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Defense Health Agency leaders dominant at annual conference

Air Force Maj. Gen. Lee Payne, assistant director for the Defense Health Agency's Combat Support Agency, speaks during this year's Healthcare Information and Management Systems Society Global Conference and Exhibition. The annual HIMSS event was held at the Orange County Convention Center in Orlando, Florida. (MHS photo) Air Force Maj. Gen. Lee Payne, assistant director for the Defense Health Agency's Combat Support Agency, speaks during this year's Healthcare Information and Management Systems Society Global Conference and Exhibition. The annual HIMSS event was held at the Orange County Convention Center in Orlando, Florida. (MHS photo)

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Combat Support | Military Health System Electronic Health Record | MHS GENESIS

Several Defense Health Agency leaders spoke at this year's Healthcare Information and Management Systems Society Global Conference and Exhibition. The annual HIMSS event was Feb. 11-15 at the Orange County Convention Center in Orlando, Florida.

Air Force Maj. Gen. Lee Payne, DHA's assistant director for Combat Support Agency, gave the preconference keynote presentation Monday, Feb. 11. Payne spoke about the challenges and opportunities involved with implementing Section 702 of the National Defense Authorization Act for Fiscal Year 2017. It calls for DHA to assume control from the military departments of all military treatment facilities across the Military Health System. The first phase began Oct. 1 with the hospitals and clinics at Fort Bragg, Pope Field, and Seymour Johnson Air Force Base, North Carolina; Naval Air Station, Florida; Keesler Air Force Base, Mississippi; and Joint Base Charleston, South Carolina. Payne also provided a thorough overview of the DHA mission. Also Monday, Army Col. John Scott, DHA's data manager, spoke about data dynamics.

Pat Flanders, DHA deputy assistant director of information operations, talked Tuesday, Feb. 12, about standardizing, modernizing, and securing health information technology.  To achieve modernization priorities, the DHA needs to move to a more secure, agile, and cost-effective infrastructure provided by shared services. Flanders discussed the primary focus of driving standardization across the enterprise to improve the performance and affordability of health IT operations, and also to enable centralized management capabilities throughout the Military Health System.

He also covered the implementation of Desktop to Datacenter, or D2D, as a critical step in streamlining health IT infrastructure service lines across MHS; cybersecurity concerns, especially for DoD as a target for national security and health care information; and opportunities for improving continuity of care for beneficiaries, who are highly mobile and often receive care from DoD, VA, and private sector health care delivery partners.

On Wednesday, Feb. 13, Dr. Paul Cordts, deputy assistant director for medical affairs, discussed the clinical quality and patient safety considerations of adopting electronic health records. He also covered the practical considerations of integrating electronic health records into patient care workflows, and summarized the steps MHS is taking to ensure the adoption of MHS GENESIS improves. He also spoke about how to ensure the outcome of improving patient safety in legacy systems as well as with the rollout of MHS GENESIS across the enterprise.

Cyber fluency was the topic Thursday, Feb. 14, for three DHA leaders: Justin Hodges, chief operations officer for DHA's Cybersecurity Operations Center; Justin Williams, deputy chief operations officer for the center; and Servio Medina, chief of cybersecurity oversight, governance and strategy. The panel discussion covered what it means to be cyber fluent, and identified cyber implications of decisions. It also explained the process behind determining mission objectives and risk tolerance, compared and contrasted business decisions against mission objectives to provide an informed decision, and proposed methods that can be used by session participants to evaluate their own level of cyber fluency.

Other speakers at HIMSS included Stacy Cummings, program executive officer for the Program Executive Office, Defense Healthcare Management Systems. Her presentation, Tuesday, was titled "MHS GENESIS: Transforming the Delivery of Healthcare." Cummings  provided an overview of the initial operational capability phase when the single electronic health record deployed to all four final initial fielding sites in the Pacific Northwest. She also talked about lessons learned and plans for future deployments, and managing user expectations for full deployment.

Approximately 45,000 health information and technology professionals, clinicians, executives and market suppliers from around the world attended HIMSS 19. More information can be found here.

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DHA-PI 6025.32: MHS GENESIS Medical Device

Policy

This DHA-PI establishes Defense Health Agency’s (DHA) procedures to provide key stakeholders’ responsibilities for connecting medical devices to MHS GENESIS; establish clinical expectations for connecting medical devices to MHS GENESIS; provide references for MTFs to use in procuring medical devices that will be connected to MHS GENESIS; and provide process for MTFs to elevate medical device connection issues related to MHS GENESIS.

DHA-PI 6040.04: Guidance for Amendment and Correction of Entries in Garrison Electronic Health Records (EHRs)

Policy

This Defense Health Agency-Procedural Instruction (DHA-PI), establishes the Defense Health Agency’s (DHA) procedures to remove erroneously entered information in the EHRs. In general, these procedures should be limited to Personally Identifiable Information (PII) or Protected Health Information (PHI) pertaining to one person or persons, but entered inadvertently into the record of a different person. These procedures may also be applied to other information (e.g., incorrect adverse diagnosis), as deemed necessary after appropriate review. All efforts to correct documentation errors at the user level should be expended prior to requesting a correction. Patient-initiated requests to correct the EHR must be completed within 60 days of the request being received by the covered entity (the Military Medical Treatment Facility (MTF)), or 90 days if applicable extension requirements are met.

DHA IPM 18-021: Guidance for Immediate Completion and Closure of Open Encounters and Records in Legacy Systems

Policy

This Defense Health Agency-Interim Procedures Memorandum (DHA-IPM), based on the authority of References (a) through (c), and in accordance with the guidance of References (d) and (e): • Establishes the Defense Health Agency’s (DHA) procedures to complete and close open encounters within the legacy systems in preparation for the implementation of Military Health System (MHS) GENESIS. • Identifies and delineates responsibilities associated with completing and closing open encounters within the legacy systems in preparation for the implementation of MHS GENESIS. • Should be used by DoD military treatment facilities (MTFs) to update procedures and workflows that pertain to the DoD Health Record Management, Patient Administration, and other MTF functions impacted by these decisions. • Is effective immediately; it must be incorporated into a DHA-Procedural Instruction. This DHA-IPM will expire effective 12 months from the date of issue.

DHA IPM 18-018: Physical Custody and Control of the DoD Health Record

Policy

This Defense Health Agency-Interim Procedures Memorandum (DHA-IPM), based on the authority of References (a) and (b), and in accordance with the guidance of References (c) through (p): • Establishes the Defense Health Agency’s (DHA) procedures for the physical custody and control of DoD Health Records at all DoD Military Treatment Facilities (MTFs) and the management, monitoring, review, and evaluation of DoD Health Record availability at MTFs. • This DHA-IPM is effective immediately and will expire effective 12 months from the date of issue. It must be incorporated into the forthcoming DHA-Procedural Instruction, “Health Records Management”.

DHA IPM 18-016: DHA IPM 18 016 Medical Coding of the DoD Health Records

Policy

This Defense Health Agency-Interim Procedures Memorandum (DHA-IPM), based on the authority of References (a) and (b), and in accordance with the guidance of References (c) through (s): • Establishes the Defense Health Agency’s (DHA) procedures for centralized oversight, standardized operations, and ensured quality and performance for the coding of DoD Health Records. • This DHA-IPM is effective immediately; it will be converted into a DHA-Procedural Instruction. This DHA-IPM will expire 12 months from the date of issue.

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