A lack of interoperability between two military electronic health record systems -- as well as between those two EHR systems and civilian pharmacies -- has made it difficult to track multiple controlled substances prescribed to U.S. Marines, according to a report by the Department of Defense Office of Inspector General, Modern Healthcare reports (Conn, Modern Healthcare, 4/13).
For the report, OIG assessed the tracking of controlled substances prescribed to sick and wounded Marines of the Wounded Warrior Battalion at Camp Lejeune, N.C., in the fall of 2010 (Brewin, NextGov, 4/11).
The report noted that current policies require pharmacists serving wounded Marines to "produce a written report listing patients who were prescribed five or more controlled medications in a two-month period" so that an intervention subcommittee can "identify appropriate interventions if there was evidence of misuse of controlled medications."
According to the OIG report, preparation of the written prescription reports has become "unmanageable" in part because of discrepancies between two EHR systems:
- The Composite Health Care System, which is used in military hospitals; and
- The Armed Forces Health Longitudinal Technology Application, which provides a lifetime outpatient EHR for military personnel.
The report stated, "[N]ot all medications listed on the CHCS profile were successfully transcribed over into the AHLTA medication profile."
The discrepancy has caused some health care providers to stop using AHLTA for medication reconciliation and instead use individually typed lists, according to a clinician interviewed for the OIG report.
In addition, the report stated, "Battalion senior leaders voiced concern that there was no real check on medications prescribed between civilian and military providers, so Marines could and had received duplicate prescriptions for large quantities of medications because the two systems were not reconciled" (Modern Healthcare, 4/13).