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The newspaper of The Johns Hopkins University December 12, 2005 | Vol. 35 No. 14
APL Helps Army Choose Systems for Digitizing Medical Records

By Paulette Campbell
Applied Physics Laboratory

APL information technology experts have been instrumental in developing the Army's Medical Communications for Combat Casualty Care program, designed to eliminate the paper-based systems widely used throughout the Army in favor of an automated digitized framework for soldier care.

In past military engagements, deployed soldiers received paper medical assessments to insert into their records at a later time. But these medical cards would often get damaged or lost in the field, leaving medical personnel to rely on a soldier's memory of previous care. The forms also did not provide a way to track medical trends on the battlefield.

After the Persian Gulf war, "too many soldiers were coming back with these strange symptoms and illnesses, and there was no paper trail for what chemical agents they might have been exposed to, what medics they saw in the field or what care they received," said Karin Marr, who manages the Lab's contract for the new system.

A 1999 law mandated that the Department of Defense develop a medical tracking system for service members deployed overseas that includes capturing the pre- and post-deployment medical history and treatments received during deployments. From that, Medical Communications for Combat Casualty Care, known as MC4, was born.

MC4 contains medical software packages sent into theater to support deployed medical forces. By working with information technology organizations like APL, the Army's MC4 personnel identify the needs and requirements for software applications, creating a system that flows seamlessly on a variety of hardware configurations.

MC4 comprises commercial and government off-the-shelf hardware and software. Using MC4 laptop computers and handhelds, medics in the field can pass patient information to an interim theater database.

Since 2001, APL's role as MC4's systems engineer and trusted agent has been to ensure the system is up to this challenge, Marr said.

"For instance, if a soldier-medic comes across a new immunization tracking software application that might be helpful to him, we'll check it out," she said. "In fact, before any software updates reach the field, we run them through our systems evaluation lab. We develop evaluation criteria, test plans and procedures and make recommendations based on our test results."

MC4 personnel have come to rely on APL's expertise. In 2004, for instance, Beth Goodman, an APL test and evaluation engineer, was asked to evaluate handheld devices because the currently fielded units had become obsolete.

"She conducted an exhaustive study on several different handheld devices," Marr said. "She came up with the requirements based on the software being deployed and the environmental constraints in a tactical situation. She developed a test plan and eventually recommended the handheld best suited for creating the electronic medical record using the Battlefield Medical Information System-Tactical software. These handhelds are being used with great success today by medics in Kuwait and Iraq and by FEMA personnel involved in the recovery effort in New Orleans."

APL also serves as MC4's lead systems engineer for the Army's Future Combat Systems program, known as FCS, a plan to create a collection of armored vehicles, unmanned aircraft and ground-based sensors and link them all in a vast war-fighting network to give soldiers a better view of the battlefield.

"So when any issue arises that may concern MC4, we are at the table representing that program and bring the concerns back to MC4 staff," Marr said. "MC4 products, which run on Microsoft operating systems, are to be installed on FCS medical vehicles. But we recently learned that FCS folks were creating products on a Linux platform."

APL's Jorge Aviles brought that to the attention of MC4 executives, and they are working to resolve that situation. "That's part of what we do from a systems engineering point of view; we raise red flags when something is proposed that is just not going to work," Aviles said.

At any given time, up to 12 APL staffers from the Applied Information Sciences Department are working on MC4.

"They have been instrumental in providing understandable answers to complex engineering questions to a wide range of Army staff," said Lt. Col. Claude Hines Jr., who until August was MC4's product manager. "I couldn't have gotten a lot of this equipment to our medics had it not been for Karin and her team. They are really an integral part of the MC4 effort."

This article appeared previously in The APL News.


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