Col. Drew Kosmowski is a U.S. Army Emergency physician deployed to the Iraq Training and Advisory Mission-Ministry of Defense (ITAM-MoD) as the physician advisor to the Iraqi Surgeon General.
What do you, as an American, with some of the best health care in the world, hate about going to the doctor? Is it that you always have to keep telling your story over and over like nobody has ever written it down before? Do you feel like the specialist you are seeing doesn’t know what you told your regular doctor and vice versa? Do you feel like it is up to you to keep all of the doctors on track with all of the routine tests and things that are supposed to be done to keep you healthy?
When I was in medical school, I was told that “all of us are patients but some of us get to be doctors.” This is true. But I can also tell you that while most of us feel these frustrations as patients, some of us doctors feel them far more frequently for each of our patients. So what if I told you that our country was going to help another country with the best health care Information Management System in the world, that this other country will have only one system so they will be able to fully share their health information by a secure network, and that they will be incurring most of the cost of implementing the system?
Col. Drew Kosmowski. Photo courtesy of U.S. Army.
Part of this country speaks a different language and has not really cooperated with the rest of their country for several years in health care. In addition to bridging the communication gap, this system can unify their entire country toward common health care goals.
As we are departing Iraq, the U.S. military will be training the Iraqi health care IT personnel in their Ministries of Defense and Health along with the Kurdish Ministry of Health to develop and implement the WorldVistA electronic medical record and management system throughout the country. This system is based on the U.S. Veterans Health Administration’s VistA system that has been improving health care for our veterans for over 30 years and is available by Freedom of Information Act as an open source system.
We have a signed Memorandum of Agreement from the Iraqi Ministry of Health, the Kurdish Region Ministry of Health, and the Ministry of Defense, where each party (representing the major Iraqi religious sects and ethnic groups) agrees to send people to centralized training, implement WorldVistA for their ministries, and to establish the necessary medical IT infrastructure.
This level of cooperation in health care has not been seen since the early 1990s. The system will allow consultation and collaboration across Iraq and will help the ministries to accomplish many of their strategic goals such as reducing postpartum tetanus and child mortality rates by reminding doctors of scheduled vaccinations.
It will reduce costs by reducing duplicate medications and tests. This will improve patient safety by providing all of the patients’ medical history, medications, and drug allergies at a glance. Iraqi health care will be the example for cooperation of effort as it rebuilds from decades of war and dictatorial leadership.
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