The backup of appointments expected at the U.S. Army hospital in Heidelberg, Germany, where doctors have reduced patient loads to learn how to use a new medical record tracking system, has not materialized as expected, hospital officials said last week.

A combination of steady call volume and patients’ willingness to put off routine appointments over the past two weeks have kept the hospital’s need to refer people to German medical centers at a minimum, said Maj. Dennis Walker, chief of Heidelberg’s clinical operations division.

“We’ve seen very little impact on the number of people we’ve had to send down into the local economy,” Walker said.

Heidelberg is the first hospital in Europe to implement the Department of Defense’s new Composite Health Care System II, an electronic medical record database that will eventually replace military patients’ paper-based files. When fully applied, examination rooms throughout the military will be outfitted with a desktop computer where doctors can access a patient’s complete medical file online from a central database in Alabama.

But medical staff members have to trade off patient visits for classroom time, and must lengthen individual appointments while learning to use the system, leading to potential backups, CHCS officials warned in January.

Walker said Wednesday, however, that Heidleberg has received almost no complaints of decreased access to doctors, and numbers of referrals to German facilities have been low.

“There were days we would send out four to five [patients], and there were days we didn’t send out any,” he said.

Normally, the hospital treats about 200 patients a day and does not have to refer any patients to German facilities, he said.

Maj. David Blair, a physician and CHCS II integration expert flown in this week from the States to help train the Heidelberg doctors, said many were dubious when they first saw the system, because it does not contain much patient background yet, providing only basic information from recent treatments.

But as a doctor — not a software trainer — who has worked with the system for two years, Blair said he was able to show Heidelberg medical staff members practical ways to use CHCS II, and showed them what a complete medical record will eventually look like.

Generally when doctors see a full record on CHCS II, “their view of the system has been improved,” he said.

The next hospital to implement CHCS II will be the Landstuhl Regional Medical Center, where officials are already taking lessons from the Heidelberg training to improve the integration process, said Tina Coffman, CHCS II program manager for central Europe.

Officials at the hospital, where more than 1,000 new computers will be installed for CHCS II, will lengthen some of the early training sessions and prepare more “champions” — medical staffers who learn the system early and help teach it to their colleagues — to help get the hospital online sooner, Coffman said.

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