The EHR, known as MHS Genesis, was originally slated to reach its initial operating capability at a handful of hospitals and clinics by early December, but that date will likely move back by a few months due to unexpected glitches in integrating the commercial software with the legacy systems the military services use to store and process patient data.
“We challenged ourselves to a very, very aggressive schedule, because we know this system is going to work and it’s going to improve health care,” Stacy Cummings, DoD’s program executive officer for Defense health management systems, told reporters. “When we identified issues, we decided to take the time we needed to get it right. We think the users we’re supporting deserve that, and the few months we’re investing right now is going to enable us to get it right on day one.”
Cummings said the problems were discovered during tests involving DoD and its prime contractor, Leidos, that simulated various health care scenarios and measured the ability of the software, made primarily by Cerner, to respond to them.
“During the testing of those scenarios, we found that the data exchange wasn’t happening in the way that we intended,” she said. “But these are technical issues, they’re solvable and we have confidence that we will solve them.”
The department’s original schedule called for clinicians to move away from DoD’s legacy AHLTA and CHCS systems and begin using GENESIS on Dec. 6. The initial sites were to be Fairchild Air Force Base in Spokane, Washington and the Oak Harbor Naval Hospital on Washington’s Whidbey Island.
Program officials will spend the next 30 days determining how serious the integration issues are before drawing up a new schedule, but they still intend to use those medical treatment facilities as the first sites for the new EHR, and for Washington hospitals and clinics at Joint Base Lewis-McChord and Naval Hospital Bremerton to follow shortly thereafter.
Defense officials began system validation sessions with clinicians at Bremerton last month in order to begin gathering user feedback ahead of the launch. Cummings said they’d uncovered no major issues beyond the technical problems DoD and Leidos already identified.
And she said based on DoD’s market research, the glitches aren’t too unlike the integration problems major commercial health care systems have faced as they’ve tried to introduce new electronic health record systems.
“On average, even a commercial provider takes 15 to 18 months from contract award to implementation. I don’t think we’re seeing anything out of the norm,” she said. “I will say that what’s different about us is we’re adopting an enterprise solution. We can’t optimize GENESIS just for one military treatment facility, we’re doing this integration and these interfaces once, as opposed to a commercial hospital where they might have interfaces that are local.”
The Defense Department said the delay would not result in any increase to the project’s five-year $4.6 billion cost ceiling. And Cerner, the subcontractor on whose software Genesis is based said it saw no indication that the setback in initial operating capability would affect the overall schedule for a final rollout to DoD’s worldwide medical facilities.
“We’re pleased that we remain in good position for an on-time, enterprise-wide deployment and are able to facilitate this additional configuration and testing for the initial operating capability pilot sites so that the system is performing at an optimal level when scaled across all MHS facilities,” Marlene Bentley, a company spokeswoman said in an emailed statement.