[{"innerBlocks":[],"name":"core\/freeform","postId":2144,"blockType":{"name":"core\/freeform","keywords":[],"attributes":{"content":{"type":"string","source":"raw"},"lock":{"type":"object"}},"providesContext":[],"usesContext":[],"selectors":[],"supports":{"className":false,"customClassName":false,"reusable":false},"styles":[],"variations":[],"apiVersion":3,"title":"Classic","description":"Use the classic WordPress editor.","category":"text"},"originalContent":"While the Department of Defense contends that its initial deployment last year of MHS GENESIS\u2014a new Cerner electronic health record system\u2014at four military sites in the Pacific Northwest was a success, the EHR is \u201cneither operationally effective nor operationally suitable,\u201d according to a new report from DoD\u2019s director of operational test and evaluation.

DOT&E\u2019s initial test and evaluation report, dated April 30 and released by DoD on Friday, is based on an assessment of three of four military sites in Washington State that were part of the rollout.

\u201cMHS GENESIS is not operationally effective because it does not demonstrate enough workable functionality to manage and document patient care,\u201d wrote Robert Behler, director of operational test and evaluation, in a letter to senior Pentagon officials accompanying his report. \u201cUsers successfully performed only 56 percent of the 197 tasks used as measures of performance. MHS GENESIS is not operationally suitable because of poor system usability, insufficient training and inadequate help desk support. Survivability is undetermined because cybersecurity testing is ongoing.\u201d

Also See<\/b>: DoD initial rollout of Cerner EHR comes under fire from senator<\/a>

In addition, Behler reported that users of the Cerner EHR gave its usability \u201can average score of only 37 out of 100 on the System Usability Scale (SUS), well below the threshold of 70 that indicates acceptable usability,\u201d while \u201ctraining was insufficient to overcome usability problems, and a lack of documentation forced users to develop their own operational workarounds.\u201d

As a result of the findings, Behler recommended that the Under Secretary of Defense for Acquisition and Sustainment delay further fielding of the Cerner EHR until the Joint Interoperability Test Command completes the initial operational test and evaluation and the Program Management Office \u201ccorrects any outstanding deficiencies.\u201d

According to Behler, the initial operational test and evaluation was conducted at Fairchild Air Force Base and Naval Health Clinic Oak Harbor from September 25 to October 6, 2017, and Naval Hospital Bremerton from December 4 to 15, 2017. However, he said IOT&E at Madigan Army Medical Center was postponed to \u201cremediate significant problems discovered at the first three sites\u201d and will be rescheduled later this year. After the review at that site is completed, he said his office will release its final report.

Last year, DoD completed full deployment of the Cerner system to all four initial operational capability sites, culminating with Madigan Army Medical Center.

Stacy Cummings, program executive officer for Defense Healthcare Management Systems, told members of the press on Friday that despite the findings of the DOT&E report, DoD still plans to continue deployment of MHS GENESIS beyond the Pacific Northwest beginning in 2019, and that the system continues to be on track for full deployment by 2022.

Cummings noted that DoD conducted an eight-week \u201coptimization period\u201d starting in January and that the military has \u201cmade significant progress in adoption of workflows, roles and responsibilities, issue resolution, and training and change management activities.\u201d

She also said DoD \u201cengaged HIMSS Analytics\u2014widely recognized as the industry standard for measuring electronic health record adoption\u2014to conduct an independent measure of the progress and effectiveness of MHS GENESIS at our four initial sites.\u201d According to Cummings, prior to MHS GENESIS deployment, the average score for its legacy systems was Stage 2 EMRAM out of a possible Stage 0 to Stage 7 scoring on the HIMSS Analytics scale. However, post deployment, the sites scored at or above Stage 5\u2014which is \u201cwell above the national average,\u201d she added.

