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by Travis Dalton
Published on April 23, 2018

Recently, I provided an update about our progress with the deployment of U.S. Department of Defense's (DoD) new electronic health record, MHS GENESIS, within the initial operational capability (IOC) region in the Pacific Northwest. While the Leidos Partnership for Defense Health acknowledges there have been some normal adoption and process challenges, we are pleased by the improvements that are happening as a direct result of our recent optimization efforts. The deployment is gaining momentum and benefits from this stabilization effort are setting up DoD for success in future deployments.

Working together with military health to make optimization a success 

In collaboration with our military health counterparts, the optimization plan considered the feedback from many inputs and spanned across many functional areas. Our team evaluated site priorities, incoming ticket volume, Cerner consultant observations and system analytics to determine areas of focus. To most comprehensively stabilize the IOC sites, we focused on retraining complex clinical areas, consolidation of role profiles, conducting solution sessions to refine workflows, and streamlined change control processes.  In addition, we leveraged data-driven processes to find opportunities for improvement and targeted end users for adoption training. 

Impacts on clinical productivity

The IOC sites have experienced performance improvements based on users becoming more comfortable with the new functionality and workflows. Practitioners have noted their ability to more quickly document care, which provides them more time to see patients. In addition, there have been many more measurable improvements that are keeping service member patients safe and improving the quality of care:

  • Bar code medication administration (BCMA) workflow and capabilities are designed to prevent potential medication errors and safeguard patients from inappropriate treatments. Since October 2017, inpatient care units at the IOC sites saw a 23 percent increase in BCMA compliance. Before MHS GENESIS, The IOC sites did not have technology supported bar code medication administration processes. These advancements improve patient safety in the medication administration process by ensuring the right patient, receives the right medication and the right dose, at the right time.
  • The total time providers spend in the EHR has decreased for ambulatory clinics within the IOC sites. On average, providers are saving approximately five minutes per patient as they become more efficient reviewing a patient's chart, entering orders and completing documentation. Overall, the total time spent in the EHR has decreased 23 percent since the initial 60 days post-conversion.
  • Prior to the deployment of MHS GENESIS deployment, the average score in the IOC was below Stage 2 on the HIMSS Analytics Electronic Medical Record Adoption Model (EMRAM). Over the past year since deployment, the sites have gained a score of at or above Stage 5, with Fairchild Air Force Base achieving Stage 6. These scores are an important indicator that an organization is effectively leveraging the functionality of its EHR system, and are well above the national average.
  • While the number of patients seen in the ambulatory setting has increased, the time providers spend completing clinical documentation per patient has decreased. On average, the IOC sites have seen a seven percent decrease in total time to complete ambulatory clinic documentation per patient.
  • Clinical decision support reconfiguration has reduced the number of duplicate medication alerts to outpatient pharmacy personnel within the IOC by almost 8,000 per week—a 46 percent improvement.

While there are items that will continue to be improved through future functionality and upgrades, these improvements at the IOC sites are all signs we’re on the right track to move towards full deployment across the entire military health system. 

Cerner has always understood the goal and importance of the mission to support the safety and efficiency of care for the men and women serving in the U.S. armed forces. We are committed to working with DoD to aid with the successful adoption of a single integrated military health record that improves access to a service member’s medical record today and throughout a lifetime of care. Learn more here.