MHS GENESIS a force multiplier, one read at a time Published May 17, 2019 By Douglas H. Stutz Naval Hospital Bremerton Naval Hospital Bremerton -- Naval Hospital Bremerton (NHB) and the Air Force 92nd Medical Group are geographically distinct and culturally different, except when using MHS GENESIS to support mission readiness. As well as share – and deliver – timely patient-centered care. NHB was the first site with the Department of Defense new electronic health record in 2018 to provide results of radiology studies completed at one military treatment facility for another. “The 92nd Medical Group at Fairchild Air Force Base sent two radiology studies to NHB using MHS GENESIS, which were read by providers in our radiology department and finalized in about 30 minutes,” said Cmdr. Afshin Afarin, Clinical Support Services director. The relative fast turnaround was an improvement from previous routines. According to Afarin, before MHS GENESIS, Fairchild Air Force Base clinic providers had to either send their patients into town for x-ray service or wait for the clinic to get their results several days after the fact. The 92nd Medical Group would send an x-ray to Travis Air Force Base for processing, with an expected turnaround time of 24 to 48 hours. The entire protocol relied on using multiple electronic systems, with multiple steps, and multiple procedures to finalize. “The process in place with Travis was cumbersome and impeded workflow. It took a lot longer than necessary to interpret the x-rays, formalize a report, and subsequently cut and past the report into another system before seeing the results,” Afarin explained, noting that MHS GENESIS eliminates having to use more than one electronic system which essentially reduces any potential errors, increases reliability, and makes results immediately available to the provider. Although advances in medicine continue to take place all the time, it’s no small exaggeration that such significance with MHS GENESIS for military medicine needs – such as providing timely radiology study interpretations at the 92nd Medical Group - are akin to Alexander Graham Bell’s uttering ‘Mr. Watson, come here, I want to see you,’ the first spoken words over the telephone almost 150 years ago. “This really is huge. Convenience, timely, and expert interpretation are the most significant impacts of MHS GENESIS as a unifying electronic health record and an integrating force multiplier. MHS GENESIS has laid the foundation of real time, collaborative provider to provider consultation on radiology studies, no matter which military department or sector of the world as long as there is internet connectivity. We’re saving money, offering superior radiology reports for ordering providers, and delivering better patient care,” Afarin said. MHS GENESIS allows NHB to ensure 92nd Medical Group providers have results often times under 30 minutes allowing for spot disposition for their active duty and beneficiaries patients. The combined behind-the-scene effort of the Defense Health Agency and NHB Information Management Department has seamlessly integrated 92nd Medical Group exams into NHB workflows to the point that the interpreting radiologist frequently didn’t even realize that the exam was from a remote site. NHB handled 418 x-ray exams for 92nd Medical Group in 2018. “The new electronic health care furthermore allows for safe communication from the radiologist provider and patient’s primary care team, and important access to pertinent patient history,” said Afarin. Initial deployment of MHS GENESIS took place in 2017 at the 92nd Medical Group in February, followed by Naval Health Clinic Oak Harbor in July, NHB in September and Madigan Army Medical Center in October. There were a host of critics, cynics, and contrarians who wanted – and demanded - instant results. “Implementing a new, seamless electronic health record was an enormous undertaking. Naval Hospital Bremerton moved from sustaining several existing electronic health and dental records to employing a new one that consolidates health and dental information into a single record. We took a commercial off-the-shelf product and, along with the Program Executive Office, Defense Healthcare Management Systems, identified areas for improvement within the new system so we could take corrective actions not only for our hospital but to prioritize future enhancements based on the needs of other military treatment facilities. What was key to the success of MHS GENESIS was that we were committed to making it happen,” commented Lt. Cmdr. Bryan Wooldridge, NHB chief medical information officer, and family physician. “Our ability to provide real-time radiographic interpretations for another military treatment facility is just one example of how the new electronic health record is moving us into the 21st century,” added Capt. Jeffrey Bitterman, NHB commanding officer. “A fully integrated EHR and future interoperability with the VA will provide greater continuity for our beneficiaries from accession to retirement.” Making a commitment for those in need is the norm for NHB. NHB’s Radiology Department has a history of providing support to remote sites. NHB MRI (Magnetic Resonance Imaging) technologists immediately responded in 2011 for advanced technology help by sending complex examinations protocols and related instructions for the newly installed MRI machine at Camp Leatherneck, Afghanistan. The MRI was an important addition for the Marine Base in Helmand Province to help diagnose and care for such medical concerns as concussions, at that time the number one most common combat-related injury. From the past on the far side of the Hindu Kush Mountains to across the Cascade Range today, NHB continues to support mission readiness and enhance patient-centered care by applying advanced technology – such as MHS GENESIS – as a force multiplier, one read at a time.