As all Defense Health Agency-managed military medical treatment facilities implement MHS GENESIS as the standard electronic health record, beneficiaries and their providers will not lose access to their old records.

The Department of Defense Health Care Management System Modernization (DHMSM) program office, which oversees the deployment of MHS GENESIS, will keep beneficiaries' old medical records in the Joint Longitudinal Viewer (JLV) clinical application, ensuring these remain available to beneficiaries through their providers. The app provides an integrated, read-only display of records from the DOD, Department of Veterans Affairs, and private-sector partners in a common viewer.

"JLV is a read-only web application that allows health care providers to create a personalized view of electronic health record data from the federal EHR (MHS GENESIS), legacy DOD and VA health data systems as well as community health partner data in a single, integrated display," explained Holly Joers, the DHA's program executive officer for the DHMS program executive office.

"Functionally, JLV is a dashboard that allows a provider to view a patient's current health records from all of the sources mentioned," she added. "Until the single, common federal record is fully deployed, JLV is the only tool available that provides a longitudinal view of up-to-date health records from all sources."

The JLV app, which can be accessed through MHS GENESIS and offers access to private-sector data, supplements the electronic health records by storing and providing access to legacy data that may not be available within it, said Joers. This is important in providing improved care – giving providers a single view of patients' full histories, thereby reducing risks and costs related to missing information, duplicate testing, or duplicate treatments.

"MTF personnel are trained to use JLV as part of their MHS GENESIS go-live experience," she added.

The First of Many

Fairchild Air Force Base, in Washington, was the first to successfully decommission their legacy EHR system in June, after completing a backup and providing it to local site personnel, a process all MTFs must undergo during their transition to MHS GENESIS.

"We knew here at Fairchild AFB that we were leading the way, bringing health care into the 21st century, and starting the journey to being able to track medical care from the field all the way through the Department of Veterans Affairs experience," said Air Force Lt. Col. Brandon White, chief of medical staff at the 92nd Medical Group at Fairchild AFB. "It was exciting, even though we knew it was going to be full of yet unforeseen challenges."

The decommissioning followed completion of a series of steps in late 2020 and early 2021 to consolidate all beneficiary medical records into one system before migrating fully to MHS GENESIS. Standardizing military medical health records is particularly important for service members, veterans, and their families.

"Not only do beneficiaries move often in comparison to the civilian world, but so do providers and the medical staff," explained White. "Standardizing the medical record system and how it is used makes for an easier and safer transition when these moves occur from base to base as well as from the DOD to the VA."

And although the process takes time, organization, and patience, the long-term outcome facilitates maintaining a medical ready force and a ready medical force.

"Being able to review medical records from deployments as well as from any VA medical facility allows for more accurate and safer care," White said. "Utilizing mass vaccination and mass readiness tools within the new EHR allows for quicker and more standardized care, which leads to improved outcomes."

Madigan Army Medical Center, on Joint Base Lewis McChord, outside Lakewood, Washington, followed suit Sept. 21.

Madigan officials said the effort to fully decommission the legacy systems and transition to MHS GENESIS is a milestone, marking progress in the Military Health System/DHA efforts to modernize its health care delivery system.

According to White, lessons learned at Fairchild AFB include "being open-minded."

"Change is never easy, and working through the challenges with such a large change has been difficult," he said. But "knowing that the product allows for better continuity and safer care going forward makes it exciting."

"This is a journey to improving medical care and the documentation that goes along with it," he added. "There are unique challenges within military medicine that the current civilian EHR has not previously seen. Being able to identify these challenges and be a part of finding the solution will go a long way in the satisfaction of using the new EHR and the safety for our beneficiaries."

As of September 25, DHA has transitioned 47 MTFs to MHS GENESIS. The 2017 National Defense Authorization Act directed the MHS transition, administration, and management of all MTFs to DHA.