The Defense Department has deployed a commercial-off-the-shelf electronic health record system from Cerner at Fairchild Air Force Base, near Spokane, Wash., as part of an initial operating capability.
DoD’s plan is to install Military Health System (MHS) GENESIS at four sites in the Pacific Northwest this year, with full deployment of the EHR to be completed in 2022 at fixed defense facilities across the United States and around the globe. Ultimately, the Cerner Millennium solution will serve more than 9 million DoD beneficiaries worldwide.
During a media briefing on Wednesday, Lt. Gen Mark Ediger, Air Force surgeon general, called MHS GENESIS a “collaborative tool” designed to present a “common sight picture” to clinicians on individual patients to support their unique medical needs and treatment.
“This electronic health record is really built to enable a team approach to providing health services to patients,” said Ediger. “In medicine today, we leverage a number of different skill sets on a healthcare team. So, it goes well beyond just the typical doctor-patient interaction to leverage skill sets like nutritionists, exercise physiologists and disease management nursing.”
According to Ediger, Fairchild AFB is piloting a health coach capability as part of the EHR deployment to help patients with tobacco cessation, weight loss and other lifestyle changes between visits to promote better outcomes.
“As a pediatric nurse practitioner who is very familiar with our previous legacy system, MHS GENESIS is streamlined, intuitive, and makes it much easier for the provider to get through the notes,” said Col. Margaret Carey, commander of the 92nd Medical Group at Fairchild, who added that the base has fully transitioned over to the Cerner EHR from its legacy system.
Among the features of the Cerner EHR that Carey likes are the alerts generated by the system which flag potential patient safety issues for clinicians. In addition, she said that a portal enables patients to become “partners in their healthcare” with access to their medical records including laboratory, radiology and medication information.
The Pentagon in 2015 awarded a $4.3 billion contract to prime contractor Leidos to modernize DoD’s EHR system. The Leidos-led team includes consultancy Accenture and dental software vendor Henry Schein, while Cerner provides the core Millennium capability.
“It’s one code set, which has been delivered and is commercially available off the shelf,” said Zane Burke, president of Cerner.
Stacy Cummings, program executive officer for Defense Healthcare Management Systems, emphasizes that DoD is “not trying to reinvent the wheel” when it comes to Cerner’s Millennium EHR and Henry Schein’s Dentrix Enterprise dental practice software.
“We’ve been able to leverage the commercial best practices of those two companies, that have deployed around the world with hundreds of thousands of people using those commercial EHRs and dental records,” said Cummings.
The initial deployment of the Cerner system was slated for this past December. But, DoD delayed the rollout until this month to allow additional time to resolve technical issues, including finalizing system interfaces between Cerner’s software and legacy military health systems.
“It was just a few weeks in schedule change to make sure all those interfaces were completely ironed out,” said Jerry Hogge, deputy group president for Leidos Health. “Collectively, with our customer, we thought it most prudent to adjust the schedule a few weeks to make sure we reached the finish line completely prepared. And, the first week has really gotten off to a great start here at Fairchild.”
Nonetheless, Carey said that her staff experienced some training challenges in transitioning to the new EHR system. “I think it was just the lag time between the training period and our actual go-live,” she added, noting that both computer-based and instructor-led training were provided. Carey also observed that “there’s a different ‘language’ for MHS GENESIS than there is for what we have been using before,” which took some getting used to for Fairchild personnel.
Still, Cummings said that DoD is “on track” to begin to deploy MHS GENESIS to the next three initial operating capability sites in the Pacific Northwest as early as June. Those next three deployment sites include Navy hospitals in Oak Harbor and Bremerton, Wash., as well as Madigan Army Medical Center in Tacoma.
“We’re basing our next scheduled dates based on our experiences here (at Fairchild), capturing lessons learned as well as technical feedback,” concluded Cummings. “We will do operational testing, which is an opportunity for us to have an independent look at our training, our solution, and how it’s being used in those four initial sites.”
Full deployment of MHS GENESIS is slated to start in 2018 and end in 2022, she added.
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