Casualty Care Comms
CASUALTY CARE COMMS
Medical Communications for Combat Casualty Care (MC4),
the deployed medical IT system used in the combat zone to
digitally document patient care, was first deployed in 2003.
By Ray Steen
Staff Sergeant Matthew Sims saw it coming. Before Iraqi insurgents’ gunfire reached the patrolling M1A1 main battle tanks, Sims radioed back to his tank commander. This move gave heed to his rear comrades, but it also earned Sims three injuries. A 7.62-mm AK47 round to the helmet propelled him backward into the turret of the tank.
A broken neck, fractured third cervical vertebrae and broken right femur put Sims in an all-too familiar place—the Balad Air Force Hospital. As a senior line medic for the 270th Armored Battalion, Sims had seen his share of explosions. An IED scattered shrapnel to Sims’ left side and face, puncturing his left lung, while the blast ruptured his ear drum. Two weeks after recovering, he revisited the facility after taking the brunt of a nearby mortar landing, leaving his lower left leg filled with shrapnel.
After logging this third visit to the emergency room in the past 12 months, Sims would don his third Purple Heart, and to his chagrin, a deployment home to continue recovery. At home, his bad luck continued. Sims soon sought treatment for a spreading rash and abdominal pain at Brooke Army Medical Center (BAMC), Texas.
Fortunately, Sims’ litany of injuries had been kept up to date electronically, allowing physicians at home to see the whole picture.
“Every time you come back, you see a different doctor,” Sims said. “Having medical records on hand electronically allows them to see what has happened while you were deployed, how long you’ve been treated and a course of action for continued treatment,” Sims said. “They were able to tell that I had chicken pox because they could look at my records and see if what I had was from my deployment. I also had a long history of kidney stones, so having my records available electronically has allowed doctors to see what treatments have been tried and which one have been most effective.”
Like so many wounded warfighters, Sims was the beneficiary of Medical Communications for Combat Casualty Care (MC4), the deployed medical IT system used in the combat zone to digitally document patient care. MC4 was first deployed in 2003, and is currently fielded to deployed medical forces throughout Iraq, Kuwait, Qatar and Afghanistan in support of Operations Iraqi and Enduring Freedom.
The program is overseen by the MC4 Product Management Office, which is part of the Army Program Executive Office Enterprise Information Systems.
Electronic Records
Today, more ailments plague Sims, who continues treatment for deployment-related vision and hearing problems at Fort Belvoir’s Dewitt Hospital, Va., and the Andrew Rader Acute Care Clinic at Fort Meyer, Va., where he currently serves as the non-commissioned officer in charge. Like at BAMC, his treatment plans are based on his doctors and nurses digitally reviewing his medical information from Iraq—a capability Sims wishes he had in previous deployments.
“I have been deployed to Saudi Arabia and twice before to Iraq and in a lot of cases, important medical record information does not make it back from deployment,” Sims said. “A lot of paper medical records from deployments often get lost in the excitement of returning from deployment. But having my medical records available electronically has helped doctors track and follow my treatment that I have received at all of the different facilities.”
Master Sergeant Wynton Hodges has also experienced first hand the benefit of electronic medical records during his deployment to Mosul and Baghdad, Iraq. Hodges, a medical platoon sergeant in a Stryker-equipped infantry battalion, fractured his ankle in 2006 during a counterinsurgency mission and was medevaced to a nearby combat support hospital (CSH) where X-rays confirmed an avulsion fracture.
“During the next six weeks, I received medical treatment at the CSH, care at a level II support battalion and was seen at a level I battalion aid station,” Hodges said. “All of the medical care was entered into the MC4 computer system, at all the different medical treatment levels, and was easily available for providers and physical therapists at all the different facilities.
“My physical therapist at the level II support battalion explained she was able to review my initial records from the CSH, including X-rays and my previous consultation with the orthopedic surgeon,” Hodges said.
Like Sims, Hodges returned home from his tour of duty only to find himself back under the microscope at the Fort Sam Houston Troop Medical Clinic. The visit revealed an underlying problem with his leg, possibly related to his ankle injury. The doctors were not sure if the two ailments were related and required additional information on Hodges’ past.
“Before going to my next consultation with the physical therapist and orthopedic surgeon, all of my deployment medical records were available electronically and provided a clear picture of all treatment received,” Hodges said. “Without the digital medical records, X-rays and treatment plans, they would have to count on my memory. After hundreds of missions and 16 months of continuous combat operations, my memory of the facts had changed.”
Data Repository
Instead of relying on a shaky memory, Hodges’ doctors tapped into the DoD’s central data repository where deployment patient records are stored.
“They were able to access my past medical treatments, review all X-rays and determine what kinds of treatment I had received,” Hodges said. “They needed to rule out the ankle fracture and focus on my new symptoms that they later diagnosed as compartmental syndrome. The clinical staff at BAMC had all of the facts and not just the memories from a combat vet.”
In October 2007, Hodges underwent surgery to repair his right leg thanks to a diagnosis that would have otherwise been difficult to make without a full medical history. Hodges is almost completely recovered and serves as the senior enlisted adviser to the president of the Army Medical Department Board.
“MC4 is an invaluable tool that has moved Army medicine light years ahead with the aid of digital records,” Hodges said.
“Using MC4 in theater allows pertinent medical information to be reviewed by doctors, who have access, from anywhere in the world,” Sims said. “I feel that this system in the near future will replace all paper medical records.” ♦
