U.S. Air Force and UPMC receive federal funding for Integrated Medical Information Technology System

Pittsburgh 22 January 2002In a benchmark collaboration between an academic medical centre and a branch of the United States military, UPMC Health System and the U.S. Air Force Medical Service (AFMS) will work to develop sophisticated telemedicine technology which will ultimately link specialists in pathology, radiology and dermatology with outposts at distant locations around the globe. The partnership, which was made possible by an $8,5 million appropriation in the defence spending bill for 2002, brings together vast clinical and information technology expertise and will aid in the recognition and treatment of many types of medical conditions, including those caused by chemical or biological agents.

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This marks the beginning of what the two organisations hope will represent a long-term strategic partnership that also will serve as a national model for improving the United States' health care delivery system. In addition, UPMC received $1,94 million in federal funds from the Labor-Health and Human Services-Education spending bill for implementation of a seamless electronic health record, a key feature of UPMC's clinical integration of a comprehensive health care delivery network. The electronic health record will link UPMC's rural hospitals, physicians' offices and clinics with its flagship hospitals and specialists in Pittsburgh.

In total, $10,44 million was allocated to support the UPMC-Air Force telemedicine technology partnership and UPMC's information technology initiative for fiscal year 2002. "Our charter is to provide affordable, first-rate health care to our 40.000 personnel and their family members around the world. This relationship will be of great benefit to the patients our two institutions serve. In the not-too-distant future, it will impact our personnel serving abroad and, ultimately, the delivery of health care everywhere", stated Colonel Robert Munson, director, Medical Readiness, Science and Technology Branch, Office of the Surgeon General, AFMS.

Service men and women and their families are among the most mobile members of society. As a result, they are often subjected to a wide variety of difficult-to-diagnose medical conditions, and their deployment to different locations often means their medical records and information are stored in disparate health information systems, hampering effective diagnosis and treatment decisions. Compounding the situation has been the closure of a number of medical treatment centres in recent years that has resulted in a reduction in funding and staffing for medical care for military personnel.

"Like our civilian counterparts, the Air Force is interested in implementing information technology which eliminates inefficiencies, increases utilisation and improves quality of care, while also lowering our administrative and delivery costs. Improved information technology and management is essential if we are to deliver the best care possible given the limited manpower and resources we all are facing", explained Colonel Munson. "Together, we are developing the next generation of technology, which we fully expect to have an impact beyond our two organisations. In fact, we view this endeavour as a national model and hope to expand the collaboration throughout the broader health care delivery network", added Dan Drawbaugh, chief information officer for UPMC Health System.

Over the next year, UPMC and the Air Force aim to develop an Integrated Medical Information Technology System, a multi-speciality teleconsultation system with a common platform that initially will support dermatology, pathology and radiology clinical services. It will enable clinicians to have access to and view various types of medical information, from pathology slides to CT scans, as well as to consult with specialists at distant locations. The system will allow for swift diagnoses of various conditions where speciality medical care may not be readily available.

Indeed, the need for such a partnership is driven in large part by a decline in both the private and military sectors of specialists who are essential for the accurate diagnosis and treatment of medical conditions. For example, the military's medical services are expected to lose 50 percent of their radiologists over the next three years because of a nationwide shortage of these specialists and the military's inability to effectively compete with job opportunities in the civilian market. Routing radiology and pathology images, pictures of the cellular make-up of tissue, would help offset the shortage of specialists and make readily available real time consultation by specialists within the Air Force system or in the private health care sector.

With biological and chemical attack looming as potential threats on society, it is more important than ever to have instant access to dermatologists who can readily recognise suspicious skin lesions which might be caused by exposure to toxic agents. A teleconsultation system would allow for swift diagnosis and more rapid treatment of conditions that manifest themselves on the skin, before life-threatening complications could develop. In the first phase of the partnership, the telehealth initiative will be operated in conjunction with Keesler Medical Center at Keesler Air Force Base in Biloxi, Mississippi, home of the 81st Training Wing.

The Air Force Medical Service (AFMS) works in close co-ordination with the Assistant Secretary of Defence for Health Affairs, the major air command surgeons, the departments of the Army, Navy, and other government agencies to deliver medical service for more than 2,57 million eligible beneficiaries. Beneficiaries include active duty, family members and retirees, during both peacetime and wartime. The AFMS consists of approximately 42.000 officers, enlisted and civilian personnel, plus an additional 20.000 members assigned to the Air Force Reserves and the Air National Guard. The AFMS has an annual budget of approximately $5,9 billion and runs 74 military treatment facilities, including five medical centres.

UPMC Health System, affiliated with the University of Pittsburgh Schools of the Health Sciences, is an integrated health care delivery system in western Pennsylvania and one of the largest in the United States. As an academic medical centre, it is one of the country's experts in medical research and is a system that represents the full continuum of care, with a network of 19 tertiary, speciality and community hospitals, located in both rural and urban settings; 225 physician practice offices throughout western Pennsylvania; and several nursing, personal care and long-term care facilities.


Leslie Versweyveld

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