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MHS GENESIS: From IOC to Wave TRAVIS, Capt. Tepera’s journey

Image of Two medical officers wearing masks. Click to open a larger version of the image. Navy Capt. (Dr.) Christopher Tepera (right), past executive officer at Naval Health Clinic Lemoore in California, now serves as commanding officer, Navy Medicine Readiness Training Command Pearl Harbor, Hawaii. Tepera has become a big fan of MHS GENESIS. (Naval Health Clinic Lemoore photo)

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Navy Capt. (Dr.) Christopher Tepera says he's a big cheerleader for MHS GENESIS, the Department of Defense’s new electronic health record. He served as a urologist and director of surgical services at Naval Hospital Bremerton, Washington, when the new electronic health record was launched at initial operational capability (IOC) sites in the Pacific Northwest.

"I was a provider learning to use the program as well as part of the command board motivating others who were adopting the program," Tepera said. "I consider myself very computer literate, and I like technology. So for me, it was an easy transition to MHS GENESIS."

After Tepera became executive officer at Naval Health Clinic Lemoore in California, MHS GENESIS followed as part of Wave TRAVIS, the next EHR deployment.

"Infrastructure improvements based on feedback [from the IOC sites] made adoption much smoother for everyone at Lemoore," said Tepera, now commanding officer, Navy Medicine Readiness Training Command Pearl Harbor, Hawaii.

"Also, we learned from the IOC sites what type of training worked, and what didn't. That feedback made the Wave TRAVIS training significantly better. It was tailored to our needs."  

The Military Health System is in the midst of historic transformation to build a more integrated and effective system of readiness and health. MHS GENESIS is a cornerstone of this effort. The new EHR provides enhanced, secure technology to manage beneficiaries' health information. It also integrates inpatient and outpatient solutions that will connect medical and dental information across the continuum of care, from point of injury to the military medical treatment facility. This includes garrison, operational, and en route care, increasing efficiencies for beneficiaries and health care professionals.

When fully deployed, MHS GENESIS will provide a single health record for service members, veterans, and their families. Beyond the user experience, the system also helps the MHS organizationally to better tailor resources to operational requirements.

After Go-Live at the IOC sites in the Pacific Northwest in early 2017, lessons learned were implemented for future deployments.

Tepera said the IOC sites didn't have a stable platform initially, and that led to some problems. "But many of the challenges came from it being a new way of doing things," he said. "Just like when you get a new car or a new TV, you have to learn how to work it. And sometimes if you get so ingrained in your old way of doing things, it's a little challenging to transition to the new way of doing things. "

With MHS GENESIS, "There were all new pathways on how to do your job on a daily basis," Tepera said. "But that's so we can standardize things across the MHS. Eventually, we'll be plug and play with all the MTFs."

In September 2019, MHS GENESIS went live at military medical treatment facilities in California at Travis Air Force Base (AFB), Naval Air Station Lemoore, the U.S. Army Health Clinic Presidio of Monterey, and in Idaho at Mountain Home AFB. Between the IOC and Wave TRAVIS sites, changes based on feedback were implemented to infrastructure, training, and the MHS GENESIS product itself, significantly improving the ease of adoption and providing benefits to users as well as beneficiaries.

"The initial rollout was a struggle," Tepera said. "I noticed significant updates from IOC to Wave TRAVIS. Just a lot of the functionality of the product improved. The number of trouble tickets we were submitting was minuscule compared to what we were doing at the IOC site. I'm pretty sure at Lemoore, we were up to full speed command-wise within about four weeks."

Tepera gives credit to "the overall can-do attitude at Lemoore to help make it work." As for MHS GENESIS, he lists several improvements, including an enhanced ability to update patient history and transfer among providers, and the ability to electronically check medications for potentially harmful interactions with patients’ other prescriptions before being ordered and dispensed.

"The ability to reply to emails from patients, or even to forward notes to other providers, seems simpler," Tepera added." And then the ability to do what we call ‘power plans’ on the day of surgery was simplified. I wasn’t spending a significant amount of time writing orders."

Tepera stressed the importance for users to realize that MHS GENESIS means a change. “Adopting it may take some time,” he said, “and it may seem difficult at first. And for patients, it may slow things down for a while. But the ultimate expectation is increasing access to quality care, and increasing access to your own medical records.” And there is interoperability, he added, making medical data truly portable.

"I absolutely love MHS GENESIS," Tepera said. "I can't wait to get back on it."

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