Bryan Bergeron

One of the greatest sources of innovation in medical informatics today is the U.S. military.  A quick read of the latest DOD Small Business Innovation Research (SBIR) program announcement (http://www.acq.osd.mil/sadbu/sbir/solicitations/sbir052/index.htm) reveals a call for technological solutions to problems ranging from training medics in the field to extracting wounded soldiers with unmanned autonomous vehicles.  Given that the focus of the SBIR program is to get technologies into the hands of the general population, it's only a matter of time before these next-generation technologies will be available to clinicians.  However, most clinicians are ill-prepared to accept even the current push for a ubiquitous electronic medical record.  The American Medical Informatics Association (AMIA) has decided to address this latter challenge through its 10 x 10 program (10,000 physicians trained in informatics by 2010).  While this initiative is laudatory in that it addresses a real need, the enormity of the task and the timeline suggest that training clinicians on even more advanced technologies may be untenable - that is, unless innovative education technologies are used to train overextended clinicians.  Customized training through technologies such as intelligent tutoring systems (ITS) is one possible solution, but these systems aren't yet mature enough to handle the task.

Department of Defense EMR System a Model for National Version? (Nancy Collins, Wed, Jun 22, 2005) The DOD is progressing with a roll out of an EMR system that has been in development since the late ‘80s. Serving nearly 10 million military personnel and families, the implementation of and lessons learned could provide clues to what lies ahead for broader usage of EMR in the US. The DOD system has several advantages in comparison to what will be required for a national EMR system: The military has been working on EMR for more than 20 years and it has a strong hierarchical institutional structure that could make some of the necessary decision-making and implementation processes easier. In addition, the first component of the EMR was limited to hospitals. Now, the ambulatory portion is to be completed by the end of 2007. This experience for sharing data among healthcare facilities will be useful as a national EMR becomes a reality. Reference www.eweek.com/article2/0,1759,1785785,00.asp