Information about patients’ health care isn’t always accurate or complete in the Defense Department’s new electronic records system, according to a survey of defense health care providers conducted by the Inspector General’s Office.
These digital records allow providers to share a patient’s information with other providers — both within and outside the military health care system. But mistakes and lapses have had an impact on doctors’ ability to provide quality patient care, according to the IG.
Nearly 58% percent of the survey respondents expressed concern with the accuracy and completeness of the electronic health records, auditors found, according to a May 5 management advisory report. Conducted in October and November 2020, the survey reached 7,378 health care providers at eight military treatment facilities. Of those, 701 providers — 9.5% — responded. Among the findings:
- 260 providers identified inaccurate or incomplete DoD patient health care information in the Military Health System Genesis electronic records system.
- 172 providers identified inaccurate or incomplete VA patient health care information in MHS Genesis.
- 248 providers identified inaccurate or incomplete information in other systems used by providers to get a patient’s health care records.
In his response to DoD auditors, Army Lt. Gen. Ronald Place, director of the Defense Health Agency, stated that health officials worked on improvements to MHS Genesis throughout 2021, performing two major commercial system upgrades and creating 13 new capabilities.
That team also resolved more than 3,500 trouble tickets submitted by Genesis users, which resulted in 1,393 “user-directed” system changes, he said.
Place said DHA has already started working with health care providers to assess how the system is working for them and to determine whether the concerns highlighted in the IG survey still exist. For those that do, DHA is developing a plan to address them, he said.
DoD began implementing MHS Genesis at military medical treatment facilities in 2017. By December 2021, Genesis was being used at 49 of its 490 MTFs, according to auditors. DoD plans to complete the rollout of Genesis to all of its MTFs by 2023.
The digital records contain a patient’s up-to-date medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory and test results. They allow access to clinical tools, such as real-time reporting, that providers can use to make decisions about a patient’s care, and they are supposed to automate and streamline work to provide timely, effective treatment.
Some 94% of the providers who responded to the survey said inaccurate or incomplete patient health care information affected their ability to provide quality care. About 40% said it led to inaccurate, delayed or incomplete diagnosis; 35% said it resulted in longer patient visit times; and 25% reported that patients had to make more visits than might have been necessary to complete their care.
Of the 145 respondents who reported using medical devices (such as radiology equipment) to provide care, 56 percent said these devices sometimes transferred inaccurate or incomplete information to MHS Genesis. Not all medical devices interact with MHS Genesis.
”These devices/viewing systems (i.e., radiology) do NOT ‘connect’ to [MHS Genesis],” wrote one provider. Said another, “ … the process to get medical devices connected is CONTRARY to 21st century health care delivery. We just choose to ignore that equipment isn’t connected.”
Auditors noted that one of the limitations of the survey was that “a non-response bias” most likely existed because health care providers who haven’t had significant problems using MHS Genesis were less likely to respond.
“As a result, it is more likely that we heard from respondents who had significant problems with using MHS Genesis,” they wrote. “Consequently, the survey results are likely to be biased toward those who have problems.”
Karen has covered military families, quality of life and consumer issues for Military Times for more than 30 years, and is co-author of 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, Fla., and Athens, Ga.