A major milestone for the Defense Health Agency in 2021 was to advance the successful rollout of MHS GENESIS, the new electronic health record system deploying to military hospitals and clinics around the world.

The MHS GENESIS system is the centerpiece of a larger transformation to securely standardize, integrate and manage medical records across the Defense Department and the Department of Veterans Affairs.

Army Lt. Gen. (Dr.) Ronald Place, the DHA's director, highlighted the rollout's progress among the agency's "top six points of pride" across 2021. "I am immensely proud of the collective work across the entire Military Health System to continue deploying MHS GENESIS during the pandemic. It is much more than a single electronic health record that stays with a patient during their entire life cycle in the MHS and VA. It is transformative by design to help us improve patient safety, communication and ultimately better health outcomes."

Beginning in 2017, Military Health System facilities worldwide are deploying MHS GENESIS in 23 waves. In 2022, the system will pass a key milestone: implementation of MHS GENESIS in more than half of all military hospitals and clinics.

The Most Successful Wave

MHS GENESIS deployed to Wave TRIPLERTripler Army Medial Center in Honolulu, HI; Naval Health Clinic Hawaii, Makalapa at Joint Base Pearl Harbor-Hickam, HI; 15th Medical Group at Joint Base Pearl Harbor-Hickam, HI; Desmond Doss Clinic at Schofield Barracks, HI; and Branch Health Clinic Kaneohe Bay at the Marine Corps Base Hawaii, HI.Wave TRIPLER in September, underscoring the importance of teamwork as a key component for success. Encompassing five military hospitals and clinics in Hawaii, the rollout is considered the "most successful wave deployment of MHS GENESIS to date," according to Holly Joers, program executive officer for the Defense Healthcare Management Systems office, which oversees the transformation.

For Army Col. Kevin Peck, chief information officer at the Tripler Army Medical Center in Honolulu, Hawaii, the electronic health record deployment at Tripler was a success because of teamwork, communication, and planning.

"Our success was driven by the foresight of our chief technology officer to allocate travel funds in the budget for fiscal year 2020," said Peck.

That allowed Tripler's information technology staff to visit other medical facilities "prior to and during their 'go-live' to capture their lessons learned in person, to discuss with them face-to-face what they would have done differently, and to observe what went right and wrong," he said.

The facilities that the Tripler team visited included Naval Medical Center San Diego in California; Carson Tahoe Regional Medical Center in Carson City, Nevada; and the U.S. Air Force Academy in Colorado Springs, Colorado.

As a result, Tripler was able to "incorporate the successes while adjusting fires for the shortfalls in our 'go-live' preparation and execution," Peck said.

Additionally, Peck and his staff prioritized communicating to leadership and staff the importance of teamwork to ensure they remained on track to 'go-live,' which occurs when a system becomes operational.

"We leveraged leadership as needed and proactively informed the staff of all changes to ensure they remained flexible and positive," he said.

Wave TRIPLER incorporated MHS GENESIS to 4,800 providers throughout 130 locations in Hawaii, according to a report from the Defense Healthcare Management Systems Program Executive Office. "It brings the total number of locations live on MHS GENESIS to over 1,000," the report said.

More Major Successes

Like Tripler, there were other major MHS GENESIS successes in 2021.

"We deployed at three successful waves, including 30 military hospitals and clinics," said Air Force Col. (Dr.) Thomas Cantilina, the DHA's chief health informatics officer and deputy functional champion for the electronic health records system.

"Currently, MHS GENESIS has been deployed at 47 MTF commands, which includes 64,000 active users and represents 35% of the Department of Defense deployment," Cantilina said.

In parallel, the team has continually upgraded the system to keep it current with the commercial model, which includes thousands of underlying code updates as well as hundreds of user interface improvements, he said.

As part of DHA's broad response to the COVID-19 pandemic, MHS GENESIS supported patient and agency needs. The new electronic health record system provided military leaders with real-time data and information about the DHA's capacity to take on new patients from an enterprise level, the CIO said.

In addition, "DHA health informaticists added approximately 40 new system functions to MHS GENESIS, enabling providers to better address the needs of patients with presumptive positive cases of COVID-19," said Cantilina.

They also added several systems to support MHS GENESIS and MHS operations, including:

• A file-sharing protocol that supports a secure email interface to comply with the 1996 Health Insurance Portability and Accountability Act (HIPAA).
• The MHS Video Connect feature, which is a platform supporting virtual video visits between MHS patients and providers.
• Two platforms designed to connect and transform electronic health records data to leverage machine learning to better understand common trends in the MHS patient population.
• A new MHS GENESIS Revenue Cycle Expansion, or RevX, a system designed to integrate clinical business systems that drive standard processes. RevX will help enable accurate resource management.

"Our team is working to advance RevX at military hospitals and clinics already using MHS GENESIS, and we're excited by the advancements it will bring to the MHS once all of our military hospitals and clinics transition to MHS GENESIS," said Cantilina.

MHS GENESIS in 2022

In 2022, Cantilina and the rest of the DHA teams involved in the rollout expect to deploy MHS GENESIS at another 10 waves, including 54 additional military hospitals and clinics.

This "will be our largest group of military hospitals and clinics in any calendar year," said the CIO. For patients, this means access to the improved MHS GENESIS Patient Portal, which allows online scheduling and secure messaging to providers, as well as increased security protocols for sensitive health data.

For more information on the MHS GENESIS rollout, check out these articles on super users, lessons learned, and the peer-to-peer pay-it-forward program.