Enabling comprehensive health services to deployed forces with Sunrise for Military - White Paper
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White Paper
Enabling comprehensive health
services to deployed forces
with Sunrise for Military
1
Contents
Military Health’s Duty to the Warfighter.................................. 3
An EHR Purpose-built for Military............................................ 3
Why Allscripts?........................................................................ 3
Overview of Sunrise for Military.............................................. 5
Successful Military Deployment.............................................. 7
Conclusion............................................................................... 7
2
Enabling comprehensive health
services to deployed forces
with Sunrise for Military
Military Health’s Duty to the Warfighter Medical treatment for the
A key tenet of Military Health is to triage, treat, evacuate, and return military personnel to active warfighter must not be
duty as timely and efficiently as possible. An electronic health record (EHR) can support this tenet compromised by the lack
by enabling clinicians to make critical decisions and deliver uncompromised care regardless of of information. A data
venue or conditions with integrated, timely, and accurate medical information. communication backbone
A wounded combatant’s path from injury, initial treatment, and evacuation to an advanced Military capable of functioning
Treatment Facility (MTF) may be a long and challenging process. Failure to provide all partners in in austere conditions
the healthcare delivery network access to a longitudinal health record with relevant and accurate without connectivity is
information delays effective treatment. Delays caused by the need for additional triage and mandatory for a Military
duplicative testing may result in severe complications for the patient and even death. Health platform.
Medical treatment for warfighters must not be delayed or compromised based on data availability
resulting from limited network connectivity. Unlike civilian medical systems, it is essential for
military EHRs to function in the most austere conditions with constrained, intermittent, and non-
existent communications environments. Sunrise for Military is the only EHR that delivers the
ability to completely disconnect from a network, operate with intermittent or no bandwidth, and
automatically synchronize medical data once connectivity is established.
An EHR Purpose-built for Military
Sunrise for Military is a proven Electronic Health Record (EHR) that is combat-ready and purpose-
built to fulfill the unique requirements of Military Health. It provides a comprehensive solution
for non-civilian organizations to deliver high-quality care from first responder care and forward
resuscitative care to theater hospital care and U.S. and overseas definitive care.
Sunrise for Military includes core functionality for primary and acute care as well as many other
key capabilities, including occupational health, surgery, pharmacy, group orders and scheduling,
and patient engagement. Additionally, Sunrise for Military contains tools specifically designed to
support care delivery in complex and extreme environments with strict security standards.
Why Allscripts?
For more than 30 years, Allscripts has been a leader in global healthcare IT. Our core clinical
solutions have empowered healthcare organizations, militaries, and governments worldwide to
drive the best healthcare delivery across every setting of care—from clinics and hospitals to military
bases and front-line battlefields.
With our Military Health vision, robust military capabilities, and successful large-scale military
and government deployments, Allscripts is best positioned to address the needs of the Joint
Operational Medicine Information Systems (JOMIS). We’re proud to have a long history of success
supporting large health systems and critical government initiatives with our vast portfolio of
solutions, which meet the demands of care delivery today and prepare us for tomorrow.
3
Military Health Vision connectivity through offline access to the complete medical
record for an indefinite period.
Allscripts Military Health vision is to provide a modern platform of • Portable EHR—Helps users distribute unlimited subsets
health that supports the continuum of health services for military of patients, like deployment manifests, and makes them
operations that maintains a healthy, fit, and protected force and available via the disconnected, portable EHR.
treats ill and injured warriors. The platform provides a longitudinal
• Secure confidential medical data—Protects confidential
health record with relevant and accurate medical data essential for
or sensitive data for key military personnel in a separate
emergency medicine practices. With advanced clinical decision
restricted environment with data not available in the main
support capabilities presented in meaningful ways, it helps prevent
EHR. The figure below illustrates the workflow and preparation
and minimize the impact of operational, environmental, and
of a deployed EHR dispatched to support clinicians caring for
occupational health threats, and provides comprehensive theater
VIPs.
capabilities for treating deployed forces. Sunrise for Military, our
end-to-end solution, optimizes Defense readiness by fostering, • Data synchronization—Automatically synchronizes
protecting, sustaining, and restoring health. appropriate data captured during offline deployment across
required EHR instances when connectivity is re-established
using our proprietary Message Air Gap (MAG) technology.
