it is unreliable, difficult to use and has decreased the number of patients they can see each day. We have also heard that medical professionals leave the profession because of their frustrations with AHLTA.”

Rep. Jeff Miller (R-Fla.), the ranking member of the terrorism panel, warned that congressional patience was wearing thin. “We have to get this right,” Miller said. “Four billion dollars later and it appears that things are not working as advertised. Again, $4 billion later, we have to get this right.”

To emphasize the point, Miller asked the service branch leaders, “Do your folks spend more time working with or working around AHLTA?”

Lt. Gen. Eric Schoomaker, the commanding general of the Army Medical Command and the surgeon general of the Army, answered first.

“Sir, I’d have to say candidly at the provider level, they spend as much or more time working around the system as they do working with the system,” Schoomaker said. For primary care, the functional problems with the system are not so bad, according to Schoomaker, but for medical specialists, “the system is hard to use.”

Discontent came to a head last summer around the time of the town hall forum in July.

“We faced a near mutiny of our healthcare providers, our doctors, our nurse practitioners,” Schoomaker said.

One bright light with AHLTA, Schoomaker said, was the system makes it easier for leadership to access some population data that had been impossible to obtain before. But overall, he said, “At the provider level, there are too many work-arounds.”

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