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Reports: DoD-Cerner EHR Rollout Postponed for 8 Weeks

January 17, 2018
by Rajiv Leventhal
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The Department of Defense (DoD) and Cerner are suspending their MHS Genesis electronic health record (EHR) modernization project for eight weeks, according to multiple media reports.

A NextGov report this week noted that the pause in the EHR rollouts across DoD sites will allow those involved to “assesses the ‘successes and failures’ released to the field thus far. Meanwhile, Politico’s morning eHealth newsletter recently reported that there are currently “1,600 ‘open tickets’ from the early users of the system at four Washington state medical clinics and hospitals.” To this end, NextGov received word from a spokesperson for the Defense Healthcare Management System who said the DoD has actually received 17,000 “trouble tickets” from users at the four test sites, of which some 11,000 have already been addressed.

The Politico newsletter stated, “Several doctors and IT experts familiar with the rollout say that doctors using the system are unhappy about the workflows. They have reported problems in everything from prescribing to referrals to lab report requests.”

In October, Madigan Army Medical Center in Takoma, Wash. became the fourth military site to go live with the MHS Genesis EHR system. That deployment followed installations at Fairchild Air Force Base, Naval Health Clinic Oak Harbor and Naval Hospital Bremerton. Madigan was the largest and last of four Pacific Northwest bases that make up the initial phase of the multi-billion-dollar Cerner implementation.

In 2015, the Pentagon awarded a $4.3 billion contract to Leidos to modernize Department of Defense’s EHR system. As the prime contractor, Reston, Va.-based Leidos formed a team of industry leaders including core partners Cerner, Accenture Federal Services, and Henry Schein to lead the development and integration of MHS Genesis through the program lifecycle.

According to the Defense Department, MHS Genesis will support the availability of electronic health records for more than 9.4 million DoD beneficiaries and approximately 205,000 MHS personnel globally. MHS Genesis is a single, integrated electronic inpatient and outpatient health record, and is managed by the DoD Healthcare Management System Modernization (DHMSM) Program Management Office (PMO), under the Program Executive Office, Defense Healthcare Management Systems (PEO DHMS).

The deployment plan, according to officials, which was delayed at the onset, was to start the installations in the Pacific Northwest and then phase it into the rest of the MHS over the course of several years, which will allow time to tweak it as necessary to meet any changing needs, and identify and correct unanticipated problems early.

Indeed, as Defense Healthcare Management System spokesperson David Norley recently said to NextGov, responding to the project’s struggles, “The purpose of our test phase is finding things we need to make adjustments on. We were always going to do an evaluation of what we have in the field and make adjustments to it.”

Meanwhile, a Leidos spokesperson, in a comment emailed to Healthcare Informatics, noted, “Over the next eight weeks, the Leidos Partnership for Defense Health, the DoD Program Executive Office, and Military Health Systems providers will conduct a scheduled and planned assessment of the system rolled out in the Initial Operational Capability (IOC) deployment.”

The spokesperson added, “Throughout the IOC we received feedback from users and DoD independent test agencies for recommended refinement and adjustment of the system.  We recognize the need to apply lessons learned in the feedback to adjust training, adoption of workflows, and modifications to change management activities. We remain dedicated to the successful delivery of the system across the IOC facilities, which includes the necessary due diligence to test the technology. Our immediate goal is to work with the DoD to make any necessary adjustments before the final deployment decision is made, allowing MHS Genesis to be successfully deployed around the world.”

According to Politico’s report, if the independent assessment clears the initial work by this fall, the work will go forward at other military installations, starting in San Diego.  What’s more, Politico spoke to a senior Navy doctor who said that the DoD's Cerner system workflow “was developed without enough input from clinicians who were actually going to be using it.”

The Kansas City-based Cerner, the vendor which was also awarded the contract to modernize the Department of Veterans Affairs’ EHR system, released a statement to Politico which said that the “company was ‘pleased with the adoption, performance and value that is being generated’ at the four initial MHS Genesis sites, and that it was crucial to have a deployment process and system that could be standardized across all military treatment facilities.”

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