It's been two weeks since the Defense Health Agency started up its electronic health records system, and Vice Adm. Raquel Bono is thrilled.

"I'm happy to say that the deployment at Fairchild Air Force Base is incredible," she said, speaking at a media session during the 2017 HIMSS conference in Orlando, Florida.

"We had the right combination of all the support and the leadership and the adoption. We already learned some pretty useful lessons to move forward on that."

The EHR system — dubbed Military Health System Genesis — went live on Feb. 7 at the base outside of Spokane, Washington, the first step in a wave rollout DHA officials have planned for 2017, with three other Washington installations set to get the system this summer.

DHA initially planned the rollout to go live at all four installations — including Naval Hospital Bremerton, Naval Hospital Oak Harbor and Tacoma’s Madigan Army Medical Center — in December 2016, but was delayed while DHA officials ensured the cybersecurity interfaces for the Cerner-designed system worked effectively with legacy systems.

Bono said that by testing the rollout at Fairchild first, DHA officials had some flexibility to test the system’s capabilities for expansion to larger sites.

"We could start relatively small, but scale it up pretty rapidly," she said. "For Fairchild, they are strictly an outpatient facility. So we had no inpatient care that we needed to try to deploy.

"Also, we knew that they had a fair number of pharmacy transactions, as well as laboratory and radiology transactions, so we thought this would be a great place to start and understand how our processes meshed and what we needed to pay attention to."

With this summer’s planned rollout set for three new facilities, Stacy Cummings, Defense Healthcare Management Systems program executive officer, said MHS Genesis will expand the capabilities modules to match the needs of the installations.

"From an EHR perspective, the workflows in an inpatient environment are different from the workflows in an outpatient [environment]," she said. "Same thing around things like surgery, blood transfusion, natural language processing tools; these are some of the capabilities that we will be adding as we move to the larger facilities that weren’t requirements of the small facility."

The interoperable health system has been years in making, with the goal of an EHR infrastructure that will facilitate the free flow of patient data across the Department of Defense.

Cummings said DHA was also tracking how users interact with the system with a metrics tool called the Lights On Network, providing the agency with better insights on how Genesis should develop.

"One of the real benefits of this commercial off-the-shelf tool is the alerts," she said. "The information that’s stored in the electronic health record, partnered with some of the decision support tools that [system] gives us, we’re going to be able to give good advice to the provider and we can track to see if they follow that advice."

The alert functions in MHS Genesis will notify providers with tools like updated dosage recommendations based on information contained within the EHR, such as elevated lab levels.

MHS Genesis is projected to be fully deployed by 2022.