Nonetheless, according to DOT&E\u2019s initial operational test and evaluation report, users of MHS GENESIS rated the training they received as \u201cpoor,\u201d with most users (67 percent) indicating that they needed more training. In response, Cummings acknowledged that the MHS GENESIS \u201ctraining strategy really needs to change as we move forward,\u201d and \u201cone of the things that we learned is that we need to do a better job of preparing our sites from a technology as well as a workflow readiness perspective.\u201d

The DOT&E report also reported that users of the Cerner system \u201coften suffered from unacceptably long MHS GENESIS login times.\u201d However, Cummings countered that as a result of a software upgrade that took place last month, DoD has been able to reduce login times by 50 percent \u201cand our reliability has gone up significantly.\u201d

When it comes to scalability, the DOT&E report observed that although the system\u2019s scalability \u201chas not been formally tested,\u201d there are \u201cindications that MHS GENESIS may not be scalable.\u201d

In response, Travis Dalton, Cerner\u2019s federal general manager, told reporters that the EHR vendor is \u201cvery confident\u201d in the system\u2019s ability to scale, citing the fact that the company has customers that are \u201cexponentially larger\u201d than the current size of DoD\u2019s MHS GENESIS deployment.

\u201cThe systems and the code that we\u2019re utilizing here for DoD are the same set of code and systems that are live at thousands of commercial sites around the globe,\u201d added Dalton. \u201cWe\u2019re entirely confident in the safety, the quality and the capability of our solutions, as evidenced by our position in the marketplace and their use globally.\u201d

DoD awarded a $4.3 billion contract in 2015 to prime contractor Leidos to modernize the military\u2019s EHR system, which will be deployed worldwide to support healthcare delivery for 9.4 million beneficiaries. The Leidos-led team includes consultancy Accenture, dental software vendor Henry Schein and Cerner, which provides the core Millennium capability.

\u201cWhile we still have challenges to overcome, we are clearly making significant progress and are on the right track to deliver a modern, secure and connected electronic health record to the Military Health System,\u201d concluded Cummings. \u201cAnd, we continue to be\u2014and have been\u2014open and transparent.\u201d

Cerner\u2019s Dalton added that there were no \u201csurprises\u201d for the EHR vendor in terms of the findings of the DOT&E report. \u201cWe expected there to be things to work through, and we\u2019re working through them in a consistent manner,\u201d he said. \u201cIt\u2019s consistent with what we might see in a commercial environment.\u201d","saveContent":"While the Department of Defense contends that its initial deployment last year of MHS GENESIS\u2014a new Cerner electronic health record system\u2014at four military sites in the Pacific Northwest was a success, the EHR is \u201cneither operationally effective nor operationally suitable,\u201d according to a new report from DoD\u2019s director of operational test and evaluation.

DOT&E\u2019s initial test and evaluation report, dated April 30 and released by DoD on Friday, is based on an assessment of three of four military sites in Washington State that were part of the rollout.

\u201cMHS GENESIS is not operationally effective because it does not demonstrate enough workable functionality to manage and document patient care,\u201d wrote Robert Behler, director of operational test and evaluation, in a letter to senior Pentagon officials accompanying his report. \u201cUsers successfully performed only 56 percent of the 197 tasks used as measures of performance. MHS GENESIS is not operationally suitable because of poor system usability, insufficient training and inadequate help desk support. Survivability is undetermined because cybersecurity testing is ongoing.\u201d

Also See<\/b>: DoD initial rollout of Cerner EHR comes under fire from senator<\/a>

In addition, Behler reported that users of the Cerner EHR gave its usability \u201can average score of only 37 out of 100 on the System Usability Scale (SUS), well below the threshold of 70 that indicates acceptable usability,\u201d while \u201ctraining was insufficient to overcome usability problems, and a lack of documentation forced users to develop their own operational workarounds.\u201d

As a result of the findings, Behler recommended that the Under Secretary of Defense for Acquisition and Sustainment delay further fielding of the Cerner EHR until the Joint Interoperability Test Command completes the initial operational test and evaluation and the Program Management Office \u201ccorrects any outstanding deficiencies.\u201d

According to Behler, the initial operational test and evaluation was conducted at Fairchild Air Force Base and Naval Health Clinic Oak Harbor from September 25 to October 6, 2017, and Naval Hospital Bremerton from December 4 to 15, 2017. However, he said IOT&E at Madigan Army Medical Center was postponed to \u201cremediate significant problems discovered at the first three sites\u201d and will be rescheduled later this year. After the review at that site is completed, he said his office will release its final report.

