MHS GENESIS CDR Alexander Holston Director, Clinical Informatics Chief Medical Informatics Officer

Large-scale technology implementation at MHS today Agenda Learning from our past: prior MHS electronic health record (EHR) implementations Large-scale technology implementation at MHS today MHS GENESIS functional community engagement Post-Deployment Preview

Prior MHS Clinical EHR Implementations AHLTA Essentris Outpatient EHR Inpatient EHR Deployed in JAN 2004 Deployed in the early 1990s Implementation Lessons Learned Leadership engagement and the need for a Functional Champion Streamline governance and make decisions at lowest possible level Engagement of frontline care professionals in decision-making Increase on the ground support for communications and training Increase post-go live support Extract benefits of using a COTS product

Current MHS EHR Implementations Integrated commercial off the shelf EHR, called MHS GENESIS Going from 50+ legacy systems to 1 Joint Legacy Viewer (JLV) Web-based, integrated system to access legacy data, and allow a read-only view of data from the Department of Defense (DoD) and Veteran Affairs (VA) systems 2017 2022

MHS GENESIS Guiding Principles Standardize clinical and business processes across the Services and the MHS Design a patient-centric system focusing on quality, safety and patient outcomes that meet readiness objectives Flexible and open, single enterprise solution that addresses both garrison and operational healthcare Clinical business process reengineering, adoption, and implementation over technology Configure not customize Decisions shall be based on doing what is best for the MHS as a whole – not a single individual area Decision-making and design will be driven by frontline care delivery professionals Drive toward rapid decision making to keep the program on time and on budget Provide timely and complete communication, training, and tools to ensure a successful deployment Build collaborative partnerships outside the MHS to advance national interoperability Enable full patient engagement in their health The MHS GENESIS Guiding Principles were approved by the Surgeon General and are critical to enabling agility

MHS GENESIS Functional Community Engagement 850 + Tri-Service Subject Matter Experts (SMEs) are the voice of the functional communities providing expertise in 6 key areas Workflow Design Process Redesign Standardization Training Material Review Testing Issue Resolution Primary focal areas of involvement: Requirements generation Enterprise design decisions Issue Resolution and governance

Functionally Driven Functional Champions Leadership Group (FCLG) and Functional Advisory Council (FAC) Serve in senior governance role for decision-making Make decisions raised to them by representatives of the functional community working on the design of MHS GENESIS Tri-Service Workflow Advisory Groups (TSWAGS) 19 lines of business across 6 branches: Health Care Operations Ambulatory Care / Readiness Inpatient & Hospital Based Outpatient Care Specialty Care Clinical Support Revenue Cycle

Enterprise Issue Resolution Development involved 60+ stakeholders from across the MHS: Services PEO / PMO, Functional Community, DHA Heath IT DHA Information Management Leidos Partnership for Defense Health

Post-Deployment Preview The First 90 Days Post Day 90 Program Office assets remain on the ground for support Major Players: Change Champions Adoption coaches Super Users Site User Role Assignment Coordinator Site Point of Contacts (POCs) Site assumes responsibility for the system Major Players: Change Champions Super Users System Administrators Local Site Trainer

Key Takeaways Lessons learned from AHLTA and Essentris EHR deployments highlight the need for MHS GENESIS deployment to focus on: Explain how the MHS GENESIS deployment differs from previous deployments (AHLTA and Essentris) Identify potential site and/or role-related risks and potential strategies for mitigating them Differentiate various means by which the MHS functional community has participated in the rollout of MHS GENESIS Following the MHS GENESIS Guiding Principles facilitates its agile deployment The functional community has made major contributions to the design and rollout of MHS GENESIS as evidenced by the Enterprise Issue Resolution Process Perceptions and behaviors related to the MHS GENESIS will vary depending on the stage of the implementation (i.e., pre/post 90 days