Pentagon revises schedule for electronic health record rollout, including several months of delays

The Defense Department will begin the much-anticipated rollout of its new commercially derived electronic health records system in February, according to a new deployment schedule officials announced on Tuesday.

DoD had planned to demonstrate initial operational capability of the system, known as MHS Genesis, in December at four Pacific Northwest hospitals. The EHR is now set to go live at just one facility, Fairchild Air Force Base, in February. The other three Washington State hospitals that had been picked as early test sites won’t get it until June 2017 at the earliest. The plan for full, worldwide deployment remains unchanged: that will take until 2022.

The delay, which officials first forecast a month ago, was because of the need for more development work on the interfaces between DoD’s legacy health IT systems and the modern EHR platform, which is based on widely deployed commercial software made by Cerner, said Stacy Cummings, the department’s program executive officer for defense health management systems (DHMS).

“It also provides additional time for the program team and our vendor to implement clinical capabilities, complete cybersecurity risk management and test these capabilities prior to initial deployment,” she told reporters during a brief conference call Tuesday.

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Cummings said the longer delay at the other Pacific Northwest sites — Oak Harbor Naval Hospital, Joint Base Lewis-McChord and Naval Hospital Bremerton — would allow for the early addition of features that hadn’t been planned for inclusion in the EHR until much later in the five-year roll out of Genesis. Those include voice recognition technologies and blood transfusion management.

“Those additional capabilities aren’t requirements at Fairchild, but they are at the other three sites,” she said. “So in order to have the best possible user experience for our clinicians and beneficiaries, this made the most sense for long-term program success.”

The delays are in line with warnings by the Defense Department inspector general, which said in a May 2016 audit that DoD could miss the December deployment deadline by two-to-four months because of 39 separate “program risks” the DHMS office had identified, including seven factors that were categorized as “high risks” for cost or schedule slippage.

“We agree that we set a very aggressive schedule for ourselves, and that schedule included significant concurrency, meaning we were doing several different things at the same time around contractor-led tests, government-led tests, cybersecurity risk management, and moving quickly into deployment,” Cummings said. “So what we’ve done in this modified schedule is give us time to fix any defects we identify. The re-plan we’re announcing does take into account all of the risks that were identified by the IG, but also those risks that were identified by us.”

However, the aggressive schedule wasn’t entirely of DoD’s own choosing. In the 2014 Defense authorization bill, lawmakers, frustrated over halting progress toward EHR improvements in the departments of Defense and Veterans Affairs ordered both departments to deploy “modernized  software supporting clinicians of the Departments by no later than December 31, 2016.”

A second provision in the same bill ordered the departments to make sure both their legacy systems and their modernized ones were interoperable with one another. On that score, Cummings said they had already succeeded: DoD and VA formally certified to Congress in April that their health records are now fully interoperable, based in part on the Joint Legacy Viewer, which lets clinicians in each department see the same patient’s records in one another’s systems.

“We’re proud of that accomplishment, and we continue to strive to share more and more data even beyond the requirement of the 2014 NDAA,” she said. “We’ll continue to transparently share our plans and progress with our oversight committees and our functional users in the military health system.”

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