The pathway to the CPR: improving military health care in the age of managed care

The unique population served by the Department of Defence´s (DoD´s) Military Health System (MHS) poses exceptional challenges for the provision of care. The need to manage care has exposed deficiencies in medical record-keeping and created demand for the coordination of care to maximize the value of patient services. The paper-based health record does not effectively document care or support preventive measures, and is often inaccessible at the point of care. Further, the lack of data standardization hampers the ability to perform epidemiological studies. To implement managed care strategies, comply with data standards and assure medical readiness, the MHS requires the capability to access and transmit health information. Therefore, in the fall of 1998, the DoD and its members awarded a contract for a Government Computer-based Patient Record (G-CPR). Concurrently, the DoD began deployment of the Composite Health Care System II (CHCS II), which integrates data from medical treatment facilities. Utilization of CHCS II and the G-CPR should lead to urgently needed medical data standardization in the military health arena and is key to the successful implementation of managed care strategies. Ultimately, implementation of the G-CPR will reform MHS business practices and provide a multi-faceted model for private-sector utilization of a CPR