AHLTA- How Much does it cost to keep it running?

[gastrodoc]

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I googled AHLTA since things are quiet here at the old Aid Station (I'm regretting typing that already), and this came up. It's from Washington Tech.

Northrop Grumman has received a $67.7 million follow-on contract from the Military Health System for continued support of the Defense Department’s Armed Forces Health Longitudinal Technology Application (AHLTA) electronic health record system, the company said.
Northrop Grumman said that under the eight-month contract, which has two one-year options it will provide security accreditation and information assurance, management information services, commercial-product monitoring and configuration management for AHLTA.

67 million for an 8 month contract? Wow.

 

[Mirror Form]

Not bad considering AHLTA is a useless POS. Of course, that 67 million is just the tip of the iceberg. And then there's the gigantic amount of lost productivity due to health care proffesionals wasting hours upon hours of time because of it.

 

[Trajan]

.

 

[IgD]

I heard some figures that a hospital might expect to spend 5% on an IT budget. So with 67M in expenditures that would put the DoD medical budget around 1.4B. Sound right?

 

[Gastrapathy]

I heard some figures that a hospital might expect to spend 5% on an IT budget. So with 67M in expenditures that would put the DoD medical budget around 1.4B. Sound right?

AHLTA cost more than $6B to implement. I wonder how much it cost to name it AHLTA.

 

[BomberDoc]

AHLTA cost more than $6B to implement. I wonder how much it cost to name it AHLTA.

It probably cost billions just to think, Ah Hell Let's Try Again.

CHCS was okay, but at least quick once you learned it.

PGUI was a stripped down AHLTA that gave us a preview of how slow and painful the inevitable would be.

AHLTA is, as Trajan pointed out, a very strong reason to get out of military medicine ASAP. It is the biggest productivity killer ever invented.

 

[TX_NFS]

As mentioned in this article (http://www.military.com/features/0,15240,93457,00.html ), there were supposed to be 'system upgrades' last September that improved AHLTA's speed. Has it improved at all since AHLTA was initially rolled out?

 

[DiveMD]

I personally measure AHLTA's cost in "Tylenol pills/working day". I am up to 4 TP/wd!

 

[Mirror Form]

As mentioned in this article (http://www.military.com/features/0,15240,93457,00.html ), there were supposed to be 'system upgrades' last September that improved AHLTA's speed. Has it improved at all since AHLTA was initially rolled out?

NO

 

[gastrodoc]

AHLTA sucks. No 2 ways about it. TMIP ( AHLTA lite, used while deployed) is much faster and more stable. I free text all my notes, so don't know if the coding thing works or not, but there is essentially no lag time when you switch modules and We've not had any downtime at all. Granted I've got no viz on notes done elsewhere, but overall a much better program.
What are other's thoughts on this?

 

[IgD]

In the late 1990's when I went to med school the VA had (and still has a system) that has much more efficient data entry and retrieval than AHLTA. You click on the patient and can scroll through notes. It's basic free text entry augmented by templates. I think the symptom treeview in AHLTA is an interesting concept but for me it is a lot slower than free text and templates.

 

[a1qwerty55]

asdf

 

[Mirror Form]

In the late 1990's when I went to med school the VA had (and still has a system) that has much more efficient data entry and retrieval than AHLTA. You click on the patient and can scroll through notes. It's basic free text entry augmented by templates. I think the symptom treeview in AHLTA is an interesting concept but for me it is a lot slower than free text and templates.

Clicking through those trees isn't just slow, it's unsafe for patients. Whenever I try to actually interpret a note that was done in such a fashion it's impossible. It's just some long non-punctuated paragraph of a bunch of "such and such was unremarkable." So this is what you get

such and such was not abnormal, such and such was not abnormal, such and such was not abnormal, such and such was not abnormal, such and such was not abnormal, such and such was not abnormal, such and such was not abnormal, such and such was not abnormal, such and such was not abnormal, such and such was not abnormal, such and such was not abnormal, such and such was not abnormal, such and such was not abnormal, such and such was not abnormal, such and such was not abnormal, such and such was not abnormal, such and such was not abnormal, such and such was not abnormal,

and it's impossible to find the pertinent positives and negatives. The only decent way to use AHLTA is to just free text everything. The problem there is that many things are better described w/ pictures, and that's where ahlta really really fails.

