BY Bob Brewin
Published on Nov. 14, 2006
The Military Health System (MHS) lost records of almost 5,000 patient encounters because of hardware and software problems with portions of the Defense Department’s Armed Forces Health Longitudinal Technology Application (AHLTA) electronic health record system, a top MHS official told Federal Computer Week.
The system is also experiencing backup problems with data stored locally at military treatment facilities (MTFs), which a Defense Information Systems Agency official described as anomalies but not systemic. DISA maintains the MHS network and provides mainframe storage at one of its data centers and local storage at MTFs.
Robert Foster, director of MHS’ Joint Program Executive Office, said the software problems occurred after local cache servers (LCS) were installed at 101 facilities and Northrop Grumman provided a new AHLTA software patch.
The patch, designed to improve LCS performance, was successfully installed at 99 MTFs, but did not work at Fort Stewart, Ga., and Fort Drum, N.Y., when it was installed in August, Foster said.
A database flag or trigger was incorrectly set at those two locations, Foster said. Consequently, clinical encounters between doctors and patients were not captured and stored because the system viewed each as an inactive patient, he said.
As a result, 2,608 encounters were not captured at Fort Drum and another 978 at Fort Stewart. MHS has resolved the patch problems at those two locations, Foster said.
A hardware problem at Fort Hood, Texas, in September resulted in the loss of information from 1,400 clinical encounters, Foster said. That loss was because of a hardware failure in a Redundant Array of Independent Disks when a Hewlett-Packard technician installed a new piece of equipment and inadvertently erased all the data on the disk by setting it to factor default, Foster said. No backup was in place.
Foster said some of the information erased at Fort Hood is stored in other MHS databases, and the system is working with clinicians to help them rebuild their records. The amount of clinical encounter information lost because of the hardware and software problems pales in comparison to the overall scale of AHLTA, which contains the records of 8.6 million active-duty and retired military personnel and their families, he added.
Alfred Rivera, DISA director for computing services, said MHS experiences local backup failures at two or three sites nightly and it is investigating the cause of the failures, which he viewed as “one-offs” and not systemic.
They include bad tapes in a backup system or the failure to insert a tape, Rivera said. DISA monitors whether backups have been performed locally, and if not, alerts the MTF to perform a backup either in during the night or the next day.
Backup is essential, Foster said, because AHLTA is an electronic system and “as general rules, we don’t do paper backups.” The LCS, which MHS started to use in February, provides redundancy to the AHLTA Clinical Data Repository housed at a DISA data center, he said. The repository is mirrored at that data center and at a remote center, Rivera said.
MHS’ disclosure of its data loss follows DISA’s acknowledgement earlier this month that the repository experienced a 20-minute failure in late October. Last week DISA dispatched its vice director, Army Maj. Gen. Marilyn Quagliotti, to the data center that houses the repository to conduct a review of that outage, an agency spokesman said.
The purpose of Quagliotti’s visit was to examine AHLTA from technical, operational and organizational perspectives, and to determine if DISA needs to make improvements, the spokesman added.
Article: Government Health IT http://www.govhealthit.com/article96828-11-14-06-Web