After investing 18 months and less than $1 million, the Army Medical Command developed and fielded a data portal that allows hospitals to assess the mental health conditions of soldiers much more efficiently than they could previously. Last month, the Pentagon required all Defense Department entities to use it.
The Behavioral Health Data Portal was the government winner of this year’s Excellence in Enterprise Information award from the Association for Enterprise Information, an affiliate of the National Defense Industrial Association.
The Army started developing the portal in March 2012 and by September had fully fielded it to all 56 of its medical treatment facilities. On Sept. 9, Assistant Secretary of Defense for Health Affairs Dr. Jonathan Woodson directed all military services to use BHDP.
When doctors assess physical conditions they have a range of information to help with that process, such as X-rays and laboratory test results. But assessing mental illness can be much more difficult and requires time consuming conversations between medical personnel and patients.
The BHDP accelerates that process through the use of a Web-based tool that allows patients to self-report their conditions when they show up at behavioral health clinics, said Lt. Col. Millard Brown, a psychiatrist who also holds a master’s degree in medical informatics and serves as the Army’s behavioral health clinical capability manager.
At each Army behavioral health clinic, patients automatically sign onto a computer with a barcode scan of their ID cards. They are then asked a series of questions that can help their clinician determine if they suffer from four conditions: anxiety, depression, post-traumatic stress disorder and excessive alcohol use.
Their responses are immediately scored and are simultaneously transmitted to a BHDP provider portal used by medical staff. Medical personnel securely access the portal from their office workstations to review data just prior to seeing the patient. Answers are scored and color-coded based on risk so clinicians can easily identify areas of significant concern.
That information can be melded with other data, such as pre- and post-deployment health assessments on a dashboard, said Brown, who is stationed at Tripler Army Medical Center in Honolulu.
BHDP also features an automated clinical notes function, which saves the clinician from having to create notes on each patient visit from scratch.
Brown said the Army decided to develop BHDP because the military electronic health record system -- the Armed Forces Health Longitudinal Technology Application, known as AHLTA -- was not designed to track, sort or filter information about behavioral health treatment.
Dr. Remington Nevin, a former Army epidemiologist who left the service this fall to pursue a degree in public health at the Johns Hopkins Bloomberg School of Public Health in Baltimore, said, “The Army’s development of BHDP is further evidence of the costly failure of AHLTA, [the Defense Department’s] primary electronic medical record system, and of an increasingly fragmented and service-driven medical documentation system that highlights continued redundancies and unhelpful rivalries across the military medical services.”
The Army built BHDP for about $900,000 inside its Medical Operations Data System, a suite of Web-based applications that allowed the new portal to use already developed tools for authentication and permission-based access to patient records. All code is owned by the government, Brown said.
The Army estimates the number of behavioral health encounters its clinicians have with patients more than doubled between 2007 and 2013. By using the health data portal, those clinicians can save 20 to 30 minutes per patient visit. Brown estimated BHDP can save Army medical personnel 100,000 hours a year, which translates into $5 million to $10 million annually in added capacity using the same number of providers.