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	Director, Operational Test & Evaluation
	FY98 Annual Report

SYSTEM DESCRIPTION & CONTRIBUTION TO JOINT VISION 2010

First introduced in 1989, the Composite Health Care System (CHCS) is a tri-Service, medical management automated information system now used in all DoD medical treatment facilities worldwide to support hospital administration and clinical health care. CHCS II is the target automated information system for the Clinical Business Area of DoD's Military Health System. It is an evolutionary program intended to unite functionalities of over 50 different DoD and Service-unique automated information systems, in varying stages of development, and create computer-based patient records for all Military Health System beneficiaries. Nearly all of the new applications being integrated into CHCS II are commercial-off-the-shelf products. CHCS II supports the Joint Vision 2010 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 the civilian health care sector, and allowing medical treatment facilities to be more efficient in protecting lives and resources.

OT&E has been conducted on CHCS since its inception in 1989. When CHCS II was placed under OSD oversight in 1997, the original system became an interim migration system, and was removed from oversight. Until CHCS II can be tested as an integrated system, the applications that it comprises will be tested one-by-one or in groups to support the fielding of needed capabilities in advance of the integrated system. The first such application was the Clinical Information System, which supports inpatient care by allowing health care providers to electronically view records of treatment and medication summaries, enter orders and treatment notes, and monitor vital signs of patients. The Clinical Information System offers a foundation for the computer-based patient record, which is the ultimate objective of CHCS II. The second such application was the Preventive Health Care Application, which is used to document patient history, track immunizations, and recommend appropriate preventive care.

A TEMP for CHCS II was approved by DOT&E on September 5, 1997, and an updated TEMP is in staffing. OPTEC conducted OT&E on the Clinical Information System from April-May 1998 at three test sites: National Naval Medical Center in Bethesda, MD; Malcolm Grow Medical Center at Andrews AFB, MD; and McDonald Army Medical Center at Fort Benning, GA. The next segment, the Preventive Health Care Application, underwent OT&E in October and December 1998 at Beaufort Naval Hospital, SC, and several medical treatment facilities in San Antonio, TX. CHCS II Increment 1, the first integrated CHCS II system, is scheduled for OT&E in May 1999.

OPTEC found the Clinical Information System to be operationally effective, suitable, and survivable, with the possible exception of Year 2000 compliance. OPTEC obtained a certification in which both the Program Manager and the vendor, CliniComp International, stated that the system was Year 2000 compliant, but questions raised by DOT&E's independent analysis have caused the Program Manager to begin a reassessment in this area. The Clinical Information System offers a significant improvement over paper-based procedures and successfully performs, in the military health care environment, the functions that it was designed to do in civilian hospitals. The system will be considered operationally effective, suitable, and survivable, if it is validated as Year 2000 compliant. OPTEC has not yet issued its report on the Preventive Health Care Application. DOT&E's independent assessment is ongoing.