The March 13 launch of a joint DoD-VA electronic health record (EHR) at a North Chicago care center marked a “monumental moment” in the program’s progress, officials said during an April 4 briefing with MOAA and other veterans groups.

The launch of the federal EHR at the Captain James A. Lovell Federal Health Care Center (FHCC) — a first-of-its-kind fully integrated DoD and VA medical facility which sees 75,000 DoD and VA patients a year, including 40,000 Navy recruits – completes DoD’s full rollout of the Military Health System (MHS) GENESIS, its version of the federal EHR, to all 138 military treatment facilities and clinics. It also inches the VA closer to restarting deployment of its version, the Oracle Cerner Millennium, to its 172 medical centers and clinics.

Senior officials at the briefing, which included representatives from DoD, the VA, the Coast Guard, NOAA, and other agencies, offered high praise for the changeover, calling it the “best ever,” a “monumental moment,” and a “spectacular achievement in its own right.” Lovell boasts 3,200 DoD and VA employees.

“This is a moment marked in time that will show we are going to be on the right side of history,” said Capt. Salee Jan Oboza, the facility’s associate director for readiness. “We will have a full clinical picture of a servicemember, and optimizing data analytics will help us deploy at future sites.”

What’s Next?

The launch represents the start of further convergence of the EHR in the federal government and a model for future launches. The stakeholders all stand at different points in the process:

• Neil Evans, acting program manager of the department’s Electronic Health Record Modernization office, said the launch “provides VA a path forward for restarting our EHR rollouts,” and that “significant training, learning labs using sandbox exercises, and strong peer support made the difference for this rollout.”
  
  
• For DoD, sustainment and system optimization across MHS are critical next steps. Chris Ruefer, acting director of the program executive office for the Defense Healthcare Management Systems, said next steps will be to “focus on full optimization across the system, make upgrades, harness data, and then rollout to the National Security Agency.”
  
  
• The Coast Guard and NOAA are still in the process of implementing DoD’s EHR. NOAA has already seen improvements in prescreening and onboarding officer entrants who want to join the agency, and while the Coast Guard has had some unique challenges deploying the system outside of the DoD’s network, officials see the value in faster patient record retrieval and exchange of health information with providers and reduction in administrative errors.

DoD is looking forward to cheering on VA during the way forward. Both agencies consider synchronously launching the EHR at Lovell was the right choice.

“Things are going better than expected,” said Dr. Robert Buckley, the facility director. “The thing works, we have interoperability, and we got incredible support for the pre-launch and it’s ongoing. ... Preparation is key for joint sites and this launch will provide solutions for the next site that goes live.”

EHR Background

Implementation of DoD’s EHR has been a seven-year endeavor; like VA, it experienced challenges in early rollouts. The department paused deployment based on an independent assessment until fixes were made, a move which helped accelerate future launches.

Unlike DoD, the VA did not conduct an independent assessment of its EHR system and has experienced system problems since its initial deployment in 2020 at Mann-Grandstaff VA Medical Center in Spokane, Wash. Problems persisted as the VA rolled out the system at four additional medical centers leading ultimately to a full halt last year to reset the program.

Since the reset, the VA has worked to address technical, patient safety, and system performance issues at the five sites and completed major systems upgrades before the Lovell launch. The five VA facilities using the record system are small- to medium-sized, Evans said; launching at a large complex site like Lovell and working together with the DoD has been part of the reset for the department.