 

[Gastrapathy]

Clicking through those trees isn't just slow, it's unsafe for patients. Whenever I try to actually interpret a note that was done in such a fashion it's impossible. It's just some long non-punctuated paragraph of a bunch of "such and such was unremarkable." So this is what you get

head was not abnormal, neck was not abnormal, chest was not abnormal, heart was abnormal, lungs was not abnormal, abdomen was not abnormal, abdominal tenderness was not abnormal, abdominal rebound tenderness was not abnormal, genitourinary system was not abnormal, such and such was not abnormal, such and such was not abnormal, such and such was not abnormal, such and such was not abnormal, such and such was not abnormal, such and such was not abnormal, such and such was not abnormal, such and such was not abnormal, such and such was not abnormal,

Edited to emphasize Mirror's point. This ALHTA note now reflects a STEMI.

 

[BomberDoc]

The checkbox medicine is ridiculous. So go ahead and hit AutoNeg, choose a few positives so the auditors are happy, and free text in the A/P comments section what you want the next doc to read. That is the only place where you can get useful information in an AHLTA note.

 

[ToeCutter]

I agree with the checkbox note being virtually unreadable to me or the next provider....
However, I generally free text most of the note in AHLTA, code it and move on...Is this worng?
I actually like AHLTA better than the last EMR I was using. I certainly prefer to dictate but this is becomming a rarity anywhere these days.
Unfortunately, I am completely ignorant of CHCS 1 and get lost in the DOS Mode 😕

 

[a1qwerty55]

I agree with the checkbox note being virtually unreadable to me or the next provider....
However, I generally free text most of the note in AHLTA, code it and move on...Is this worng?
I actually like AHLTA better than the last EMR I was using. I certainly prefer to dictate but this is becomming a rarity anywhere these days.
QUOTE]

Fewer and fewer staff are using the medcin tree -thanks God since I can't figure out what the hell happened.

Free texting and manual coding is Kosher.

With voice recognition you will be able to dicate into the free text fields and manually code. This should help us all a ton.

 

[Mirror Form]

I agree with the checkbox note being virtually unreadable to me or the next provider....
However, I generally free text most of the note in AHLTA, code it and move on...Is this worng?
I actually like AHLTA better than the last EMR I was using. I certainly prefer to dictate but this is becomming a rarity anywhere these days.
Unfortunately, I am completely ignorant of CHCS 1 and get lost in the DOS Mode 😕

NO, that's the ONLY decent way to use AHLTA.

However, lots of medical information can't be free texted in. Then that information gets scanned in, which causes the patient's records to become very large, and take a very long time to load, and your computer crashes, AHLTA gives you a bunch of error messages, and the note you saved doesn't get saved in AHLTA, etc etc etc.

 

[ToeCutter]

The biggest problem with a paper chart (other than we can't read each others writing 😉) is that we entrust it too often to the patient. I'm prior enlisted and was always given my medical chart to travel with. What's to stop me from taking out what I don't want in it? Also had an experience of going to Urgent Care once - went back the next week and they had absolutely no record of my visit the week before - gone from paper chart and not in CHCS....still doesn't exist. I had to get my record from St. Louis a while back and was told there was a fire that burned something like 40% of all the med records (rumor I heard but can't substantiate). I was lucky and mine was okay.....Anyone heard of storing your med recs on Yahoo?

 

[Mirror Form]

The biggest problem with a paper chart (other than we can't read each others writing 😉) is that we entrust it too often to the patient. I'm prior enlisted and was always given my medical chart to travel with. What's to stop me from taking out what I don't want in it? Also had an experience of going to Urgent Care once - went back the next week and they had absolutely no record of my visit the week before - gone from paper chart and not in CHCS....still doesn't exist. I had to get my record from St. Louis a while back and was told there was a fire that burned something like 40% of all the med records (rumor I heard but can't substantiate). I was lucky and mine was okay.....Anyone heard of storing your med recs on Yahoo?

I agree that EMR is definitely the future. However, AHLTA is a very poor and very unreliable EMR. I'm sick of my medical license being put at risk b/c information scanned into AHLTA somehow disappears.