Optimization Is Next Step For Defense Department’s Health Records Platform

The next two months will be a pivotal time for the Defense Department’s commercial electronic health records platform, MHS Genesis.

Developed by Cerner under a $4.3 billion contract won by defense contractor Leidos, the platform is undergoing significant optimization based on feedback—including several thousand open “trouble tickets”—across four pilot locations.

While 11,000 tickets have been closed, around 5,000 of them are “tier 3,” which means they’ve been deferred to senior decision-makers and rise to the level of possibly requiring enterprise-level changes, said Defense Healthcare Management System spokesperson David Norley.

The department, along with teams from Cerner and Leidos, will address those issues and implement additional tweaks, lessons learned and best practices over the coming eight weeks, but officials from all three sides told Nextgov they are confident the implementation period won’t derail the platform’s schedule.

“We are on schedule,” said Jerry Hogge, senior vice president for Leidos Health.

Hogge said the two-month implementation period was planned since the contract’s inception, although it was initially up to 10 months in duration in the contract’s request for proposal.

“This is not a pause or a surprise, it’s a planned element of the program,” Hogge said. “We’re going to get it done in eight weeks time.”

Travis Dalton, Cerner's vice president and federal general manager, told Nextgov the approach mirrors what Cerner has done in the past developing electronic health records platforms in the commercial sector.

“It’s very similar to what we’ve seen with large health systems with 50-plus hospitals,” Dalton said. “There is always a period of time where you optimize what you’ve done. We have a process we use to garner best practices and feedback from our clients. Most of the content and workflow we adopt are driven by our client base along with our best thinking.”

In total, Defense wants MHS Genesis deployed at more than 1,200 sites, including 56 hospitals and medical centers, by 2022. Norley said Defense officials will decide in spring whether to fully deploy the software. If it does, Hogge said, it will be a single commercial platform “with a common set of workflows.” Whereas many Defense medical facilities are used to customized versions of software.

Hogge said one of the “guiding principles” in the contract’s competition was the need to “get away from customized one-off systems.”

Initially, that could upset some users because change, Hogge said, can be difficult.

“There is a learning curve, a temporary loss of efficiency and comfort that, over time, is more than offset by the benefits of the new system,” Hogge said. “Cerner has mountains of data that show productivity improvements over the long- and medium-term once the learning curve is overcome.”