Northrop Grumman - Defining the Future

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We work closely with major health care systems by interconnecting personnel health records and clinicians with local, regional, and national exchanges.


Clinical Information Systems NGIT CIS Brochure

The Clinical Information Systems division uses health information technology (HIT) to:

  • Inform clinical practice by developing and
    deploying electronic health records (EHRs)
  • Interconnect clinicians using regional and national health information exchanges (HIEs)
  • Personalize care by providing consumers with access to and control of their health information using personal health records (PHRs) and HIE-related technologies
  • Enable population health by connecting clinician's data to quality and public health initiatives.

        We work closely with the Department of Defense, the Department of Veterans Affairs, the Department of Health and Human Services, and other Federal agencies with HIT interests and investments. Our technologies are used to create and integrate EHRs, build and connect HIEs, translate terminologies and ontologies, create and enable PHRs, and enable surveillance, outcome research, and quality monitoring.

        Northrop Grumman has developed the largest enterprise EHR in the world for the DoD, and the first national clinical information exchange system in the nation for the DoD and VA, bringing expertise in software development, systems integration, medical informatics, system deployment and training, information security, electronic medical record systems, and network analysis and management in support of our customers. We excel at projects that require large-scale systems integration to tie complex and disparate platforms, databases, and technologies into a cohesive whole. We have designed systems that support all necessary standards to operate in the health systems enterprise, including Health Level 7 (HL7) versions 2.x and 3, National Council of Prescription Drug Programs (NCPDP), Systematized Nomenclature of Medicine - Clinical Terms (SNOMED-CT), Continuity of Care Record / Continuity of Care Document (CCR/CCD), Logical Observation Identifiers Names and Codes (LOINC), and others. We participate in national forums such as the Health Information Technology Standards Panel (HITSP) and HL7 working groups to keep abreast of developing initiatives and ensure that emerging standards and our solutions are continuously in line. We have built one of the prototypes for the Nationwide Health Information Network and continue to participate in that and state HIE initiatives.

        Managing Clinical Data

        AHLTA, formerly Composite Health Care System (CHCS) II, is a DoD-wide medical and dental information system. The goal is to provide service members and their dependants with a lifelong EHR - one patient = one record. AHLTA includes highly structured patient encounter documentation; discrete, computable data for reports and data mining; and a global centralized data repository that supports patient care, population health and medical readiness. The system smoothly integrates with multiple other military systems (legacy applications, personnel system, workload accounting, billing, etc.). As of Fall 2007, AHLTA was deployed to more than 130,000 medical staff at more than 400 clinics and 65 military hospitals spanning 11 time zones worldwide. In any given week, it supports 2.2 million prescriptions, more than 640,000 outpatient encounters and more than 19,000 inpatient admissions. Total data storage is more than 37TB that covers more than 9 million beneficiaries.

        AHLTA includes a real-time upload of legacy system data into a centralized Clinical Data Repository-Enterprise Master Patient Index. The Health Data Dictionary normalizes data so there is a single record per patient worldwide, giving DoD an enterprise-wide view of the data. To address DoD's desire for a COTS solution, Northrop Grumman implemented the back-end electronic medical record (EMR) engine, 3M's Care Innovation Suite, with a fully reengineered front end and expanded architecture that was refactored to create a fully functional cache at every facility to support continued operations in disconnected mode and provide near-100% availability. By integrating into the user interface the MEDCIN medical terminology engine, we allow the capture of coded symptom and physical finding-level data to facilitate data mining, public health reporting, and military readiness. An abstracted data access software layer is used for all modes of the application-theater (laptop), direct access to repository, training (laptop), local disconnected server (for availability) allows AHLTA to be available wherever services are deployed. Data synchronization service keeps the central repository up to date.

        Interconnecting Clinicians

        By executive order, President Bush called for widespread adoption of interoperable EHRs for most Americans by 2014 (April 27, 2004). The President created the new Office of the National Coordinator for Health Information Technology. This order established health information exchange as a national priority. One of the four parts of this initiative is the development of a Nationwide Health Information Network (NHIN) to interconnect EHRs, securely exchange health information, transport electronic medical information to/from clinicians, and integrate with public health and bioterrorism monitoring as needed. In Phase 1, Northrop Grumman worked as part of a consortium to develop four potential architectures for health information exchange, prototypes that demonstrate the viability of the proposed architectures in the clinical setting and business models for sustaining an NHIN.

        Northrop Grumman has a long history with health information exchange. We developed and operate a joint system for perpetual one-way transfer and two-way exchange of electronic health information between DoD and VA called the Federal/Bidirectional Health Information Exchange (FHIE/BHIE). FHIE/BHIE provides on-demand electronic DoD health information to assist in the compensation process. We demonstrate compliance with HIPAA regulations by creating an interagency environment for storing very sensitive information. The system uses a patient-focused information technology familiar to authorized VA and DoD users.

        Clinical/Health Data Repository (CHDR) is an interagency effort between the VA and DoD to develop software component services used to exchange computable clinical information to achieve interoperability between the VA HealtheVet Health Data Repository (HDR) and the DoD AHLTA Clinical Data Repository (CDR). Our work on CHDR completes the DoD and VA's healthcare system interoperability trifecta. Currently in Phase 2, our CHDR work is enhancing the AHLTA application to include VA and Pharmacy Data Transaction Service (PDTS) data in the patient medical record for "Active Dual Consumer" patients, and adding the CHDR framework components in the AHLTA architecture to enable bidirectional data transfer between the VA HDR and the DoD CDR. This phase also is enabling bidirectional exchange of the data domains for outpatient medication, allergy, and laboratory systems. The VA/DoD data mediation/mapping developed under CHDR is key to exchanging computable data and includes TSB services.

        Northrop Grumman provides the ability to map and manage the clinical terms of multiple medical terminologies (vocabularies) into a Terminology Service Bureau (TSB) that can be represented and used in an open standard fashion. TSB strategically provides for semantic interoperability, allows migration to standards-based terminologies and models, and maximizes interoperability and protection from reliance on proprietary systems. Regardless of the lexicon or language used, TSB can map to LOINC, SNOMED-CT, MEDCIN, PKC, ICD, or HDD.

        This heritage informs our solution for health information networks. We are continuing our participation in both the NHIN initiative and the creation of state-level health information exchanges and networks. We participate in the HITSP, helping to create the standards that will be used for entity-to-entity and network-to-network exchange of patient-centric health information. We work with state leadership in identifying the potential gains from HIE technologies, the capabilities for addressing quality initiatives and cost reductions, and the solutions that will realize these goals. We participate in thought leadership through organizations such as Connecting for Health, the eHealth Initiative, and the New York eHealth Collaborative, where the future of HIE and the models for state and regional exchanges are created. By extending these efforts to the consumer and population health organizations, we are pushing HIE toward maturity by beginning to personalize health and enable population health initiatives.

        Summary

        Many of our clients have taken advantage our innovative and effective solutions to meet their information technology needs. Whatever strategies, services, and solutions your healthcare organization requires, we are ready and committed to serve you. Let us make you another one of our satisfied clients.

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