DHA Official: Optimization is ‘Future’ of Federal EHR

The Defense Department’s health agency wants to optimize shared data to strengthen patient care as part of its participation in the federal electronic health record modernization (FEHRM), Dr. Yvette Weber, program executive officer for the Program Executive Office at Defense Healthcare Management Systems, said Tuesday during an update on the shared record.

“We are excited with full deployment – 100% use of [common DOD record of medical and dental information] MHS Genesis. We’re just really scratching the surface on a truly rich set of data,” said Weber. “Deployment was our first priority, but optimization is where we’re headed into the future.“

Weber said that Defense Health Agency (DHA) releases two capabilities each year, with the most recent one spanning several platform and infrastructure upgrades. Weber said that the optimization of services spans nutrition management, patient data interoperability and billing interfaces.

“We’re constantly looking at ways to upgrade,” Weber added. “We’re trying to do that at the speed that the users really need these upgrades to happen.”

Weber added that her office is using a continuous improvement program to modernize DHA processes to connect with FEHRM. Agile improvement, she said, is the next step in the patient and provider experience.

“We’re using a continuous integration and continuous improvement program,” said Weber. “We’re constantly looking at ways to upgrade, and we’re trying to do that at the speed that the users really need these upgrades to happen.”

Officials said that EHR relies on usable data to operate and cited programs across government that aid in EHR interoperability. Tara Reavey, chief of the Policy and Program Management section of the DHA Immunization Healthcare Branch, said that the Centers for Disease Control and Prevention’s (CDC) Immunization Information Systems (IIS) Immunization Gateway has been integral in helping clinicians eliminate time spent on administrative tasks.

“The ability to build a more comprehensive immunization record for our patients and the reduction in workload for transcription has been the most-cited benefits for our health care team,” Reavey said. “The ease of access to these digital records through the IIS allows our clinicians to then have timely discussions during their appointment around the immunizations an individual would need based on their health status or age, lifestyle factors or occupation.”

Interoperability is critical

The CDC system is available to providers across different organizations and health systems, making immunization records more easily accessible for patients of DHA and Department of Veterans Affairs clinics, Reavey said. Interoperability is critical for public health analytics and health outcomes, she said.

“Many schools, employers and other health care groups routinely access the IIS system to view immunization data for their populations,” said Reavey. “With DOD and VA now participating, we’re helping remove the burden on our beneficiaries to gather the paper records and then have to transport them to those outside sources.”

Clinicians and health systems need access to usable FEHRM data on-site, in theater and in virtual health settings, Weber said. Combat environments present a specific challenge, Weber said, and DHA is looking to extend the federal EHR to deployed members throughout the world in challenging and sometimes remote situations.

“This is a complex ecosystem and these tools need to work in austere and low- and no-comms environments to be interoperable with one another,” Weber said.

She added that DHA is beginning work on a care delivery platform to connect data and combat environments back to MHS Genesis that will be available for deployment next year.

“We are in the midst of testing our tools through an operational assessment and then operational tests later this year, which will lead to a deployment of our tools in 2025,” said Weber. “When our tools are deployed, we will be able to trace care all the way from role one through role four back to garrison. It’s going to be a phenomenal opportunity to make sure we’re enhancing our patient care.”

DHA is migrating data from FEHRM into the military health information platform to supports data analytics, she added. Better care needs operable data everywhere, she emphasized.

“We’ve turned our attention to optimizing the system and the data that the system provides,” Weber said. “We can really use that to tune the system to make it more usable and a better experience.”