The Department of Defense’s federal electronic health records system, MHS GENESIS, completed its final site deployment at the Captain James A. Lovell Federal Health Care Center in North Chicago, Illinois.

Lovell FHCC, a first-of-its-kind partnership between the Department of Veterans Affairs and the DOD, opened MHS GENESIS to providers and patients on March 9, 2024, marking the end of the DOD’s seven-year deployment. The global rollout of MHS GENESIS began in the Pacific Northwest on Feb. 7, 2017.

“The launch of the federal EHR at Lovell FHCC will help the DOD and the VA deliver on the promise made to those who serve our country to provide seamless care from their first day of active service to the transition to veteran status,” said Dr. Lester Martínez-López, assistant secretary of defense for health affairs.

Martínez noted the importance of collaborating with the VA.

“A joint electronic health records system demonstrates the power of technology to improve health care delivery, and we look forward to continued collaboration with our VA partners,” Martínez said.

Significance of DOD/VA Partnerships and Integration Capabilities

Lovell FHCC was established on Oct. 1, 2010, when an existing VA medical center and the Naval Health Clinic Great Lakes merged their resources and services. Lovell FHCC provides care to 75,000 patients and more than 30,000 U.S. Navy recruits annually. The deployment of MHS GENESIS at the center “enables a continuum of care that will enhance our operations as we work to optimize health outcomes for those we serve,” said Dr. Robert Buckley, Lovell FHCC’s director.

“The federal EHR will enhance care for all beneficiaries who walk through our doors, whether they are veterans, U.S Navy recruits, students, active-duty service members, their dependents, or retirees,” Buckley said.

Lovell FHCC is the first VA site in 21 months to launch the electronic records software after the VA put its EHR rollout on hold in April 2023.

“While VA continues with the broader reset of our electronic health record modernization program, we are learning lessons from this deployment to inform our future decisions,” said Dr. Neil Evans, acting program executive director of the VA Electronic Health Record Modernization Integration Office. “Deploying the federal EHR improves the ability for DOD and VA to coordinate care and share data with each other and the rest of the U.S. health care system.”

“This will not only benefit the patients and staff in North Chicago, but all joint sites that need joint solutions to effectively deliver care,” said Bill Tinston, director of the joint DOD-VA Federal Electronic Heath Record Modernization Office. Frequently asked questions about the FEHRM, what it is, and its partnership with Lovell FHCC and the VA are on the DHA website.

MHS GENESIS replaces numerous DOD legacy systems and integrates with civilian hospitals and networks via the FEHRM’s Joint Health Information Exchange, which securely connects health and benefit information systems from DOD, VA, and other federal and private sector partners.

End-User Satisfaction

DHA has turned its focus to optimizing MHS GENESIS with continual upgrades to the system. DHA is focusing on the patient experience by designing products around the end user and tailoring offerings to their satisfaction, according to DHA’s Program Executive Office, Defense Healthcare Management Systems. This industry best practice provides visibility into progress in meeting the goals and enables corrective action as the goals progress, according to DHMS. The office is also collaborating with DHA’s Health Informatics Office and its end-user engagement team.

While the end of deployment marks the successful rollout of MHS GENESIS, feedback from end users truly demonstrates the value of the platform. “I like the real-time documentation of immunizations,” said one end user in a survey response. “Previously, we would have to spend hours documenting after the event.”

Another end user noted the significance of integration, saying, “I am excited about the outside records capability. This is a great win, as we don’t have to do extraneous tests for patients.”

Select Milestones

With approximately 194,000 active users, MHS GENESIS is now live at 100% of DOD garrison facilities, deployed to 138 parent military hospitals and clinics, and used at more than 3,600 DOD locations worldwide.

The rollout of MHS GENESIS has seen a significant number of milestones, some highlighted here by DHMS.

In February 2017, DOD officially “went live” with MHS GENESIS at Fairchild Air Force Base in Washington state as the first of four initial operational capability sites.

Following that deployment, DOD conducted an assessment and improved deployment and training processes. As a result, DHA created the Office of the Chief Health Informatics Officer—a team of health informatics experts who identify pain points and refine key products to improve the end-user experience.

In September 2019, MHS GENESIS started a four-year phased deployment plan at Travis Air Force Base in Fairfield, California, and incrementally rolled it out to every military hospital and clinic and other sites, ending with Lovell FHCC.

Since April 2018, DOD has applied biannual commercial upgrades to MHS GENESIS. Released in February 2024, the latest enhancement added the ability to refill prescriptions within the patient portal and enhanced breast milk documentation. An interactive voice response is in the works for pharmacy refills on the portal.

U.S. Navy ships docked in ports were onboarded to MHS GENESIS, starting with Click to closeWave SAN DIEGO Naval Medical Center in San Diego, CA and the 1st Dental Battalion at NMC San Diego, CA.Wave San Diego in February 2021. Health care providers on a ship or designated port location can now access and update patient records in real-time, facilitating better coordination of care and reducing the risk of errors.

In January 2022, Brooke Army Medical Center in San Antonio, Texas, went live simultaneously with five other military hospitals and clinics. BAMC is the largest U.S. hospital in the MHS and houses the military’s only Level I trauma center and specialized burn unit.

In November 2022, DOD commenced full-scale deployment of business tools for revenue cycle expansion, originally referred to as RevX.

Platform Key to Adaptability

The value of MHS GENESIS became apparent during the COVID-19 response and mass vaccination capabilities in 2020 and 2021.

Although the pandemic meant a few pauses on the ground, DHA implemented COVID-19 specific configuration changes for MHS GENESIS “within hours on several occasions that provided senior military and civilian leaders with timely information on COVID-19 laboratory testing results and the health of our force and our beneficiaries,” said former DHA Director Lt. Gen. (Dr.) Ronald Place, in his prepared testimony to the House Appropriations Committee on May 21, 2021. “The same changes in our legacy systems took nearly four weeks to implement,” Place noted.

The ‘MassVax’ capability rollout in early 2021 produced a significantly improved workflow that allowed all U.S. armed forces “to assess the status of service member inoculations in order to ensure readiness,” Place said.

The MHS expects the increased flexibility of a commercial off-the-shelf product to be demonstrated again in the future, especially as the DHA continues to standardize processes and improve its data analytics capabilities.

“Now, the hard work of ensuring the adoption of the new standards, optimizing the technology and workflow and taking full advantage of the voluminous data flowing from the new system begins,” said U.S. Air Force Col. Thomas Cantilina, chief of DHA’s Health Informatics Office.