Robust Military Capabilities • Batch registration and attendance functionality—Enables
With Sunrise for Military, defense organizations protect new patients to be entered quickly and easily, such as for
themselves from risk with a proven platform configured to registering new military recruits, or for providing humanitarian
accommodate military workflows, protect highly confidential aid or disaster recovery assistance.
patient identities and medical data, and operate in extreme • Group check-in and group scheduling of appointments—
environments with little to no connectivity. Additionally, Allscripts’ Helps personnel groups quickly schedule and check-in for
Application Programming Interface (API) capabilities are based on medical care, such as for immunizations or hydrotherapy.
a centric open architecture, enabling easy integration with other
• Group orders—Streamlines order entry and documentation
clinical systems. The breadth of our APIs make the transition from
for clinicians, while safeguarding personnel with alert
resuscitative battlefield care seamless and effective.
checking to prevent adverse outcomes. Improves efficiency
Distinguishing features of Sunrise for Military include: by processing large personnel groups for the same healthcare
• Offline EHR—Enables clinicians to deliver and document purpose.
uncompromised patient care in austere conditions without
6
2 1 7 5
3
4
1. Main EHR—Contains no VIP 4. MAG file scanning and validation 6. Disconnected EHR—Contains 7. High-clearance users—
records. before delivery to secret network. a sub-set of re-aliased VIPs, e.g. Applications GUI, workflows and
Verified MAG file format prevents John Smith = Bill Jones. Selection business rules aee identical in all
2. Typical end-users—Providing care
transfer of executable (malicious) of patients and generation of new three EHRs.
to non-VIPs.
software. aliases can be refreshed for each
3. Synchronizing of configuration deployment. VIP records can include
5. Secret EHR—Contains aliased
settings, drug inventory, clinician basic info (allergies, problems, etc.) or
VIP records, e.g. Paul Black = John
names, facility names, report full clinical history. Also contains many
Smith. Also contains many fake
definitions, custom business logic, etc. fake identities and histories. Loss of
records with ongoing generation of
into Secret EHR Laptop does not compromise alias
fake visits and data.
mappings into the secret EHR.
4
Proven in Market clinical, ancillary, and operational features to support preventive,
routine, emergency, surgical, en-route care, and diagnostic care.
Allscripts Sunrise for Military is a proven Military Health solution Additionally, the platform includes Sunrise Military Extended
that meets the needs of non-civilian healthcare, and it’s in Systems with components designed to serve the specific needs
use today by an Allied Force. Since 2016, Singapore Armed of deployed environments.
Forces (SAF) has been using Sunrise for Military to power its
electronic medical record system, referred to as the Patient Care
Enhancement System (PACES).
Sunrise Military Extended Systems
As evidence of its successful deployment, SAF was the winner Sunrise Military Extended Systems includes two key components:
of the “Digitalised Care to Support One Healthcare System” Allscripts Message Air Gap (MAG) and Sunrise Disconnect.
category at the National Health IT Excellence Awards in 2017.
Additionally, Allscripts has extensive experience with large,
Allscripts Message Air Gap (MAG):
complex healthcare systems and government deployments. For MAG is designed to transfer and synchronize data among
example, in multiple geographies around the world, Allscripts Sunrise instances by optimizing bandwidth consumption. Built
maintains state-wide, province-wide and national contracts, in on proven, mature Microsoft replication technology, MAG can
which our solutions are supporting thousands of clinicians. tolerate long periods of disconnect. MAG transfers data via
customizable, proprietary, text-only format, with an extremely
restricted character set that prevents malicious software from
Overview of Sunrise being embedded.
for Military Protecting elite force members’ identities is critical in some
environments. For this reason, Sunrise for Military incorporates
Allscripts Sunrise for Military is a world-class, fully enabled EHR anonymization proprietary software. Depending on configuration,
capable of providing an end-to-end software solution to support confidential information is either not synchronized to the central
JOMIS’ medical business practices and operational medicine instance or it is anonymized multiple times with multiple aliases
capabilities in deployed environments. prior to synchronization.
