After a pause because of the COVID-19 pandemic, the Defense Department's commercial health record installation program is back online. The Coast Guard is also transitioning to the new system.
The U.S. Coast Guard has deployed the military’s new commercial electronic health record system to four new pilot sites after the Defense Department suspended the effort so health care providers could focus on the COVID-19 pandemic response.
The Coast Guard went live in August with MHS Genesis, a version of Cerner's health record system, at four pilot sites in the San Francisco Bay Area to aid in adjustments to DOD workflows, training, and equipment setups, defense health officials told reporters during a Nov. 19 briefing.
There are plans to deploy MHS Genesis to Coast Guard Pacific areas in early 2021 with 14 clinics and approximately 300 health care providers and end users in the San Diego region, Rear Adm. Douglas Schofield, the Coast Guard’s acquisition director of and program executive officer, told reporters Nov. 19. The Atlantic wave is set to start next summer and would include 26 main clinics.
Additionally, Schofield said digitizing paper health records is on the agenda next year after the wave deployments. DHA plans to digitize paper-based records and use common agency equipment that can interface with the MHS Genesis system. The Coast Guard is currently using paper and electronic records during the transition but is considering both machine-readable and image solutions for use in the MHS Genesis system.
The Defense Department suspended activities in March related to the MHS Genesis rollout that would impact the hospitals and providers needed for the COVID-19 response, slowing feedback loops with providers who would use the systems. But the technical and support work on the backend to existing sites using MHS Genesis, and those in future waves, continued, a DHA spokesperson told FCW.
DOD also went live with two wave deployments: Nellis in September, which included 10 sites in California and Nevada, and Pendleton in October with four sites in California and Alaska. Both waves include military bases, camps, posts, stations.
Training schedules saw the most disruption due to travel restrictions during the pause, but the move has put MHS Genesis migration on track to be fully fielded in 2023 and that virtual tools and training helped mitigate delays.
Holly Joers, the acting program executive officer for Defense Healthcare Management Systems, said the development of virtual tools for training would help minimize disruptions, such as “enhancing and expanding our digital health solutions with virtual health and how we can expand video capability, and other IT tools to enable encounters with providers and patients."
DOD also added alerts to MHS Genesis to help providers anticipate and prevent potential opioid overdoses and a mass immunization process that can be used for pre-deployment and annual vaccinations, officials said.
Brig. Gen. Ned Appenzeller, the assistant director for combat support at the Defense Health Agency, said the mass immunizations function, which could become pertinent in the event of future COVID-19 vaccine dissemination, had been running “fairly well” and that overall the EHR system has made it easier to respond to COVID-19 cases in the military.
"With new changes that happened, a power to the patient, provider and enterprise is the ability to centrally change things when things are dynamic and fluid in the environment,” Appenzeller said.
When new COVID-19 tests come on board, MHS Genesis allows providers to more accurately and centrally document patient information to make it more trackable, which can boost patient outcomes.
“[That] has an impact to patients' ability to get tests, facilities' ability to order appropriate reagents for their test, the enterprise's ability to track where tests are being done, what rates are to get good estimates of what prevalence may be and where things are changing -- that can all be done in Genesis in a matter of hours, as opposed to going site by site in our legacy system, where it can take days to weeks."