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MHS GENESIS enabler to more effective military health system

Air Force Maj. Gen. (Dr.) Lee Payne director for Combat Support at the Defense Health Agency, discusses the transformative effects of MHS GENESIS, the Department of Defense’s new electronic health record, during the 2019 Society of Federal Health Professionals’ annual meeting in National Harbor, Maryland. Payne explained that the new electronic health record will ensure high quality care for patients while protecting the safety and security of patient information. MHS GENESIS will deploy in phases to all DoD military treatment facilities by 2023. (DHA Photo) Air Force Maj. Gen. (Dr.) Lee Payne director for Combat Support at the Defense Health Agency, discusses the transformative effects of MHS GENESIS, the Department of Defense’s new electronic health record, during the 2019 Society of Federal Health Professionals’ annual meeting in National Harbor, Maryland. Payne explained that the new electronic health record will ensure high quality care for patients while protecting the safety and security of patient information. MHS GENESIS will deploy in phases to all DoD military treatment facilities by 2023. (DHA Photo)

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Electronic Health Record: MHS GENESIS

The Military Health System continues to implement a new, modern electronic health record – named MHS GENESIS – to harness advanced technology and transform how military health care is delivered to more than 9.5 million beneficiaries.

The system’s functional champion, Air Force Maj. Gen. Lee Payne, assistant director for Combat Support at the Defense Health Agency, said the MHS is focused on three key priorities as it continues deploying the new record: ensuring that MHS GENESIS facilitates a high quality of care, protects the safety and security of patient information, and is trusted by healthcare professionals and patients.

“The bottom line of the national defense strategy is enhancing readiness and increasing lethality,” Payne explained. “We want our system to help us do that, and then enhance our ability to make the health care system operate more effectively. MHS GENESIS helps us move in that direction.”

Payne emphasized the quality, safety and security features of the system when he addressed hundreds of attendees at the annual meeting of the Society of Federal Health Professionals, also known as AMSUS, held at National Harbor, Maryland, Dec. 3.

Currently, eight sites on the west coast are using MHS GENESIS. In June 2020, deployments will continue under a phased approach with full deployment scheduled to be completed in 2023.

Air Force Lt. Col. (Dr.) Tara Conner, Defense Health Agency, Health Informatics User Integration Branch chief, demonstrates the capabilities and functionality of MHS GENESIS, the Department of Defense’s new electronic health record, during the 2019 Society of Federal Health Professionals’ annual meeting in National Harbor, Maryland. MHS GENESIS will deploy in phases to all DoD military treatment facilities by 2023. (DHA photo by Mark Oswell)
Air Force Lt. Col. (Dr.) Tara Conner, Defense Health Agency, Health Informatics User Integration Branch chief, demonstrates the capabilities and functionality of MHS GENESIS, the Department of Defense’s new electronic health record, during the 2019 Society of Federal Health Professionals’ annual meeting in National Harbor, Maryland. MHS GENESIS will deploy in phases to all DoD military treatment facilities by 2023. (DHA photo by Mark Oswell)

Advanced technology

MHS GENESIS replaces a patchwork of legacy systems and will make inpatient and outpatient information instantly available wherever it is needed across the continuum of care, from point of injury to the military treatment facility. When fully implemented, each service member, veteran, and family member will have a single health record.

It relies on secure cloud computing technology to create global availability, and that technology may create vulnerabilities, including cybersecurity threats by actors who would use medical data for nefarious purposes. Payne said the MHS GENESIS implementation process has included careful and comprehensive testing of medical devices, cloud computing resources, and other computer security protocols that make MHS GENESIS “probably the most secure system on the planet right now.”

The military’s record benefits from other health information technology systems currently in use. “MHS GENESIS is built from commercial off-the-shelf components, allowing us to build a global system,” Payne said.

That is important, he added, because the future of this health record includes developing a single record to be shared between DoD and the Department of Veterans Affairs, impacting more than 20 million beneficiaries from both departments.

“We are getting the same record. It's not just an interoperable record; it's the same record,” Payne explained. “We're looking at all our business processes and clinical workflows. So you can imagine, if we're all using the same system, and our clinical communities are talking to each other… That's going to be hugely powerful.”

With health information from millions of DOD and VA beneficiaries, Payne said the MHS will learn more about health care requirements to better meet national security objectives. It will help improve readiness, while providing better health and at lower cost, he added.

Implementing MHS GENESIS

The first live version of MHS GENESIS launched in 2017 at military medical facilities in Washington State – Fairchild Air Force Base, Naval Hospital Bremerton, Naval Health Clinic Oak Harbor, and Madigan Army Medical Center at Joint Base Lewis-McChord.  After months of upgrades, configuration changes, improved training, and enhanced change management approaches, the second deployment came more than two years later. Sites known as “Wave Travis,” named for the largest base in the group – Travis Air Force Base, Naval Air Station (NAS) Lemoore, and the Presidio of Monterey in California and Mountain Home AFB, in Idaho – went live on Sept. 7.

“(MHS GENESIS) had multiple upgrades,” Payne said of the difference between the 2017 and 2019 versions. “It had stabilization and adoption (changes), and it had thousands of configuration changes. The record that went live at Wave Travis was drastically different from the record that went live in February 2017, and that made all the difference in the world.”

In June 2020, the next to receive MHS GENESIS will be Nellis AFB and NAS Fallon in Nevada; and Fort Irwin, Marine Corps Air Ground Combat Center 29 Palms, Beale AFB, Edwards AFB, Vandenberg AFB, Los Angeles AFB, Port Hueneme, and Marine Corps Mountain Warfare Training Center, all in California.

That will launch the “wave” approach, and every few months geographical groupings of MTFs will transition to MHS GENESIS over the next three years. Phasing in this way allows the MHS to make sure each medical facility is ready to switch from legacy systems to the new electronic health record while ensuring patient safety remains paramount. 

The process hasn’t been easy, Payne admitted, but as with any transformation, training and an 18-month preparation timeline help ensure success. He said close involvement of MTF commanders was the key to its successful deployment.

“Wave Travis was the first area where I was able to say to the commanders directly, ‘This is a heavy lift. We can help you from DHA, but at your level, it's all about your leadership.’ And I can tell you, they've done a great job. That’s the model to be successful,” Payne said.

He summed up his remarks with an eye toward constant improvement of the Military Health System. “MHS GENESIS can be a lever for the larger MHS Transformation,” he told the AMSUS audience. “I believe we have the opportunity to change American medicine.”

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