MHS GENESIS' patient portal is rapidly increasing in size, capability and usability.

Features gaining in popularity include a health library, provided by corporate partner Healthwise, said Air Force Lt. Col. John DaLomba, solution owner for the MHS GENESIS patient portal, at the Defense Health Agency, or DHA, in Falls Church, Virginia.

"People can look up pretty much anything that they want" such as knee pain or diabetes, he said. "It's really quite good, and quite extensive."

But the portal's "best feature, in my opinion, is the secure messaging," said DaLomba, who is also an occupational therapist. "You can exchange secure information with your provider or provider's team, and all the communication takes place within the electronic health record program. You have exactly what was conveyed - there's no opportunity to misconstrue what was typed in."

Older MHS GENESIS communication systems were limited to a member's primary care physician. The new portal system allows communication with an empaneled provider or specialty clinic and their teams of professionals with authorized access. That last part is important so that communications go to a "message pool," and don't just sit unopened in an inbox if a provider is unavailable.

The tool allows communication with certain civilian health care professionals, too, and decreases the need to use a fax machine, DaLomba said. He added that there are more new features coming for the patient portal but couldn't give an exact timeline because of the need to work out licensing and acquisition periods.

Meanwhile, there is an online scheduling capability for primary care physicians, and patients have the opportunity to view (and print) a lot of information from visit summaries and clinical notes, DaLomba said. Tests and measurements can also be viewed, though there is a built-in 36-hour delay for radiology and lab results, enabling doctors to view the results and prepare to communicate what they mean to the patient, particularly if there is an issue to discuss. For COVID-19 testing results, however, this delay has been removed.

DaLomba has used the MHS patient portal as a provider as recently as last year when he came to the DHA. And he had plenty of experience with the Military Health System's legacy documentation efforts - two separate systems for inpatient and outpatient records. MHS GENESIS, which he started using at Travis Air Force Base in California in September 2019, incorporates both.

"It was a big change for everybody to get used to," he said. "Were there challenges? Of course, there were. We were trained and there was plenty of support available. But it went well."

MHS GENESIS has been rolling out in waves around the military; eventually, the entire MHS will transition from the legacy platforms. "It's a very complex deployment schedule, and it's mapped out through the next several years," DaLomba said. The first wave came in 2017, at sites in the Pacific Northwest.

Navy Cmdr. (Dr.) Catherine Soteras (right), Department Head for the Main Operating Room, Directorate of Surgical Services at Naval Hospital Twentynine Palms, California, during MHS Genesis mock “go-live” training in September 2020 (Photo by: David Marks, Naval Hospital Twentynine Palms).

E-visits

Another feature on the patient portal is a COVID-19 "e-visit," a structured, secure screening initiated by patients, which includes a questionnaire that uses "branching logic" (a method that creates a custom pathway in a survey, based on a user's responses). DaLomba noted it also creates a "disposition" for the patient, letting them know if they should report to the emergency room, contact their primary care physician, or take lesser measures.

A report generated by the e-visit is sent to the physician and the team viewing such reports, and a COVID-19 test might then be recommended.

That feature was added early in April 2020, and "has gotten really good utilization," DaLomba said, adding there have been about 4,000 such e-visits. "It was designed to assist, and ... to decrease the number of people traveling to the military (medical) treatment facility (MTF)."

Further, that tool made it possible to make changes to the pharmacy prescription activation process. A visit to a typical military pharmacy involves a two-step process to get medications. First, you check into the pharmacy to "activate" your prescription and only then is the prescription filled. But with COVID-19, many pharmacies adopted a phone activation process to decrease foot traffic, DaLomba explained. From there, a new secure message tool for online activation was developed (also in spring 2020) for the patient portal, though not all pharmacies have adopted this feature.

Another implement in the patient portal kit bag that's coming: an online clipboard, that will enable the MTF staff to send certain paperwork to a patient to fill out before an appointment, which could include a health history, a questionnaire, a behavioral health checklist.

The patient portal, though mobile-friendly for iOS and Android, does not yet have an app to accompany it. DaLomba said an app is under discussion at the moment.

The improvements come on the heels of MHS GENESIS's new "MassVax" program, a large digital record of COVID-19 vaccinations administered to service members and their families that will more accurately track and ensure that the Department of Defense patient population has received COVID-19 vaccinations.