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Military


 DOT&E

Director, Operational Test & Evaluation
  
FY97 Annual Report

FY97 Annual Report

COMPOSITE HEALTH CARE SYSTEM II (CHCS II)

ASD(HA) ACAT IAM Program
600 systems
Total program cost (TY$) $2,142M
Average unit cost (TY$) $3.6M
Life cycle cost (TY$) $7,228M
Full-rate production (IOC) 1QFY99

Prime Contractor
None. Fourteen companies support various activities under contracts supported by the Defense Supply Service-Washington (DSS-W)

SYSTEM DESCRIPTION & CONTRIBUTION TO JOINT VISION 2010

First fielded in 1989, CHCS is a tri-Service medical management automated information system (AIS) now used in all DoD medical treatment facilities (MTFs) worldwide to support hospital administration and clinical health care. CHCS II will be a "system of systems" that will provide the functionality of over 50 clinical information systems developed by the Department of Defense. When deployed, CHCS II will provide a standardized clinical application information system to support: 1) health care delivery to armed services personnel, retirees, and beneficiaries; 2) medical readiness of military forces; and 3) quality managed care. The computer-based patient record (CPR), an end product of CHCS II, will capture, maintain, and provide comprehensive, relevant, and accurate patient-focused information for health service delivery at any time and at any location over the beneficiary's life time.

Nearly all of the new applications being integrated into CHCS II are commercial-off-the-shelf (COTS) products. Meanwhile, the functional modules of the original system continue to be enhanced with the release of new software versions. CHCS II supports the JV2010 concept of focused logistics by integrating all the clinical systems of the three Services into a single, joint system, increasing access to information, taking advantage of advanced business practices, integrating with the civilian health care sector, and allowing the MTFs to be more efficient in protecting lives and resources.


BACKGROUND INFORMATION

OT&E has been conducted on CHCS continually since its inception in 1989. The latest full OT&E was conducted in September 1996, on CHCS Version 4.5 at Madigan Army Medical Center (MAMC), Fort Lewis, Washington, and its outlying catchment area, by the U. S. Army Operational Test and Evaluation Command (OPTEC), the independent Operational Test Agency (OTA).

An integrated product team (IPT) was formed in October 1996 for CHCS II to address the future test and evaluation of the system, approved for a Milestone-0 decision on November 14, 1996. The IPT draws expertise from the developmental and operational test communities and the Joint Interoperability Test Command (JITC). The IPT has served to establish and cement cooperative relationships among all its members, resulting in the completion of the CHCS II Test and Evaluation Master Plan (TEMP), which was approved on September 5, 1997. The TEMP approval authorized the test and evaluation of three major components of CHCS II: Clinical Information System (CIS), Preventive Health Care System (PHCS), and Defense Dental Standard System (DDSS).


TEST & EVALUATION ACTIVITY

As a result of the unsatisfactory September 1996 OT&E, Version 4.5 could not be deployed until further testing to resolve the remaining operational effectiveness issues. The CHCS PM initiated action to correct the software deficiencies and new test sites were selected. FOT&E was then conducted in stages during the first half of 1997. The MASCAL features were tested during a scheduled exercise in Europe. Eventually, all of the issues were successfully resolved, and approval was granted to deploy CHCS Version 4.5 to all MTFs worldwide. The FOT&E for CHCS 4.6 is planned for the first half of 1998. The first formal OT&E activity under the CHCS II umbrella will be conducted on the CIS in January 1998 at Walter Reed Army Medical Center. CIS is a part of the CHCS II that will provide needed automation in the area of inpatient care. Additional OT&E is planned for CHCS II throughout FY98 to meet a planned initial operational capability (IOC) in early FY99. The TEMP is being revised to reflect the technical and functional core upon which the target CHCS II will be constructed.


TEST & EVALUATION ASSESSMENT

CHCS Version 4.5 is operationally effective and suitable, and its current deployment is justified by the FOT&E results. Initial assessment of the CHCS II program awaits IOT&E. Since CHCS II is to integrate and subsume gradually the functionality of more than 50 Defense clinical information systems, the OT&E community will need to work with the program management office to identify an executable system migration strategy first, before any meaningful OT&E activities can be planned and conducted. Further, since these clinical information systems will be integrated and subsumed in different stages, the OT&E community will need to assist the functional community to determine the appropriate operational performance criteria for each of the increments. Seamless system integration will be a major issue for the operational testers to address.



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