The Defense Department is making progress to modernize its electronic health records system, but it still has some distance to go, according to a recent report from the Government Accountability Office.
DOD relies on multiple electronic systems implemented over the last 30 years to maintain health records. In seeking to implement a more modern comprehensive system called Military Health System GENESIS, the department has already improved system performance, GAO reports.
Still, some already identified defects persist. System users also reported that training and communication on the new tools have been ineffective.
GAO said it examined the effort “to determine what progress DOD has made toward implementing a new electronic health record system, and identify the challenges and key risks to MHS GENESIS implementation and what steps DOD is taking to address them.”
To that end, GAO analyzed test reports, briefing materials and incident report tracking documents. GAO also held discussion groups with 356 users and with relevant officials.
The report found DOD is making headway. The new system has been deployed to sites in six of 24 planned deployment waves, covering some 41,600 users. DOD has “improved system performance and addressed issues experienced at the initial sites,” the report found.
Still, issues that arose during testing — “system defects,” according to GAO — remain unresolved.
“DOD has not developed plans to conduct additional testing at future sites to ensure the remaining incidents are fully resolved. As a result, unaddressed incidents could lead to challenges at future sites,” the report noted.
MHS GENESIS also is plagued by training and communication challenges. Users told GAO training was not consistent with the “live” system, and that there were too many system changes to keep up. In the absence of adequate information, “users were unaware of important changes to their roles or business processes, or to system revisions and improvements,” GAO reported.
GAO has made three key recommendations for executive action based on its findings.
First, the secretary of defense “should direct the Program Executive Officer of Defense Health Management Systems to develop an approach for retesting the incidents identified by testers to ensure that the incidents have been resolved,” GAO said.
The secretary should also direct the program executive officer of Defense Health Management Systems to improve the effectiveness of training, ensuring it is relevant to user roles.
Finally, the secretary of defense should direct the Defense Health Agency chief health informatics officer “to ensure users are aware of system changes and to monitor users’ awareness of changes.”
DOD’s objective has been to replace its legacy systems with a real-time electronic health record, and GAO indicates these changes would help drive that goal.