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MHS GENESIS improves patient experience for military families

Image of a military doctor and a family Air Force Maj. (Dr.) Joseph Migliuri and the Doberman family pose for a photo after the pediatrician used MHS GENESIS, the new electronic health record, to condense their scheduled appointments. [Note: Migliuri was a captain at the time of this photo.](Courtesy Photo.)

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In 2017, Air Force Maj. (Dr.) Joseph Migliuri, a pediatrician at Fairchild Air Force Base in Spokane, Washington, became an early adopter of the Department of Defense’s new, modern electronic health record—MHS GENESIS.

Looking back, Migliuri acknowledges the initial rollout carried with it a steep learning curve. Now, more than three years into the integration, he sees dividends from the time and investment made by staff, especially during the current pandemic.

When COVID-19 led the governor of Washington to issue a stay-at-home order in March, Migliuri’s practice quickly adapted and moved to nearly 100% virtual visits using MHS GENESIS. As the state progressed into the first phase of reopening, his office adjusted to around 80% virtual care for nearly two months.

Using the scheduling feature to triage necessary in-person clinical care and visits that could take place transformed his practice. About half of his patient visits are now virtual. “It eliminates access issues and allows for safer care for families and staff,” he said. “It has really shifted our clinic workflow.”

Recently, when a military parent called about her child’s sore throat, Migliuri consulted using video telemedicine and confirmed a likely diagnosis of bacterial strep. “I was able to determine there were enough features of strep that we could proceed with treatment without an in-person clinic visit and swab,” he said. “To maintain social distancing and limit exposure, I e-prescribed amoxicillin through MHS GENESIS to a civilian drive-thru pharmacy near the patient's home.”

The ability to seamlessly prescribe medications electronically and send them to civilian pharmacies, which often have drive-thru windows, has been a benefit of using MHS GENESIS during COVID-19, Migliuri said. But the biggest benefit for his practice has been scheduling functionality that allows his office to take ownership of patient schedules and flex within the system.

“MHS GENESIS allows us to control the chaos of what is going to come in that day and make it manageable,” said Migliuri. “The extra autonomy gained by the provider and staff trickles down to the families and patients and allows for happier staff and families.”

That same autonomy thanks to MHS GENESIS—providers managing schedules with an easy click of a button—helped a military family with nine children. A year ago, Migliuri’s office rescheduled separate visits for the family’s children when the familiar calendar-like view within MHS GENESIS allowed a staff member to see the family had been booking up to three different appointments at a time to bring in all nine children for a visit.

“Within minutes, we rescheduled them all into one morning,” he said. “MHS GENESIS provides a lot of flexibility with our schedule to provide better care for our families.”

Watching the siblings interact in his office was a priceless moment giving Migliuri better insight into the family under his care. “This family has been in the military their entire lives and has never been able to come into a pediatric clinic all together,” he said. “I saw the interactions of all the siblings that day, and as their pediatrician, I feel more of a link to the whole family now. That was a morning I would never even have imagined before MHS GENESIS.”

Using a wireless workflow and the ability to be in multiple charts at once also helped ensure accuracy when ordering medications and referrals during the family’s visit.

As a pediatrician, Migliuri considers continuity of care for children to be top of mind as they grow up within the MHS amid permanent change-of-station moves that are a normal part of military life. A single electronic health record that stays with the child regardless of location and physician can only benefit the patient’s point of care, he said.

“Continuity of care helps us better know our patients right away. The faces may change for our patients every summer as they move to a new base or our doctors move to a new base, but the record system is continuous,” he added.

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