DoD MHS GENESIS EHR Implementation Heads Down the Homestretch

Following a series of setbacks, the Federal EHR Modernization (FEHRM) project has seen some bright spots. Among them, the Defense Health Agency (DoD) stands out as it makes headway with its MHS Genesis EHR implementation.

Nearly three-fourths of DoD’s clinics and hospitals are now using the EHR system, with 160,000 users and 6.1 million beneficiaries in the system to date.

Overall, the department is on schedule to complete the project, including the integration of overseas military treatment facilities (MTFs), by March of next year.

“As we’ve gone through this transition, we’re not just replacing a legacy system; it brings new capabilities to bear,” Holly Joers, executive program officer for Defense Healthcare Management Systems, said in a Federal News Network reporting.

“We’re really excited about creating a lifetime record under the single common federal EHR, and that will enable patient-centered care. It will be a record about the patient, not where care is delivered — from when someone accesses into the military, all the way through service with Veterans Affairs. We’ll be able to gain new insights about population health, the medical readiness of the force, and really ensuring that we’re taking care of our service members and their families.”

Although the project is currently progressing well, it had a rocky start. In February 2017, DoD introduced MHS GENESIS at Fairchild Air Force Base in Washington state. Subsequently, the system was launched at Naval Hospital Oak Harbor, Naval Hospital Bremerton, and Madigan Army Medical Center.

However, soon after, a report was released indicating that the MHS GENESIS EHR system implementations at Initial Operating Capability (IOC) care sites were operationally ineffective or inappropriate. Clinicians and administrative staff were concerned about the potential patient safety risks of the EHR system's significant shortcomings.

Following the initial implementation sites, the deployment process saw significant improvements. The DoD faced challenges but also learned valuable lessons, that led to a shift in their management and IT deployment practices.

“I can’t comment specifically on VA, but when I look at where they are now, I’m taken back to where DoD was in the 2017-2018 timeframe,” Joers said. “There were challenges with the network, and so we made rules about what infrastructure had to be in place before a go-live, and how long it needed to be stable before we went live.”

“We looked at our governance and management process to hear different inputs,” she continued. “When you’re only dealing with four sites, everyone wants to make it work for what their workflow was before. So you really have to have the fortitude to look at making an enterprise standard, knowing that it might not match what they’re currently doing today. And we had to go through those growing pains.”

Lt. Gen. Ronald Place, MD, former director of the Defense Health Agency (DHA), highlighted the health IT implementation’s progress among the agency’s “top six points of pride” for 2021.

“I am immensely proud of the collective work across the entire Military Health System to continue deploying MHS GENESIS during the pandemic,” Place told the Fort Hood Sentinel.

“It is much more than a single electronic health record that stays with a patient during their entire life cycle in the MHS and VA,” he added. “It is transformative by design to help us improve patient safety, communication, and ultimately better health outcomes.”