The Department of Defense (DoD) has made progress in implementing a new electronic health records (EHR) system, but some challenges remain, the Government Accountability Office (GAO) says.

After the initial rollout, DoD has started a phased deployment for its new EHR system, Military Health System (MHS) GENESIS, and improved system performance. However, DoD identified some defects that remain unresolved. But the department doesn’t have plans for additional testing to address the defects.

Further, system users reported that “training and communication about system changes were ineffective.”


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“DoD deployed the new system to sites in six of 24 planned deployment phases (i.e., waves), which included about 41,600 users,” wrote GAO in a new report. “DoD also improved system performance and addressed issues experienced at the initial sites. Even with this progress, incidents identified during testing—such as system defects—remain unresolved.”

As of May 2021, 288 unresolved incidents remained after DoD took steps to improve performance by closing 422 of 710 incidents identified by the Joint Interoperability Test Command. 142 of the remaining 288 unresolved incidents were classified with an incident priority level of “critical” or “major.”

GAO found that system defects persist and that the implementation of MHS GENESIS faced training and communication challenges. According to GAO, “test results and selected system users indicated that training for MHS GENESIS and the dissemination of system change information were ineffective.”

GAO made three recommendations for the implementation of the new EHR system, all of which were agreed to by DoD, including:

  1. Direct the Program Executive Officer of Defense Health Management Systems to develop an approach retesting the incidents identified by testers to ensure that the incidents are resolved;
  2. Improve the effectiveness of MHS GENESIS training through ensuring its relevance to user roles; and
  3. “Direct the Defense Health Agency Chief Health Informatics Officer to ensure users are aware of system changes and to monitor users’ awareness of changes.”
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Jordan Smith
Jordan Smith
Jordan Smith is a MeriTalk Senior Technology Reporter covering the intersection of government and technology.