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Decisions, decisions: Experts aim for higher quality, safer care in building electronic health record

Dr. Paul Cordts, director of the Defense Health Agency Office of the Functional Champion, speaks on a panel regarding the decision-making behind a large scale electronic health record while at the AMSUS Annual Meeting at the Gaylord Resort and Convention Center in Oxon Hill, Maryland, on November 29. (Courtesy photo) Dr. Paul Cordts, director of the Defense Health Agency Office of the Functional Champion, speaks on a panel regarding the decision-making behind a large scale electronic health record while at the AMSUS Annual Meeting at the Gaylord Resort and Convention Center in Oxon Hill, Maryland, on November 29. (Courtesy photo)

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Department of Defense leaders came together to share insights on behind-the-scenes, decision-making that supports the first major upgrade to health documentation for the Military Health System in more than a decade.

The rollout of MHS GENESIS, the military’s integrated medical and dental electronic health record for 9.4 eligible beneficiaries, started in February in the Pacific Northwest. More than 50 legacy systems will collapse as MHS GENESIS deploys, which is expected to be complete by 2022.

 Over the course of the year, the EHR was implemented at four sites. Maj. Gen. Roosevelt Allen, Air Force Functional Champion, said the Pacific Northwest was chosen because all three services are represented at these locations. The facilities vary in size and capability, allowing those involved with the program to address issues and lessons learned from each site before the next rollout.

“The objective was to learn as much as they could from these initial sites and then press forward, and … use what they’ve learned at those initial sites in order to make things better,” said Allen, speaking as a panel member at the AMSUS Annual Meeting at Gaylord Resort and Convention Center in Oxon Hill, Maryland, on November 29. The functional champion panel of experts listed training methodology, issue resolution, change management, and technical readiness as lessons learned at the four sites so far.

Army Functional Champion Brig. Gen. Ronald Stephens said it’s critical for those involved with the program to focus on the long-term picture for the electronic health record. MHS GENESIS has been guided by four core principles:

•           Basing decisions on what’s best for the MHS as a whole

•           Configuring an off-the-shelf electronic product that can adapt to the DoD environment

•           Standardizing clinical and business processes across the MHS and military services

•           Designing a system that focuses on quality, safety, and patient outcomes.

Dr. Paul Cordts, the electronic health record functional champion for the Military Health System, said while risks are inherent with changing clinical and business processes in military treatment facilities, the goal is higher quality and safer care for patients.

 “The functional community has been heavily involved since day one,” said Cordts, referring to the Functional Advisory Council and Functional Champion Leadership Group – the two governing structures of the MHS GENESIS deployment. The decision-making behind MHS GENESIS has also involved stakeholders from all of the services and about 850 subject matter experts, including health care providers and information technologists, Cordts said.

“What we’re trying to do is identify how we can make the entire product easier for the user to use and safer for the user to use,” said Michael Malanoski, Navy functional champion, stressing that the adoption of the software is dependent on those two factors. The electronic health record can make the health system better by improving data collection and usage, standardization, and decision support, he added.

 “There [has to] be a baseline of standardization across the enterprise to ensure that we’re being as efficient, effective, consistent, and interoperable as possible,” said Stephens. “Whether you’re taking care of a patient in the field or in garrison, it’s the continuum of care. It’s from the beginning of time that you start taking care of that patient until you’ve completed that care.”

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