Sunrise for Military provides comprehensive clinical and The figure below illustrates the MAG workflow.
operational capabilities that span acute and primary care
settings to maintain military readiness. The solution includes core
Main network\facility Restricted network\facility
Restricted
data
Sunrise #1 Sunrise #2
In-transit
Microsoft Replication Microsoft Replication
scanning
Technology Technology
&
Allscripts MAG validation Allscripts MAG
Replication Replication
Text files Text files
5Sunrise Disconnect • Automatically synchronizes appropriate data between systems
when network connection is available.
Sunrise Disconnect provides military organizations an EHR offline
capability to enable access and engagement with patients’ • Supports real-time data sync for minimum delay or batch-
medical data even without requiring network connectivity for an based transfers with high data compression for rarely
indefinite period of time. It enables a pre-defined set of patients connected systems.
to be uploaded to a portable EHR and then synchronizes the data • Permits async transfer versus replay. Data can be transferred
to a central instance once connectivity is established. without real-time replay, further minimizing sync time. If a
data replay issue were to occur with uploaded data, it can
The Sunrise Disconnect user interface is identical to the main
be resolved centrally, without requiring the laptop to be
Sunrise for Military instance across all Roles, so users do not
connected.
require additional training to use this function. If necessary,
configuration changes specific to the deployed instance are • Loads limited or full medical record for deployment
possible, such as limiting the drug formulary to match on-hand based on preference (ex. demographics and problems
supplies during deployment. only; demographics and problems, and recent history;
demographics and problems and full history.)
In addition, Sunrise Disconnect::
• Provides “Prioritizable” Z-Function to expunge data with one
• Enables unlimited subsets of patients (manifests) for click if the portable EHR is compromised.
distribution and synchronization across many small Sunrise
The figure below represents Sunrise EHR working in disconnected
installations. Patient manifests can be changed at any time,
mode with four deployments.
supporting bulk personnel rotation or ad hoc transfers of
individual patients.
Deployed Sunrise for Military
Main network\facility
Deployed Sunrise for Military
Subset #1
Subset #2
Allscripts
Sunrise Disconnect
Deployed Sunrise for Military
Subset
#3
Deployed Sunrise for Military
Full Sunrise
for Military EHR
Subset #4
6Successful Military Deployment
Allscripts Sunrise for Military is a proven solution in use today by an Allied Force. Since 2016,
Singapore Armed Forces (SAF) has been using Sunrise for Military to power its electronic medical
record system, referred to as the Patient Care Enhancement System (PACES).
Patient care is delivered to service overseas personnel in environments with limited connectivity
using Sunrise Disconnect, referred to as PACES Mobile by the SAF. Once connectivity is restored, all
of the data collected on the portable device automatically transfers to the main system.
“As a navy medical officer, I sail quite often. Despite connection at sea being poor, PACES
Mobile (Sunrise Disconnect) has been a great benefit to me. We are now able to take into
account the medical condition and medical history and provide a full assessment of them. During
disease outbreak for example this will enable us to see patients faster as well as to access their
medical records to decide on urgency of medical treatment as well as whether or not we need to
evacuate them.”
“Healthcare delivery for our patients and patients’ information is now available at our fingertips,
not just in Singapore, but overseas as well. This brings the healthcare we provide to a whole
new level of efficiency, a whole new level of effectiveness and with that, a whole new level of
excellence to the SAF.”
“For all of the servicemen going for exercise, their medical records will be available to the
medical officers. This is a much safer system, more professional, and more efficient.”
“The feedback given to us by our medical officers is [that] PACES Mobile has been very useful to
them. It saves [them] a lot of time, which now the Medical Corp can use to focus on the patient
experience. I believe that PACES Mobile (Sunrise™ Disconnect) has been very successful.”
Conclusion
We believe healthcare organizations and their healthcare IT supplier must share a common mission
to provide the best care possible. We are honored to serve as our clients’ trusted partner, every day.
Allscripts stands ready to deploy Sunrise for Military, our Military Health platform that supports
the continuum of health services across the full range of military operations. Allscripts defense
capabilities, Military Health vision, and successful history of deployments uniquely position us
to help JOMIS create and sustain a healthy, fit, and protected force, and deliver care for ill and
injured warriors.
7© 2021 Allscripts Healthcare, LLC and/or its affiliates.
All rights reserved.
WhitePaper_SunriseMilitary_03-08-21
www.allscripts.com
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