The Defense Health Agency’s Program Executive Office for Defense Health Care Management Systems Modernization (PEO DHMSM) held a virtual media roundtable in Arlington, Virginia, June 10. The event allowed representatives from PEO DHMSM, the Federal Electronic Health Record Modernization Office (FEHRM), and the Military Health System to provide an update on the progress and lessons learned since the most recent deployment of MHS GENESIS to an additional 25 military treatment facilities April 24.

First rolled out at MTFs in the Pacific Northwest in 2017, MHS GENESIS provides a single common electronic medical record for service members, veterans, and military family members. It is scheduled to be fully operational throughout the Department of Defense by the end of 2023.

"As of May, with the completion of Wave SAN DIEGO and Wave CARSON+, MHS GENESIS is now operational across 16 states, with more than 600 locations and approximately 42,000 active users, which accounts for 30% of our total deployment" said Holly Joers, acting program executive officer for DHMSM, the office responsible for acquisition, oversight, and deployment of MHS GENESIS. "It's worth noting that with the deployment of Wave CARSON+Evans Army Community Hospital at Fort Carson, CO; 21st Medical Group at Peterson Space Force Base, CO; 60th Medical Group, Buckley Space Force Base, CO; 10th Medical Group, U.S. Air Force Academy, CO; 21st Medical Group at Schriever Space Force Base, CO; Munson Army Health Center at Fort Leavenworth, KS; Gen. Leonard Wood Army Community Hospital at Fort Leonard Wood, MO; Irwin Army Community Hospital, Fort Riley, KS; 28th Medical Group at Ellsworth Air Force Base, SD; 90th Medical Group at F.E. Warren Air Force Base, WY; 22nd Medical Group at McConnell Air Force Base, KS; 509th Medical Group at Whiteman Air Force Base, MO; Raymond W. Bliss Army Health Center at Fort Huachuca, AZ; 27th Special Ops Medical Group at Cannon Air Force Base, NM; 355th Medical Group at Davis-Monthan Air Force Base, AZ; 319th Medical Group at Grand Forks Air Force Base, ND; 49th Medical Group at Hill Air Force Base, UT; 377th Medical Group at Kirtland Air Force Base, NM; 56th Medical Group at Luke Air Force Base, AZ; 341st Medical Group at Malmstrom Air Force Base, MT; 5th Medical Group at Minot Air Force Base, ND; 55th Medical Group at Offutt Air Force Base, NE; Naval Health Clinic Yuma at Marine Corps Air Station Yuma, AZ; Dugway Proving Grounds, UT; Tooele Army Depot Army Health Center at Tooele Army Depot, UT; and Yuma Proving Grounds Health Clinic at Yuma Proving Grounds, AZ.Wave CARSON+, we more than doubled our footprint in a single day and DOD remains on schedule for completion at the end of 2023."

Joers pointed out several examples of progress throughout the MHS that can be directly attributed to the deployment of MHS GENESIS, including:

• The ability to treat premature newborns with real-time decision support in critical moments
• Improving the ability to track the health of service members while transitioning between duty stations
• Reducing follow-on visits to manage prescriptions and ensuring medications are re-stocked in a timely manner
• Enhancing training recruit readiness, including the administration of COVID-19 vaccines

"These examples showcase how using a modern personal health record continues to improve the health outcomes and general well-being of our U.S. military personnel and their families," said Joers.

The most recent wave of MTFs provided a variety of lessons learned, she said, including geographic concerns.

"For every deployment, we take stock of lessons learned and identify things that can make us more efficient," she said. "CARSON+ was a combination of two waves that were originally planned to go at the same time. We were able to go across 25 MTFs and 12 states at the same time. It was our broadest geographic range to date. This was a really good experience for us to learn how to navigate those geographic challenges."

It also emphasized how PEO DHMSM could best leverage virtual support and their Pay-It-Forward campaign for MHS GENESIS, utilizing people who have already used the system to help their peers understand and adopt the system. Due to the scope of deploying MHS GENESIS worldwide across DOD MTFs, much of the virtual training, now a necessity, was planned prior to the COVID-19 pandemic.

One of the greatest advantages MHS GENESIS brings end users, both medical personnel and patients, is standardization.

"The standardization of workflows and processes across the enterprise is one of the most important things about this system," said Army Maj. Gen. (Dr.) George "Ned" Appenzeller, DHA's assistant director for combat support. "This is where we drive not only standard practices from a patient perspective, but also providers, technicians, and pharmacists. Everything is done the same everywhere."

This results in a higher quality of patient care, said Appenzeller.

"You're not re-learning things every time you go somewhere else," he said. "Because things are done the same way everywhere, safety and the care of our patients - the people we take care of - is improved."

The successful sharing of information and lessons learned during the deployment of MHS GENESIS hasn't been limited to the DOD, said FEHRM Director Bill Tinston.

"From the FEHRM and joint perspective, it was pretty amazing to see the power of having the three departments - the Department of Veterans Affairs, the DOD, and Homeland Security with the Coast Guard - who went live at the height of the COVID crisis," he said. "They had to bring these virtual training delivery techniques to the table - that informed what VA and DOD did next. Having the three organizations "cross-fertilizing" one another has been really helpful throughout this process."

Appenzeller said the key to any successful transition is learning as it progresses.

"There's always more to learn, but I think what we're learning as we transition is it's less drastic each time. Every time we do something new, we find things we can do better," he said.