The joint effort to provide a single, interoperable electronic health record to the Defense and Veterans Affairs departments will soon see its most visible test since the program began six years ago: deployment to the Captain James A. Lovell Federal Health Care Center, a joint facility between the two agencies used.
The Pentagon has been working on rolling out a commercial electronic health record system since 2015 when it signed a contract with the Leidos Partnership for Defense Health to provide a Cerner EHR platform Genesis of the Military Health System. Officials chose to use a commercial system to finally ensure a seamless flow of digital records between military branches and Veteran’s transition to the VA, Which signed its own contract with Cerner in 2018.
Both versions of the Cerner software – which work on the same basis, but configured separately to accommodate clinician workflows at DOD, VA, and the coast guard– Will be used in the near future at Lovell Health Care Center in North Chicago, Illinois, although the exact schedule has not yet been established.
“The real schedule for this is something we’re still working on,” said Bill Tinston, director of federal electronic health record modernization, on a call with reporters Thursday. The FEHRM program office coordinates rollouts at the DOD, the Veterans Affairs Department and the Coast Guard facilities and ensures that the combined system is interoperable. “But FEHRM, DOD and VA are working together to ensure that we are simultaneously bringing the right solution for this location in order to be successful there.”
Tinston found the facility to be unique in that DOD and VA clinics and support staff work as a single team.
“There are other sites in common that we look at similar things,” he said. “But there is no question that this facility is the most integrated facility.”
While DOD and VA use two versions of the Cerner platform – MHS Genesis and Cerner Millennium, respectively – Tinston said the EHR works as a system and every patient has a record no matter which facility they go to. However, the two versions of the system have been configured to suit the different workflows of DOD and VA clinics.
The Lovell Health Care Center will be the first to bring these workflows together and test the interoperability of the system.
It’s going to take some effort and planning, but it’s not impossible, Tinston said.
“A lot of steps have been taken to make sure IT – the IT supporting elements of it – are now working together,” he said. “They are already providing care there; they know what to do. This is how we ensure that the workflows in the two organizations are effective. We can’t bring them anything that only works for part of the organization. We have to offer them workflows that work with the integrated processes in which they work there. “
He said that a joint DOD-VA team, led by FEHRM, is already examining workflows and business processes at the center to ensure that the rollout meets all requirements.
The real goal, Tinston said, is to make sure IT isn’t a factor in how clinicians deliver health care.
In providing the Lovell Health Care Center, FEHRM hopes to “take IT out of the decision-making loop for administrators of these two health systems to make the decisions they want to make to collectively deliver health care without IT.” Make decisions or limit your freedom of choice, ”he said.
MHS Genesis’ full rollout is now 30% complete, and the system is expected to be up and running in all of the DOD’s medical facilities – domestically and internationally – by 2023, officials said.
Holly Joers, assistant program director for the Executive Office Defense Healthcare Management System or PEO DHMS program, noted that the April deployment, named Wave Carson-plus, “more than doubled our footprint” from 22 medical care facilities to 47 widths of the system 16 states and added 10,000 more users for a total of about 42,000.
After the successful implementation at several locations at the same time, the MHS Genesis team and the FEHRM office have gained the confidence to carry out more simultaneous rollouts.
“With every use we take stock of the knowledge gained and identify the things that can make us more efficient,” said Joers. After the Carson plus wave, which combined two previously separate waves, “we feel very confident about the future.”