Last year, DoD completed full deployment of the Cerner system to all four initial operational capability sites, culminating with Madigan Army Medical Center.

Stacy Cummings, program executive officer for Defense Healthcare Management Systems, told members of the press on Friday that despite the findings of the DOT&E report, DoD still plans to continue deployment of MHS GENESIS beyond the Pacific Northwest beginning in 2019, and that the system continues to be on track for full deployment by 2022.

Cummings noted that DoD conducted an eight-week \u201coptimization period\u201d starting in January and that the military has \u201cmade significant progress in adoption of workflows, roles and responsibilities, issue resolution, and training and change management activities.\u201d

She also said DoD \u201cengaged HIMSS Analytics\u2014widely recognized as the industry standard for measuring electronic health record adoption\u2014to conduct an independent measure of the progress and effectiveness of MHS GENESIS at our four initial sites.\u201d According to Cummings, prior to MHS GENESIS deployment, the average score for its legacy systems was Stage 2 EMRAM out of a possible Stage 0 to Stage 7 scoring on the HIMSS Analytics scale. However, post deployment, the sites scored at or above Stage 5\u2014which is \u201cwell above the national average,\u201d she added.

Nonetheless, according to DOT&E\u2019s initial operational test and evaluation report, users of MHS GENESIS rated the training they received as \u201cpoor,\u201d with most users (67 percent) indicating that they needed more training. In response, Cummings acknowledged that the MHS GENESIS \u201ctraining strategy really needs to change as we move forward,\u201d and \u201cone of the things that we learned is that we need to do a better job of preparing our sites from a technology as well as a workflow readiness perspective.\u201d

The DOT&E report also reported that users of the Cerner system \u201coften suffered from unacceptably long MHS GENESIS login times.\u201d However, Cummings countered that as a result of a software upgrade that took place last month, DoD has been able to reduce login times by 50 percent \u201cand our reliability has gone up significantly.\u201d

When it comes to scalability, the DOT&E report observed that although the system\u2019s scalability \u201chas not been formally tested,\u201d there are \u201cindications that MHS GENESIS may not be scalable.\u201d

In response, Travis Dalton, Cerner\u2019s federal general manager, told reporters that the EHR vendor is \u201cvery confident\u201d in the system\u2019s ability to scale, citing the fact that the company has customers that are \u201cexponentially larger\u201d than the current size of DoD\u2019s MHS GENESIS deployment.

\u201cThe systems and the code that we\u2019re utilizing here for DoD are the same set of code and systems that are live at thousands of commercial sites around the globe,\u201d added Dalton. \u201cWe\u2019re entirely confident in the safety, the quality and the capability of our solutions, as evidenced by our position in the marketplace and their use globally.\u201d

DoD awarded a $4.3 billion contract in 2015 to prime contractor Leidos to modernize the military\u2019s EHR system, which will be deployed worldwide to support healthcare delivery for 9.4 million beneficiaries. The Leidos-led team includes consultancy Accenture, dental software vendor Henry Schein and Cerner, which provides the core Millennium capability.

\u201cWhile we still have challenges to overcome, we are clearly making significant progress and are on the right track to deliver a modern, secure and connected electronic health record to the Military Health System,\u201d concluded Cummings. \u201cAnd, we continue to be\u2014and have been\u2014open and transparent.\u201d

Cerner\u2019s Dalton added that there were no \u201csurprises\u201d for the EHR vendor in terms of the findings of the DOT&E report. \u201cWe expected there to be things to work through, and we\u2019re working through them in a consistent manner,\u201d he said. \u201cIt\u2019s consistent with what we might see in a commercial environment.\u201d","order":0,"get_parent":{},"attributes":[],"attributesType":{"content":{"type":"string","source":"raw"},"lock":{"type":"object"}},"dynamicContent":""}]

DoD rollout of Cerner EHR deemed not operationally effective or suitable

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