Negative user feedback was all part of the plan for a new electronic health care system, said Department of Defense officials and their private sector partners.
Harmful slowdowns and health provider confusion were among the key complaints reported from the four initial sites that rolled MHS GENESIS, which eventually will provide a single health record for service members, veterans, and their families.
A spokesperson for the Leidos Partnership for Defense Health told Federal Times that the period of the deployment was carefully planned prior to any installation in order for the partnership and the Department of Defense to “assess opportunities to improve the system and implementation project going forward.”
As for negative reports,”we’re disappointed stakeholder feedback continues to be taken out of context to present an incomplete, inaccurate and misleading narrative about the successful completion of the MHS GENESIS initial operating capability phase,” the spokesman continued. “MHS GENESIS is already achieving meaningful improvements related to quality, efficiency and safety in the initial deployment sites. We are confident MHS GENESIS remains on track for full deployment.”
Politico initially reported that the four initial operational capability sites in Washington State — Fairchild Air Force Base, Naval Hospital Oak Harbor, Naval Hospital Bremerton and Madigan Army Medical Center — suffered from a broken system that reduced the number of patients seen, mixed up doctor inputs, and provided inadequate training.
“Recognizing that there were some initial issues with the quality of resources at the user level support, we’ve addressed those concerns and have offered all required training to improve the user experience,” said Vicki Schmanske, deputy group president at Leidos Health.
“I agree that our training was not sufficient and that the training strategy that we followed focused too much on using the system and not enough on how the workloads are going to change and be enabled by MHS GENISIS,” said Stacy Cummings, program executive officer for the Program Executive Office, Defense Healthcare Management Systems.
According to Cummings, the training shortcomings and other complaints were treated as lessons learned when moving the GENESIS system from Fairchild, the first IOC to receive deployment, through to Madigan, the most recent IOC to receive deployment.
The IOCs also took steps to prepare for the disruption and challenges that a new health system would likely cause, according to Army Col. Michael L. Place, commander of the Madigan Army Medical Center.
“We were intimately aware of what the challenges were, and had worked with the program office to make sure that we had the right kinds of resources, and then took some risk mitigation measures,” said Place. “We decreased the number of inpatient beds that we had, we decreased the number of outpatient visits per provider, our emergency room was on trauma divert for a while, for several weeks, to make sure that we were ready to go.”
At Madigan, while initial MHS GENESIS deployment caused providers to see only 60 percent of their normal patient load, that number has now climbed to approximately 90 percent, with potential for the center to surpass its normal patient load in the future, according to Place.
Navy Capt. Christine L.G. Sears, commander of the Naval Health Clinic Oak Harbor, said that her clinic also saw a decrease in patient appointments at first, but is now up and running at normal capacity.
Sears added that she has seen improvements through the GENESIS system as well. She recently referred a patient to Madigan for care and was able to see every test and note recorded in the patients file while on their referral appointment.
In January 2018, DoD and its partners also initiated an eight-week stabilization and adoption period to work through many of the initial problems.
Patients are improving in terms of their ability to use the system, said Travis Dalton, senior vice president at Cerner Government Services: There was an 8 percent decrease in the time spent ordering on the same scenario by providers, and 82 percent of physicians orders are being entered electronically.
Dalton added that while the initial GENISIS rollout saw slightly more trouble tickets come through than would normally be expected, the problems the system faced were still a normal part of a healthcare system rollout as large as this one.
The Department of Veterans Affairs, which also contracted with Cerner to develop an interoperable electronic healthcare system that can transition service members into veteran healthcare, is closely watching the developments of GENESIS, according to its chief information officer Scott Blackburn.
“It’s incredibly important to the VA that MHS GENESIS is successful. We’re here to support, we have your back for sure, we’re watching very closely and learning from both the successes and the mishaps,” said Blackburn.
According to Cummings, though full deployment decisions have yet to be made, the program is still on track for its next phase of deployment along the Pacific Northwest in 2019 and for a full deployment in 2022.
Jessie Bur covered the federal workforce and the changes most likely to impact government employees for Federal Times.