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Military Health System

Enhancing Mission Readiness with MHS GENESIS One Read at a Time

Image of Computer screen with doctor examining image. Whether it's a diagnostic imaging exam such as an X-ray or MRI being read by a staff radiologist or Dental Cone Beam Computed Tomography exam analyzed by an oral radiologist such as U.S. Navy Lt. Cmdr. Douglas Steffy (pictured), Naval Hospital Bremerton has used the Department of Defense's electronic health record, MHS GENESIS, to support crucial mission readiness and timely, patient care by receiving radiology studies, reading, and finalizing to send the results back in approximately 30 minutes.

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MHS GENESIS

Soon after Pacific Northwest military hospitals and clinics deployed the Department of Defense's new electronic health record, MHS GENESIS, the immense capabilities of the system began to be realized.

One notable method initially used was to effectively bridge the geographic distance and cultural difference between two service branches to support mission readiness. As well as share--and deliver--timely, patient-centered care.

Naval Hospital Bremerton, located along the shore of Washington's Puget Sound, and the Air Force 92nd Medical Group, in Fairchild Air Force Base, teamed up using MHS GENESIS to shorten the more than 320 miles between them to near time.

The 92nd Medical Group sent two radiology studies to NHB using MHS GENESIS, which were read by providers in NHB's radiology department in approximately 30 minutes with the results sent back immediately. NHB became the first site to conduct such a process for another military hospital and clinic using the new electronic health record.

That relative fast turnaround was an improvement from previous routines.

Before MHS GENESIS, the 92nd Medical Group clinic providers had to either send their patients into town for X-ray service or wait for the clinic to get their results several days after the fact. The entire effort relied on using multiple electronic systems, steps, and procedures to finalize.

According to NHB radiologists, that former process was cumbersome and impeded workflow. It took a lot longer than necessary to interpret the X-rays, formalize the necessary report, and subsequently cut and paste the report into another system before seeing the results. MHS GENESIS has essentially eliminated having to use more than one electronic system, which has also reduced the possibility of any potential errors. It has also increased reliability and made the results readily available to providers.

"X-rays were read consistently on weekdays throughout the duration of the coverage period [from 2018 through the early part of 2022]," said U.S. Navy Cmdr. (Dr.) Matthew Bauer, head and staff radiologist of NHB's radiology department.

Between September 2018 and April 2022, there were 5,762 exams diagnostic imaging exams--from X-rays to MRI scans--read at NHB that were performed at the 92nd Medical Group, with an average turnaround time of less than 30 minutes, according to Chet Hunter, NHB picture archiving and communication system administrator. The combined behind-the-scene's effort of the Defense Health Agency and NHB information management department has seamlessly integrated 92nd Medical Group exams into NHB workflows, to the point that the interpreting radiologist frequently didn't even realize that the exam was from a remote site.

The initial operating capability deployment of MHS GENESIS took place in 2017 at the 92nd Medical Group in February, followed by Naval Health Clinic Oak Harbor in July, NHB in September, and Madigan Army Medical Center in October. There were a host of critics, cynics, and contrarians who wanted--and demanded--instant results.

"Implementing a new, seamless electronic health record was an enormous undertaking. NHB moved from sustaining several existing electronic health and dental records to employing a new one that consolidates health and dental information into a single record," commented U.S. Navy Lt. Cmdr. (Dr.) Bryan Wooldridge, the NHB chief medical information officer at the time and family physician. "We took a commercial off-the-shelf product and along with the Program Executive Office, Defense Healthcare Management Systems, identified areas for improvement within the new system so we could take corrective actions not only for our hospital but to prioritize future enhancements based on the needs of other military treatment facilities. What was key to the success of MHS GENESIS was that we were committed to making it happen."

Another way that NHB has been able to continually apply MHS GENESIS in assisting other commands is by reading their Dental Cone Beam Computed Tomography exams, which are designed for various clinical treatments such as dental implant planning and the diagnosis of such concerns as dental cavities and dental trauma.

According to Hunter, NHB oral and maxillofacial radiologists have supported colleagues in southern California on several occasions, and as well as provided Cone Beam CT interpretations for exams acquired at Naval Health Clinic Hawaii and Naval Health Clinic Oak Harbor. Overall, they have read more than 200 CBCT exams for other commands.

"There is a lot of complexity in what we do, although most people would probably consider it to be boring. But we support Navy commands up and down the West Coast and Hawaii, as well as a few Army and Air Force from Madigan to Fort Irwin. Tha's not boring to me," said U.S. Navy Lt. Cmdr. Douglas Steffy, NHB oral radiologist.

NHB's radiology department has a lengthy history of providing support to other sites in need. MRI (Magnetic Resonance Imaging) technologists rapidly responded in 2011 for advanced technology help by sending complex examinations protocols and related instructions for the newly installed MRI machine at Camp Leatherneck, Afghanistan. The MRI was an important addition for the Marine base in Helmand Province to help diagnose and care for such medical concerns as traumatic brain injuries and concussions, at that time the most common combat-related injuries.

Whether it was to the far side of the Hindu Kush Mountains or across the Cascade Range today, NHB has continued to support mission readiness and enhance patient-centered care by applying advanced technology--such as MHS GENESIS--one read at a time.

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Last Updated: November 28, 2022
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