DoD initial rollout of Cerner EHR comes under fire from senator
The Department of Defense contends that its deployment of MHS GENESIS—a new Cerner electronic health record system—at four military sites in the Pacific Northwest was a success as part of the EHR’s initial implementation phase.
“We reached an important milestone last year, completing full deployment to all four initial operational capability (IOC) sites, culminating with Madigan Army Medical Center in Tacoma, Wash.,” testified Stacy Cummings, program executive officer for Defense Healthcare Management Systems, on Thursday before a Senate appropriations subcommittee. “Our immediate focus is to gain approval to continue to deploy MHS GENESIS beyond the Pacific Northwest beginning in 2019.”
Cummings, the executive responsible for the technology modernization program, added that the “successful deployment of MHS GENESIS to our four IOC sites was an important milestone in implementing what will be the largest integrated inpatient and outpatient EHR in the United States.”
However, Sen. Patty Murray (D-Wash.), ranking member of the Senate health committee, expressed her concern that the initial rollout has generated a “backlog of issues” that remain unresolved.
“I was very concerned when I started hearing at home about disturbing reports about the rollout plagued by technical problems,” Murray told Cummings. “I was out there. I heard issues about inaccurate prescription submissions, misdirected patient referrals, long waits to resolve problems in the program that were identified by the clinicians, and some practitioners reported that they couldn’t even open the program in a timely manner. And, worse, I received reports that staff have received inadequate training on the system and fear they may have to take money out of their own operating budget to pay for that training.”
According to Murray, all of these problems with MHS GENESIS combined have had a “significant morale impact on the practitioners in my state, not to mention serious concerns about putting patients’ lives at risk.”
Cummings responded that DoD conducted an eight-week optimization period starting this past January that included resolution of “trouble tickets,” or complaints, and support requests from users at the initial fielding sites. “When we began the optimization period, we had about 7,000 trouble tickets,” she testified. “Out of those 7,000 tickets, we’re in the process of closing about 1,000 of them…and, depending on the level of complexity and how much work needs to be done directly with the user, those changes will be made over the remainder of the year.”
However, Murray made the case that a lot of these problems “were identified long before deployment and should have been addressed prior to people all of a sudden using (MHS GENESIS), when people’s lives are at stake.”
Cummings acknowledged in her written testimony that the “configuration of MHS GENESIS deployed for IOC provided a minimally suitable starting point to assess the system, as well as the infrastructure prior to full deployment.” However, armed with “a great deal of feedback and lessons learned from those deployments,” she said DoD can now “make adjustments to software, training, and workflows and be confident the changes are positive and impactful.”
In 2015, DoD awarded a $4.3 billion contract to prime contractor Leidos to modernize the military’s EHR system, which is slated for deployment worldwide to support healthcare delivery for 9.4 million DoD beneficiaries. The Leidos-led team includes consultancy Accenture, dental software vendor Henry Schein, and Cerner which provides the core Millennium capability.
“We are on track to fully deploy by 2022,” Cummings told the senators. “And, while we still have a few challenging areas,” she concluded that “we are on track to begin our next deployments on the West Coast in 2019.”
“We’re following this very closely,” warned Murray. “I just don’t want everybody to think this is happy-dappy, rosy—because there are a lot of issues that need to be addressed and we need to stay on top of this.”