DHMS PEO Stacy Cummings Talks MHS Genesis Successes

DHMS PEO Stacy Cummings Talks MHS Genesis Successes

The program is progressing toward a 2023 full deployment.
Stacy Cummings

Stacy Cummings, program executive officer for Defense Healthcare Management Systems.

What does improving the DOD's electronic health record mean to you and the greater defense community?

The deployment of MHS Genesis has two primary focuses. One is patient safety, and the other is protecting our patients' critical private health data. So the deployment of MHS Genesis to the Department of Defense brings us an integrated inpatient and outpatient modern secure connected electronic health record that will enable the transformation of the delivery of health care across the military health system. 

How is the MHS Genesis program progressing toward first deployment this year and fully by 2022?

We deployed to our first pilot sites last year and we've had a lot of success in learning lessons, getting feedback from our users, making improvements and enhancements to the configuration of MHS Genesis. We had a major decision in December of last year that gave us the authority to proceed to our next six waves that represents about 25% of the entire military health system, and we are on track to have our infrastructure stable and ready at our first wave so that we can deploy MHS Genesis along with our training strategy, along with change management this fall to our first wave, and we expect our full deployment to be at the end of calendar year 2023. 

What challenges has your team faced and how will you, or did you, overcome them?

The whole purpose of doing a pilot was that it gave us the opportunity to see how a commercial off-the-shelf tool integrated into the military environment that's actually being used by hundreds of thousands of people around the world how we would take that commercial tool and integrate it into the military health system's unique military environment.

We learned a ton of lessons from our first deployment. One of our first biggest challenges is that we are currently deploying a new network, a local area network, and an infrastructure that has cybersecurity at its core, and we were deploying that at the same time as we were deploying our electronic health record. Major lesson learned is that we need to deploy our network well in advance of bringing the electronic health record and have enough time for network stability and to be able to securely connect our medical devices, which create a huge opportunity for our users to be able to better take advantage of the technology that we bought.

One of the things we learned coming to organizations like this, coming to HIMSS, talking to HIMSS Analytics is that you really need the health system to own the change. We just weren't organized for that. Over the last year, we've changed the way the functional community is organized to provide us requirements and to provide us feedback, creating more of a management structure as opposed to governance, and that has been really just a big shift for the military health system and a big benefit to our ability to move forward with our deployment. 

How has emerging technology played a part in the Genesis program?

One of the main reasons that we chose to go to a commercial off-the-shelf tool is because we've had electronic health records for decades and they've become aged. We would have to invest a lot of our own money in order to modernize the legacy systems that only we were using. The benefit of going to a commercial record is that not only will we get the advantage of a modern system today, but as Cerner Millennium and Dentrix Enterprises, they continue to modernize, get feedback from us and from other customers, we'll continue to benefit from the emerging technologies that they are incorporating into their electronic health record.

Also with open APIs, the ability to take advantage of other smaller companies or other initiatives that are bringing data collection and data use -- what's really important in the deployment of our single integrated electronic health record is that we will have the data structure and the data that we're collecting in a way that is much more usable than in three different systems in our legacy environment. Being able to take advantage of that while Cerner and Henry Schein continue to look outwards to their commercial customers for great ideas on how to make their capability better, we'll get to take advantage of that. 

In which areas do you see the most improvements in the program?

We've really focused on getting a single voice of the customer and being able to get feedback from our local sites, but to be able to impact them across the enterprise. So I'll talk about just a couple of patient safety examples of where, because we bought a modern system, we're able to create connections that we weren't able to do in our legacy system.

The biggest benefit is having that integrated inpatient and outpatient record where all of the data regardless of if you were seen in the emergency department, inpatient, outpatient, it's all available immediately to the healthcare provider. It's also available immediately through the patient portal, which is a great opportunity to securely connect with the patients to their providers and to be able to leverage those communications to maybe avoid someone having to come in and bring their their their family in during bad weather and they're able to leverage that patient portal. We've seen a huge increase in the use of the patient portal.

Finally I'll talk about barcode administration. Barcode administration is a very very important patient safety tool and we weren't able to take advantage of that at an enterprise level when we were using our legacy systems. We're now across our four initial sites at 85% compliance with barcode administration, and we actually represent a market leader for Cerner's customers. We're using it at such a high rate in our initial sites. That is a great patient safety initiative and we're really excited about being able to leverage that across the enterprise.