From poor user satisfaction to integration challenges, the Department of Defense’s (DoD) new multi-billion dollar electronic health record (EHR) system faces several barriers that affect its implementation and efficiency, according to a new Government Accountability Office (GAO) report.
In the last few years, the DoD has taken major steps to modernize the EHR system it uses to manage patient health information. This effort led to the deployment of its new Federal EHR system MHS GENESIS, with the final system deployment taking place last month.
However, while the new system is intended to transform health service delivery, user satisfaction rates for the new system were lower than that of users of DoD’s legacy systems and private-sector users.
“Although user satisfaction levels are below those for its other relevant systems, DoD has not yet established satisfaction goals. Without goals for improving user satisfaction, the department will be limited in its ability to measure progress, plan for improvements, and ensure the system meets users’ needs,” the report reads.
GAO recommends that the DoD direct the Defense Health Agency Health Informatics “organization in conjunction with the Program Executive Officer of Defense Healthcare Management Systems to establish MHS GENESIS user satisfaction targets and ensure that the system demonstrates improvement toward meeting those targets.”
GAO does acknowledge that DoD’s Program Executive Office implemented an issue management plan to address key issues affecting MHS GENESIS. However, the plan does not sufficiently address all the challenges DoD’s EHR system faces.
For example, the plan has failed to address problems that the system dental module —Dentrix — continues to face.
“These problems, which began in 2018, continued to plague Dentrix through January 2024. This led to DoD elevating the issue to a severe level and deciding to identify Dentrix alternatives. However, DoD does not yet have a plan or schedule for identifying alternatives. Until the office resolves the Dentrix issue, the new Federal EHR will not provide critical functionality to dentists who treat DoD beneficiaries,” according to GAO.
Additionally, the final system deployment took place in March 2024 at the Federal Health Care Center (FHCC), a joint DoD and Veterans Affairs (VA) facility. The DoD and VA completed the 35 critical tasks and milestones required to implement the new system at the joint facility, but the departments have opportunities to further integrate their systems.
According to GAO, DoD and VA began a process to resolve differences between their respective workflows and EHR configurations to increase integration, but their approach is insufficient.
“The process did not result in a fully integrated approach due to reasons such as legal and policy barriers,” the report says. “Until it addresses these barriers, DoD and VA will likely not meet the integration goal established for the Federal Health Care Center.”
Specifically, GAO recommended that the VA and DoD “direct the Federal EHR Modernization Office to identify and address specific barriers to maximizing integration at the FHCC, consistent with the FHCC executive agreement.”
In written comments included in the report, the DoD and VA agreed with GAO’s recommendations.
