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DHA proves power of collaboration in medical IT war games

Image of Men and women in room sitting in front of their laptops. Click to open a larger version of the image. The NATO Joint Force Training Centre in Bydgoszcz, Poland, hosted the 2019 Coalition Warrior Interoperability Exercise. Because of the COVID-19 pandemic, CWIX 2020 was held virtually in secure locations worldwide. (NATO courtesy photo)

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The Defense Health Agency was a lead player in medical information technology scenarios during the 2020 Coalition Warrior Interoperability Exercise. CWIX involved 22 NATO nations and partners participating in scenarios to identify, test, and resolve technical issues to ensure future success of NATO missions.

Because of the COVID-19 pandemic, this year's event was held virtually for two and half weeks at secure locations in more than 60 countries.

“Federated interoperability continues to be a priority for NATO and allied nations," said Mark Goodge, co-chair of the NATO Health Information Systems & Technology Working Group. " Leveraging technology is more important than ever for improved patient care, operational efficiencies, and decision-making," he added.

Three medical IT scenarios took place with the United States, the Netherlands, Belgium, and the NATO Communications and Information Agency participating. One scenario involved quickly and securely transmitting patient health information, medical records, and treatment provided to wounded service members from point of injury to all levels of care, including back to the home nation.

Another scenario tested functionality to evacuate sick, ill, and injured service members to military medical treatment facilities with available beds during a mass casualty situation.

A third scenario involved providing infectious disease reports to monitor disease spread and severity. "Information like isolate patients, do not send more patients to that area – this is the kind of command and control that information planners need to have, providers need to have, when you're talking about movement of patients and various roles in areas of operation," Goodge said.

The scenarios were run using OpenAHLTA, an open-source electronic health record (EHR) donated by the DHA. "It's served us very well over the last couple of decades," Goodge said, noting that OpenAHLTA is free, performs in environments with low or no communications, and uses the latest standard medical language terminology.

The EHR is a force multiplier to enhance medical readiness, response, and interoperability, said Goodge, noting that some countries still rely on paper medical records. Paper records are a risk to security and continuity of care. Paper records can result in the loss of vital medical information and the potential for medical errors, he noted.

The CWIX scenarios "proved to be a major evolutionary leap in a very quick fashion for the adoption of a platform that exists and has served the United States very well in our roles in theater combat support and operations for health care," Goodge said. "We were able to transmit real-time information. You simply can't move paper this fast and get this much situational awareness without an electronic medium."

Goodge said the successful scenarios demonstrated the power of collaboration among NATO and partner nations, commitment to innovation and continuous improvement for the well-being of service members, and the importance of using international health informatics standards.

The CWIX scenarios were videotaped and can be viewed on YouTube.

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