In 2017, the Military Health System started deploying MHS GENESIS, a new electronic health record, worldwide.

Ensuring proper training of both providers and patients is essential for the successful integration and sustainment of MHS GENESIS into MHS care.

To best prepare users to get the most out of MHS GENESIS, that training needs to include two key elements: peer training by local and regional experts in the new EHR; and leveraging data and insights obtained through clinical informatics.

Augmenting peer training with clinical informatics maximizes providers’ ability to learn best practices for using MHS GENESIS and pass them on to patients. Armed with such knowledge, both groups can more effectively increase readiness, improve access, improve care, and lower costs. The goal is to help providers spend more quality time with patients and improve transition to care throughout the MHS.

It is critically important to teach patients and caregivers how to take care of themselves because we have them in front of us less than 1% of the time. The other 99+% of the time, they are with their families and out in the community, so we must do all we can to get them to engage in healthy lifestyles. The best way to do that is with evidence-based education in which peer experts teach providers, providers teach patients, and patients use what they’ve learned to keep themselves healthier.

Peer Training

Research shows that adults retain information better from scenario-based and workflow-based training in one-to-one or small group settings.

Naturally, the best people to know the scenarios and workflows providers encounter in their specific roles are peers in the same. Experts in a particular aspect of MHS GENESIS can teach peers to consistently apply best practices for the EHR in their respective roles.

Peer training incorporates embedded clinical decision support at the point of care. These peer experts can share best practice templates, auto text, order sets, and similar tools across the enterprise and encourage user buy-in and adoption. This training teaches providers who are new to MHS GENESIS the proper decision-making process for diagnosis as well as treatment, improving care for patients.

Clinical Informatics

Teaching providers how to use MHS GENESIS is one part of helping the new system succeed. Another essential element is clinical informatics, which helps in teaching providers how to collect, analyze, and use EHR data to support improve efficiency and outcomes. It's critically important to ensure data integrity is as high as possible. If you have bad data, you make bad decisions, and none of us wants that.

Using better data to drive decisions helps improve clinical workflow, an area of significant interest and expertise for clinical informaticists and something important to train providers to do. It includes educating people on how to evaluate their current EHR workflow and training them how to eliminate waste and potentially dangerous actions.

The key is to teach optimal standardized workflow across the enterprise, which standardizes care across the enterprise. This improves outcomes.

Benefits

Peer experts who know clinical informatics can be a huge asset to their organizations by helping new and struggling users to better learn MHS GENESIS.

For providers, better training leads to better teamwork. Improved efficiency leads to more readable notes and improved care with less effort. Improved efficiency also increases job satisfaction, reduces burnout, and improves retention.

For patients, improved efficiency equals more face-to-face time with providers. Standardized documentation improves the quality of data in the EHR, which leads to more informed and effective care and better outcomes.

Biting the Bullet

Peer training backed by clinical informatics is a force multiplier that helps providers deliver care more efficiently.

MHS organizations need to “bite the bullet” and ensure peer experts have time and resources as part of their official job responsibilities to learn best practices, learn how to teach others, and actually teach them so everyone will use the system better. If all that is a collateral duty, if peer experts have to do it on their own time, it’s not going to happen.

Proper training on equipment required for a mission is essential for success in any environment, operational or garrison. MHS GENESIS has now been deployed at 74 MTF Commands spanning the entire United States and will be fully deployed to all MTFs by the end of 2023.

Dr. Robert Marshall is the program director of the Department of Defense Clinical Informatics Fellowship at Madigan Army Medical Center.