• warning: Illegal string offset 'files' in /usr/www/users/healthit/destinationata/modules/upload/upload.module on line 281.
  • warning: Declaration of views_handler_field_user::init(&$view, &$data) should be compatible with views_handler_field::init(&$view, $options) in /usr/www/users/healthit/destinationata/sites/all/modules/views/modules/user/views_handler_field_user.inc on line 47.
  • warning: Declaration of views_handler_field_node_new_comments::pre_render(&$values) should be compatible with views_handler_field::pre_render($values) in /usr/www/users/healthit/destinationata/sites/all/modules/views/modules/comment/views_handler_field_node_new_comments.inc on line 100.
  • warning: Declaration of views_handler_argument::init(&$view, &$options) should be compatible with views_handler::init(&$view, $options) in /usr/www/users/healthit/destinationata/sites/all/modules/views/handlers/views_handler_argument.inc on line 744.
  • warning: Declaration of views_handler_filter::options_validate(&$form, &$form_state) should be compatible with views_handler::options_validate($form, &$form_state) in /usr/www/users/healthit/destinationata/sites/all/modules/views/handlers/views_handler_filter.inc on line 607.
  • warning: Declaration of views_handler_filter::options_submit(&$form, &$form_state) should be compatible with views_handler::options_submit($form, &$form_state) in /usr/www/users/healthit/destinationata/sites/all/modules/views/handlers/views_handler_filter.inc on line 607.
  • warning: Declaration of views_handler_filter_boolean_operator::value_validate(&$form, &$form_state) should be compatible with views_handler_filter::value_validate($form, &$form_state) in /usr/www/users/healthit/destinationata/sites/all/modules/views/handlers/views_handler_filter_boolean_operator.inc on line 159.

U.S. Army telemedicine program makes a difference at home and abroad

By Col. Ronald Poropatich, MD, 
U.S. Army Medical Research and Materiel Command, 
Telemedicine and Advanced Technology Research Center (TATRC)
Since initially establishing telemedicine capability for deployed U.S. forces in Somalia in 1993, the U.S. Army telemedicine program has expanded significantly to both United States and overseas locations.
In 2004, a low-cost email teleconsultation system for deployed service members was established, and over time it's been expanded to include more than 19 medical and seven dental specialty services. The program has provided more than 10,000 store-and-forward consults, serving more than 2,400 deployed providers and helping to avoid costly medical evacuations while maintaining a five-hour response time. In 2008, this program was extended to all NATO forces in Afghanistan.
In 2008, with heightened focus on traumatic brain injury (TBI) and PTSD, a tele-TBI program was established. This effort provided equipment and personnel to each Army regional medical command, and it has grown to more than 91 sites across 21 time zones, providing telehealth encounters in 22 medical disciplines. More than 100,000 telehealth encounters were accomplished in FY10 and '11. Ongoing evaluation of the program estimates at least $3 million in cost avoidance by reducing travel costs, more rapid access to care and better leveraging of resources across regions.
In 2010, a simple, real-time, interactive telebehavioral health capability across Afghanistan, Iraq and Kuwait was established. There are currently 72 active sites with plans to expand to 93 sites in Afghanistan alone. As of April 2012, more than 1,200 telebehavioral consults from Afghanistan have been completed, resulting in improved access to care for both patients and providers.
The U.S. Army Medical Research and Materiel Command at Fort Detrick, Md., through the Telemedicine and Advanced Technology Research Center (TATRC), has a strong and established interest in mobile health – with 12 established national and international mobile health projects in progress.
In 2009, TATRC created the cell phone-based project "mCare," which connects injured warriors rehabilitating at home with their remotely stationed case managers through the soldier's personal cell phone. This system uses a secure-messaging HIPAA-compliant format. From May 2009 to April 2012, it provided more than 255,000 encounters to more than 900 volunteer patients (residing in 28 states within the eastern United States) reminding patients of appointments and disseminating health and wellness information. From five distinct geographic clinical sites, more than 250 military healthcare team providers are accessing the system via a secure web-based portal to manage patient message traffic and to monitor responses via a graphical user interface that is dynamic and flexible. "mCare" was recognized by the Army as one of the top inventions for 2010.
TATRC is leveraging lessons learned from its mobile health applications and electronic medical record systems to establish a mobile health laboratory environment to systematically develop and test future mHealth initiatives for system interoperability, preclinical and clinical use and formal clinical function. The mobile health laboratory environment will be linked with outcomes based clinical research trials to holistically examine the impact of mobile health technologies – to include the electronic medical record and personal health records.

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