DoD’s new electronic health record rollout is now about one-third complete

The Department of Defense has just completed the largest-ever deployment in its multi-billion dollar project to replace its electronic health record.

The most recent “go-live” for MHS Genesis installations has almost doubled the system’s footprint in a single day. It’s 42,000 active users, and about a third of the massive, multi-year IT project is now complete.

The latest series of missions – dubbed “Wave Carson Plus” by the Defense Health Agency – brought 25 separate military installations into the MHS Genesis fold at once.

These bases were scattered across 12 different states, stretching from California to North Dakota to Missouri. And the recent major rollout has been a great help in ironing out the kinks in the Genesis deployment process, said Holly Joers, assistant program director, healthcare management systems.

“This has been a really good experience for us to learn how to deal with these geographic challenges because it was the broadest geographic area we have done so far,” she told reporters on Thursday. “After this deployment, we can see how we can use virtual support as effectively as possible. We’re also using our ‘Pay it forward’ campaign to get people who actually use the system today to visit the new sites so they can help their colleagues understand the nuances of using the system. “

Since MHS Genesis was first deployed in 2017, Department of Defense health officials have claimed they could deploy the system in all 475 military treatment facilities around the world by the end of calendar year 2023. And that despite breaks in the early days of the program due to Problems leads to and while In the first wave, Joers said she still had “very high” confidence that the department would achieve this goal.

But achieving that means a significant increase in deployments starting in fiscal 2022. For the first time, the DoD will use a “stacked” model that Genesis installs in multiple of these waves at once rather than doing them one at a time.

Eight waves are slated for next year when Genesis makes its way to MTFs on and around San Antonio-Lackland Air Force Base, Fort Hood, Fort Bragg, Fort Bliss, Fort Gordon, Eglin Air Force Base, and Navy facilities Jacksonville, Florida.

According to DoD Budget documentsthat accelerating deployments will mean the department will have to hire nearly 900 new contractors to install the system and train new users, a significant increase from the 1,500 employed on the project this year.

Joers said some of the early prep work for these waves is already underway.

“We’re going out next week to launch Eglin Air Force Base and Jacksonville waves, and we’re starting that process about 18 months later with a kickoff discussion with commanders,” she said. “Every step of the way is clearly defined. While we may discover things that we can learn along the way, the process itself is standardized. We know what to expect; We know how to convey to the commanding officer what to expect in the context of the deployment and adoption. These are the things that make us feel confident that we can handle the stacked waves. It’s a rigorous process and whatever we discover – like a new medical device that needs to be put online – we have an efficient and effective process to use it. “

Meanwhile, the DoD is working on implementation plans for one of the largest tests of Genesis’ ability to work with the Department of Veterans Affairs.

Through its own contract for more than $ 10 billion, VA bought the same Cerner Millennium product on which Genesis is and is based still working through his own fights at its first locations.

But clinicians from both departments are already working side by side at the James A. Lovell Federal Health Care Center in North Chicago. This is perhaps the most interesting use case for a fully integrated health record, said Bill Tinston, director of the Federal Electronic Health Record Modernization Program Office.

“Currently VA and DoD are reviewing the end-to-end business processes to ensure we have configured workflows in place to support the operation of this facility. I think this is an opportunity for us to look at other future convergence opportunities on the workflow side that can take IT out of the decision loop of administrators of these two healthcare systems so they can make the decisions they want to make – without leaving you IT will drive that decision or limit your decision-making power, ”he said. “It’s a single system and we’re looking at how we can harmonize the workflow to ensure that the workflow works for the combined team at this location. There are other common websites that have researched similar things[s], but without question, [Lovell] is the best integrated facility. “

In the near future, the next major Genesis deployment will be in all of the military’s health care facilities in Hawaii. These rollouts should be completed by the end of this fiscal year. After that, the next major mission will take place at Joint Base San Antonio, home of the Army’s largest hospital, Brooke Army Medical Center.

And while the department is pretty confident at this point, Brig says there’s still a lot to learn. General George Appenzeller, Defense Health Agency Deputy Director for Combat Support.

“I think what we learn is less drastic each time. But every time we do something new, we find new things that we can do better, better training methods, additional things to work on, ”he said. “That’s why we’ve got the IT team so closely involved in our clinicians – with weekly calls in advance of a rollout with all commanders to discuss all the things they can and can’t do. One of the most impressive things is the data management capabilities: we can actually see how much time employees spend on the record during duty and after duty. What we found is that what some people colloquially call “pajama time” – after the roster was created – has gone way back in the Genesis locations. That means that not only is security getting better, but providers are getting back to their families as well. And a rested, happy provider is a much more productive provider who takes better care of our patients. “

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