DoD-Cerner EHR project finding improvements, despite some challenges
Cerner’s EHR project for the U.S. Department of Defense has already led to increased clinical efficiencies and reductions in duplicative testing for some sites part of the initial pilot, according to a new blog post from Travis Dalton, general manager of Cerner’s federal division.
In February 2017, DoD rolled out the first MHS Genesis EHR at Fairchild Air Force Base in Washington, followed closely by implementations at Naval Hospital Oak Harbor and Naval Hospital Bremerton. The last pilot site went live at Madigan Army Medical Center in October.
Currently, the project is in a planned eight-week assessment period to work through all of the kinks that happen with most EHR projects. To mitigate some of these issues, Dalton said DoD has leaned on commercial practices of deployment.
This includes rolling out the EHR incrementally and focusing on a smaller set of facilities first before rolling out at all sites, as a way to “work through issues and make adjustments to make the larger outcome better.”
Dalton said Cerner has worked closely with the agency to properly train users and make sure clinicians are accustomed to the new platform. But as expected with a project of this size, the rollout has seen its challenges.
“Some early adoption issues mean that change management and governance processes are being refined,” Dalton wrote. “Some issues logged have taken longer to resolve than we would have liked, and productivity at the local level has taken some time to normalize.”
“The incremental approach anticipates these types of early concerns as a part of the deployment process and integrates steps to examine issues and develop long-term resolutions prior to full enterprise rollout,” he added.
Despite these challenges, the DoD has already seen some positive results.
Fairchild achieved HIMSS Analytics EMRAM Stage 6, which demonstrates the provider is effectively leveraging the functionality of its EHR. Further, Madigan has reduced the average stay for hospital patients experiencing sepsis by 37 percent, by leveraging early recognition of sepsis risk alerts.
In addition, the pilot sites canceled 2,613 non-medication orders from June 2017 to Jan. 2018, which potentially reduced the number of duplicative procedures like imaging and labs. In the same tired, the sites decreased the time spent placing orders for each patient by about 8 percent.
“These early successes prove we are on the right track, but our job is never done and pursuit of improvement will never cease,” Dalton wrote.
In January, DoD Defense Healthcare Management Systems’ Communications Director David Norley told Healthcare IT News that the assessment period will conclude in May, and the EHR project will go into a critical review phase -- the final step to the project.
At that time, leaders from all four test sites will gather to approve the parts that are working, and get rid of what doesn’t.
The Cerner project will serve as a model for the Department of Veterans Affairs’ own EHR implementation. That contract is expected to be signed soon.