- The Department of Defense (DoD) expects to roll out the next phase of its EHR modernization in the fall of this year, with system-wide completion expected in 2023.
The new Cerner-based EHR system, called MHS GENESIS, will support more than 9.5 million DoD beneficiaries and approximately 205,000 military health system (MHS) personnel.
The EHR modernization is designed to provide “enhanced, secure technology to manage health – connecting medical and dental information across the continuum of care, from point of injury” to the military treatment facility, explained DoD in a release.
In the first phase, DoD deployed the new EHR at four sites in the Pacific Northwest in order to identify and address problems and use lessons learned for the next phases of deployment.
At the four initial sites, new EHR system resulted in a decrease in the percentage of emergency-department patients who left without being seen, the use of patient risk-alert functions leading to enhanced clinical decision making, and a substantial reduction in the number of duplicate lab tests.
“We are seeing MHS GENESIS enable easier monitoring and response to patient health through an enhanced set of tools: data reporting and tracking capabilities, improved analytics, computer-aided decision support and a user-friendly patient portal,” the department explained.
MHS GENESIS is replacing legacy DoD EHR systems, including the Armed Forces Health Longitudinal Technology Application (AHLTA), the Composite Health Care System, and components of the Theater Medical Information Program-Joint.
The new EHR system will provide two-way communication, agility and responsiveness, and integrated medical and dental records.
Among its benefits, the new system will monitor beneficiaries’ health status through improved population health data, tracking, and alerts; improve the ability to track patient safety, outcomes, and operational and medical readiness; expand access to and sharing of health data across the spectrum of military operations as well as veteran and civilian healthcare organizations; and increase accessibility of integrated, evidence-based healthcare delivery and decision making.
The DoD EHR modernization, which began in 2017, is expected to cost $5.5 billion, up from the original $4.3 billion. The DoD asked for the increase in funding to incorporate the US Coast Guard into the EHR implementation and to establish a standardized EHR baseline with the US Coast Guard and the Department of Veterans Affairs (VA), which is also modernizing its EHR system on the Cerner platform.
The standardized baseline will include common off-the-shelf software, common clinical application services, common interfaces, and shared infrastructure.
“A single common system across VA and DoD will facilitate the transition of active duty military members to VA and improve their timely access to the highest quality of care in a way never before experienced. Records residing in a single common system will eliminate the reliance on complex clinical interfaces or manual data entry between DoD and VA,” explained then VA Secretary David Shulkin in July 2017.
The VA EHR modernization has been mired in controversy. Rep. Will Hurd (R-TX) recently called the $10 billion price tag and 10-year implementation timeline “outrageous.”
Hurd expressed frustration at how long the EHR implementation was expected to take. “Why is it taking so long to map one record to the other? Have we completed that data mapping?” he asked VA witnesses during a recent House panel hearing.
Richard Stone, the executive in charge of the Veterans Health Administration, told the lawmaker that reason it will take so long is because Vista, the VA’s legacy EHR system, is a badly fragmented system, with 131 instances.
“What that means is that there are 131 datasets that go back decades that must be not only data mapped, but also combined into a single instance before we can migrate the data over into the Cerner product. This is not simply bringing an electronic medical record to life; this is about moving from a highly disjointed system without data integration to one that is fully data integrated and therefore interoperable,” Stone said.