- The Department of Defense’s (DoD’s) Cerner MHS GENESIS EHR implementation has led to increases in clinical efficiency and reductions in duplicative testing at cares sites part of the initial operating capability (IOC) program, according to General Manager of Cerner’s federal division Travis Dalton.
DoD first implemented MHS GENESIS at Fairchild Air Force Base in Washington state in Feb. 2017. This implementation was followed by launches at Naval Hospital Oak Harbor, Naval Hospital Bremerton, and Madigan Army Medical Center.
While the MHS Genesis launches have thus far proceeded at a steady clip, problems with EHR implementations are common.
“To help mitigate this, the DoD has adopted commercial practices for deployment: incremental phasing, focusing on a smaller set of facilities first to work through issues and make adjustments to make the larger outcome better,” noted Dalton in a Cerner blog post.
“The Partnership has worked closely with DoD leadership, local staff and military health system providers to identify workflows, provide the right training to the right people and get end users accustomed to the new system and the new processes that inherently follow,” he continued.
Dalton also admitted there have been issues in the early days of implementation that have warranted changes in management and government processes.
“Some issues logged have taken longer to resolve than we would have liked, and productivity at the local level has taken some time to normalize,” he wrote.
“The incremental approach anticipates these types of early concerns as a part of the deployment process and integrates steps to examine issues and develop long-term resolutions prior to full enterprise rollout,” he added.
The MHS GENESIS implementation is currently in the midst of a planned eight-week pause to process user feedback, identify any problems, and enable EHR optimization.
“We are working closely with the Partnership and the users in the Pacific Northwest to retrain, assist with change management, answer questions, address workflow where appropriate and resolve issues,” wrote Dalton.
Refining the deployment process and standardizing EHR optimization processes across DoD care sites will help to reduce problems with the Cerner EHR system in the future. Taking these measures in the early adoption phase have led to operational improvements, Dalton said.
“The IOC sites have functionality that they did not have prior to implementing MHS GENESIS, such as advanced clinical decision support, proactive care management, data analytics and built in clinical intelligence,” he wrote. “In addition, the IOC sites are now able to share data with the community-based EHR systems and with VA health care providers through the agencies’ Joint Legacy Viewer.”
Furthermore, the Fairchild Air Force Base EHR system has achieved a Stage 6 HIMSS ranking a little over a year after deployment.
“The designation puts Fairchild’s ability to support optimized patient care through efficient use of the EHR on par with levels obtained by leading commercial hospitals and clinics,” stated Dalton.
A new alert system integrated into the MHS GENESIS EHR system has also improved patient safety.
“Within the first four months of going live on MHS GENESIS at Madigan Army Medical Center, the average length of stay for hospital patients experiencing sepsis has been reduced by 37 percent due to early recognition of sepsis risk alerts,” wrote Dalton.
Sepsis alerts in the EHR system identify risk factors in sepsis patients to alert providers that early intervention may be necessary to avoid potentially fatal sepsis-related health problems.
Additionally, the Cerner system has helped DoD reduce duplicative or unnecessary testing.
“From June 2017 to January 2018, the IOC sites have cancelled 2,613 non-medication orders, potentially reducing the amount of duplicative procedures such as labs and imaging,” stated Dalton.
In the past six months, IOC sites have also seen improvements in clinical efficiency.
“From June 2017 to January 2018, order volume for IOC sites has increased and time spent placing orders per patient has decreased by approximately 8 percent,” said Dalton. “ This means users are finding the workflows easier, which ultimately is improving efficiency and allowing for more time spent with the patient.”
These early successes indicate the Cerner MHS GENESIS EHR implementation is having a measurable positive effect on patient care delivery at DoD care sites.