Errors in DoD’s new electronic health records system raise concerns among providers

Patient health care information is not always accurate or complete in the Department of Defense’s new electronic records system, according to a survey of defense health care providers conducted by the Inspector’s Office general.

These digital records allow providers to share a patient’s information with other providers, both inside and outside the military healthcare system. But mistakes and lapses have impacted doctors’ ability to provide quality patient care, according to the IG.

Nearly 58% of survey respondents expressed concern about the accuracy and completeness of electronic health records, auditors found, according to a May 5 management advisory report. Conducted in October and November 2020, the survey reached 7,378 healthcare providers at eight military treatment centers. Of these, 701 suppliers – 9.5% – responded. Among the discoveries:

  • 260 providers identified inaccurate or incomplete DoD patient health care information in the military health system’s Genesis electronic records system.
  • 172 providers identified inaccurate or incomplete health care information for VA patients in MHS Genesis.
  • 248 providers identified inaccurate or incomplete information in other systems used by providers to obtain a patient’s health records.

In his response to DoD auditors, Army Lt. Gen. Ronald Place, director of the Defense Health Agency, said health officials have been working on improvements to MHS Genesis throughout 2021, performing two major trading system upgrades and creating 13 new abilities.

This team also resolved more than 3,500 trouble tickets submitted by Genesis users, resulting in 1,393 “user-directed” system changes, he said.

Place said the DHA has already begun working with health care providers to assess how the system is working for them and to determine if the concerns highlighted in the IG survey still exist. For those that do, the DHA is developing a plan to address it, he said.

The DoD began implementing MHS Genesis at military medical treatment facilities in 2017. As of December 2021, Genesis was in use at 49 of its 490 MTFs, according to auditors. The DoD plans to complete the deployment of Genesis on all of its MTFs by 2023.

Digital records contain up-to-date patient medical history, diagnoses, medications, treatment plans, vaccination dates, allergies, x-ray images, and lab and test results. They provide access to clinical tools, such as real-time reports, that providers can use to make decisions about a patient’s care, and they are meant to automate and streamline work to provide fast and efficient.

Some 94% of providers who responded to the survey said that inaccurate or incomplete patient health care information affects their ability to provide quality care. About 40% said it led to an inaccurate, delayed or incomplete diagnosis; 35% said it increased patient visit time; and 25% said patients had to make more visits than necessary to complete their care.

Of the 145 respondents who said they use medical devices (such as X-ray equipment) to provide care, 56% said these devices sometimes transfer inaccurate or incomplete information to MHS Genesis. Not all medical devices interact with MHS Genesis.

“These visualization devices/systems (i.e. radiology) do NOT “connect” to [MHS Genesis]“wrote a provider. Another said: “…the process of connecting medical devices is CONTRARY to the delivery of healthcare in the 21st century. We simply choose to ignore that the equipment is not connected.

Auditors noted that one of the limitations of the survey was that a “nonresponse bias” most likely existed because healthcare providers who did not have significant problems with MHS Genesis were less likely to respond.

“As a result, it is more likely that we heard from respondents who had significant issues with using MHS Genesis,” they wrote. “Therefore, the survey results are likely to be biased in favor of those with problems.”

Karen has covered military families, quality of life and consumer issues for Military Times for over 30 years, and co-authored a chapter on media coverage of military families in the book “A Battle Plan for Supporting Military Families”. She previously worked for newspapers in Guam, Norfolk, Jacksonville, Florida and Athens, Ga.

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