The Military Health System's new electronic health begins its worldwide roll-out later this year starting in the Pacific Northwest. MHS GENESIS connects patients' medical and dental information from point of injury to wherever the care is provided for the MHS' 9.4 million beneficiaries.

“MHS GENESIS … must meet the unique military needs and provide a transition [to a one-system platform],” said Dr. William Roberts, MHS functional champion from the Defense Health Agency -- the doctors, nurses and medical technicians who will be using the new system. “It’s important because of unique military needs. We all need and want this to work for everyone.”

Roberts was part of a panel updating the approximately 1,500 clinicians, information technology providers and users at the Defense Health Information Technology Symposium (DHITS) in Orlando, Florida, Aug. 4. MHS GENESIS has been much of the buzz around the conference. He was joined on the stage by Stacy Cummings, program executive officer for the Program Executive Office Defense Healthcare Management Systems, and Air Force Col. Richard Terry, acting director for the Defense Health Agency’s Health Information Technology directorate.

Cummings told the crowd the MHS looked to examples in the civilian health community for how the new system would be rolled out. Starting MHS GENESIS in the Pacific Northwest and phasing it in throughout the MHS allows them to learn from any issues along the way and adapt the system so it works for all.

“The approach we’re using is really leveraging those lessons learned from the commercial [providers] and the lessons learned from our own implementation,” said Cummings. “So what the Pacific Northwest will see in December is not going to be exactly what the next phase of the implementation will see  the following year. This is the best way to ensure we’re successful in the long run.”

Terry said MHS GENESIS was conceived under several guiding principles. He highlighted three as being among the most important: configure but don’t customize a system, standardize the clinical and business processes across the services and the MHS, and make decisions that are best for the system as a whole.

Under the customization principle, Terry said it’s not cost effective for the military to try to build its own system and explains why the government turned to the commercial health IT industry to find the right solution. “We have to leverage what they were already doing,” said Terry.

Roberts pointed out how important it still was for the doctors, nurses and other health care providers to be able to configure MHS GENESIS to meet their clinical needs. “Let’s bring in those best ideas and practices as to how to take the MHS to the next generation.”

For standardization, coming from the acquisition point of view, Cummings pointed out how having this single tool MHS wide will save money while keeping the focus on the patients served. Roberts echoed those sentiments saying how having MHS GENESIS standardized as the health record keeping system also helps the MHS achieve its goal of being a high reliability organization by reducing the variability of data collection across the system. Terry said standardizing the process also simplifies and better manages how the IT community supports the health care providers.

The three also talked about how MHS GENESIS implementation will be focused on what is good for the Military Health System as a whole, and not focused on individual areas.

“That’s the way we have to operate,” said Terry. “And the focus always has to be on how we serve the customer.”

Cummings said those involved in MHS GENESIS development process needed to consider what would work best for everyone as it is phased in systemwide. “We needed to look at what is in the interest of the MHS at [initial rollout] and how are we going to learn from that so we can make the best decisions … for the clinicians, for the business people and the patients,” she said.

Roberts said they understand there will be some pushback from those in the field who will want to cite their own successes as reasons to keep doing things the way they always have. But he said they brought together more than 800 experts during the process to determine what MHS GENESIS should look like. He asked those possible naysayers to provide feedback but trust what’s being worked on is in the best interest of everyone, from IT providers to health care professionals to those receiving care.

“You all and your colleagues have participated in these decisions [of constructing MHS GENESIS],” said Roberts. “Trust us that these subject matter experts, many of whom you appointed, have worked very hard to make the decisions as to what is best for the MHS and ultimately our beneficiaries.”