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MHS GENESIS – Transforming the Military Health System
Maj Gen Lee Payne, USAF, MC, CFSAssistant Director-Combat Support
& MHS Functional Champion
AMSUS 2018
28 Nov 2018
National Harbor MD
Disclosures
Presenter has no interests to disclose.
2
Learning Objectives
At the conclusion of this activity, the participant will be able to:
1. Describe the difficulties facing the Military Health System (MHS) and how MHS GENESIS is addressing these problems
2. Identify how MHS GENESIS is improving the MHS
3. Examine the implications of an Electronic Health Record (EHR) for MTF providers and commanders
4. Recognize the utility in analyzing patient data to improve care
5. Discuss future applications of an EHR at the MTF level and across the MHS enterprise
3
Change is Hard
5
7
MHS GENESIS Guiding Principles
8
Standardize clinical and business processes across the Services and the MHS
Design a patient-centric system focusing on quality, safety and patient outcomes that meet readiness objectives
Flexible and open, single enterprise solution that addresses both garrison and operational healthcare
Clinical business process reengineering, adoption, and implementation over technology
Configure not customize
Decisions shall be based on doing what is best for the MHS as a whole – not a single individual area
Decision-making and design will be driven by frontline care delivery professionals
Drive toward rapid decision making to keep the program on time and on budget
Provide timely and complete communication, training, and tools to ensure a successful deployment
Build collaborative partnerships outside the MHS to advance national interoperability
Enable full patient engagement in their health
MHS GENESIS Deployment Timeline
9
Phases Complete
Initial Deployment Inpatient Deployment Full Deployment
Initial Operating Capability (IOC) deployment commenced at Fairchild Air Force Base
IOC deployment at inpatient facilities in the Pacific Northwest:•Naval Health Clinic
Oak Harbor •Naval Hospital
Bremerton•Madigan Army
Medical Center
Wave 1 deployment begins
February 2017 Summer 2017 2019 Target 2023
Enterprise wide wave deployment to all MTFs and Dental Treatment Facilities
Lessons Learned from IOC Sites
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• Ensure close coordination between DISA, J6, and the DHMSM PMO to get MED-COI deployed, tested, and ready for the site
• Resolve Medical Device Interfaces
Technical Readiness
• Prioritize issues (safety, readiness) and sort by Solution Owner (technical, functional)
• Communicate to end users the status of tickets
Issue Resolution
• Study user role assignments and permissions at the enterprise level
• Communicate workflows, bridging knowledge gaps from old to new processes, early in the transition
• Maintain continuous leadership communication and buy-in
Change Management
• Improve the training approach and content, and tie it more closely to workflows
• Improve subject matter expertise across the enterprise on MHS GENESIS
Training Methodology
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Word from the Western Front
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ARMY MEDICINE
One Team…One PurposeConserving the Fighting Strength Since 1775
Slide 4 of 8 1 NOV 2018
Positive Aspects
• Collaborative culture
– Inter-service Collaboration / Informal
Consortium
– Breaking down department level barriers
• Integrated Health Record
– Inpatient / outpatient / ED / All Sites
(SCMH/PCMH/EBH)
• Safety / Capability Increases
– “Hard” stops for safety checks
– Timely alerts
– Computerized Physician Order Entry
– Blood administration application
– Barcode medication administration
– Lab Application (reduced transcription error)
– Collaborative documentation platform
• Clinical Areas of Success
– Emergency Department
– Orthopedics
“After using AHLTA during
this deployment… I miss
MHS GENESIS”
– MAJ Grubish
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ARMY MEDICINE
One Team…One PurposeConserving the Fighting Strength Since 1775
Slide 5 of 8 1 NOV 2018
IOT&E Results
• Roles and Workflow
– Switching roles multiple times
• Scheduling/Appointing/Referrals
– Complex appointment order
• Dental
– Multiple system performance
issues
• Content Issue
– Specialty standardized
documentation content
• Clinical Documentation - Coding
– Difficult to find / Absent Diagnosis
• Data Reporting
– Inaccurate and unreliable data
– Limited to no access to quality
measure data
• Patient Transition Process
– Inpatient / Outpatient movement
• Referral Management
– Safety and transition of care gaps
caused by message-based system
Current State: Identify actionable deficiencies within the 388 incident reports.
Next Step: Collaborative review with OCHIO to identify appropriate action.
Way Ahead
14
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MHS GENESIS Updates
SAaB April 2018 August 2018 September 2018October
2018November
2018December
2018April
2019
15
.23 Millennium
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Password Reset Tool
Bridge 2017.01.04
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Business Object 4.2
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CEP 2018.03 Upgrade
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MHS GENESIS contract includes continuous upgrades for the life cycle of the system.
124 Simple Content and
Configurations Items
126 Cerner Update Packages
Way Ahead
• Revamped Training (Initial, Sustainment, Peer Expert)
• Stabile Infrastructure (MEDCOI & MDI)
• Robust Change Management (Pre, Go-Live, Post)
• Effective Strategic Communications
• Focused “Sprints”
16
CE/CME Credit
If you would like to receive
continuing education credit
for this activity, please visit:
http://amsus.cds.pesgce.com
Hurry,
CE Certificates will only be
available for 30 DAYS
after this event!