DoD to mark first ‘go-live’ of its new electronic health record

Almost exactly four years after the Defense and Veterans Affairs departments decided to go their separate ways in their projects to modernize their electronic health records, DoD’s brand-new EHR is now up and running, at least at one base.

At a Wednesday ceremony at Fairchild Air Force Base near Spokane, Washington, the department will officially announce that the system is now live in the on-base medical and dental clinics operated by the 92nd Medical Group, replacing DoD’s aging legacy systems, including AHLTA and CHCS (your correspondent will be on-site to speak with DoD health officials; stay tuned for updates).

Fairchild is the first site to receive the new health record, called MHS Genesis; three other Pacific Northwest military hospitals that have also been picked as initial deployment sites will see a rollout between May and July, based on a revised schedule the Pentagon announced last October.

“This morning, MHS Genesis became the single electronic health record (EHR) to document and manage care at Fairchild Air Force Base (AFB)! We achieved Go-Live!!” Stacy Cummings, DoD’s program executive officer for health care management systems, wrote in a memo to her staff last week. “This is an exciting milestone for our team. We worked hard to get to our first IOC site, and I can report first hand from the command center that everything is going as expected. Providers at Fairchild are treating patients while the government and contractor team are quickly implementing fixes to issues as they are identified.”

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It will take until 2022 before Genesis is deployed to all of DoD’s worldwide medical facilities and begins serving its entire population of 9.4 million patients, but the department pulled off its first deployment in fairly short order,  just 18 months after it awarded a $4.3 billion contract Leidos to craft the system, based primarily on commercial software developed by Cerner.

That’s partially because the department was under orders from Congress to deploy a modern electronic health record by the end of calendar-year 2016, a deadline officials expected to make until they ran into several road-bumps last fall. Officials previously told reporters that the delays were mostly caused by unforeseen complications in building the software interfaces needed to move data back and forth between Genesis and DoD’s legacy systems.

But a report by DoD’s independent director of test and evaluation (DOT&E) last month showed that cybersecurity was also a major factor as of last August: Tests had uncovered 11,000 cyber vulnerabilities “of varying severity” in both DoD’s own health IT infrastructure and the commercial shared services Genesis depends on. Most of the problems were related to commercial software patches not being installed, and Leidos told DOT&E it would solve the most severe vulnerabilities by Dec. 31, 2016.

“The number of vulnerabilities identified by the [Defense Health Agency] during the Risk Assessment and independent verification and validation was larger than the program manager expected,” the report said. “The program manager developed a plan of action and milestones with mitigations to address the highest severity findings.”

DoD’s launch of the new health record is now a somewhat separate discussion from its effort to make its health records interoperable with VA. Last year, the two departments attested to Congress that they had achieved interoperability by coalescing around a shared set of health data standards and then sharing information between their systems through a standalone application called the Joint Legacy Viewer.

The departments decided to pursue that approach rather than the previous plan to build a joint health IT system, shared by both, largely because they believed it would let them achieve interoperability more quickly and at less cost.

But the Government Accountability Office says DoD and VA have yet to show convincing financial data to support that assertion.

“The departments have not provided us with a comparison of the estimated costs of their current and previous approaches,” Valerie Melvin, GAO’s director for IT management and technology resources, told Congress last summer. “Further, with respect to their assertions that separate systems could be achieved faster, both departments had developed schedules which indicated that their separate modernization efforts are not expected to be completed until after the 2017 planned completion date for the previous single-system approach.”

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