TWENTYNINE PALMS, Calif.  –   On Saturday, Naval Hospital Twentynine Palms (NHTP) entered into a new era of military medicine. MHS GENESIS, the Department of Defense’s new electronic health record (EHR), went live, replacing legacy systems CHCS, a medical informatics system dating back to 1988, and AHLTA, a global EHR implemented DoD wide between 2003 to 2006.
The new MHS GENESIS Patient Portal allows TRICARE beneficiaries to exchange secure messages with their care team; schedule medical and (active-duty) dental appointments online; and access notes, labs and medications, and request prescription renewals online.
The implementation of MHS GENESIS began in 2017 in the Pacific Northwest with the 92^nd Medical Group Clinic at Fairfield Air Force Base, Naval Hospital Bremerton, Naval Health Clinic Oak Harbor, and Madigan Army Medical Center first deploying the new electronic health record.
Naval Hospital Twentynine Palms is benefiting from lessons learned during that initial operating capability, or IOC, and the first wave deployment to sites in California and Idaho last year; it’s also the first military medical treatment facility aboard a Marine Corps base to deploy the new system. Since the IOC, the Program Executive Office, Defense Healthcare Management Systems, and its DHA partners have changed the training strategy, created a new change-management process, and implemented infrastructure and bandwidth improvements.

Marines from 11th Marine Regiment, 2nd Battalion, 1st Marine Division aboard the Marine Corps Air Ground Combat Center, report to their battalion aid station for flu shots. (Photo by David Marks, Naval Hospital Twentynine Palms)
Navy Lt. Cmdr. Michael Berge, NHTP Radiology Department head and team leader (clinical) for the NHTP MHS GENESIS Migration Team, noted that preparation for implementation has been underway for the past 18 months. “It was a well-organized consolidated effort with many partners from many organizations coming here to support us,” Berge said. “The Twentynine Palms staff who were here overnight converting our legacy systems to MHS GENESIS did heroic work. As of this morning, we are up and running; the hospital staff are getting acclimated and they are very excited,” Berge said.
A Saturday morning ribbon-cutting ceremony was held at the hospital’s front entrance with the ribbon stretching between two MHS GENESIS portable work stations. Navy Capt. Lynelle Boamah, a pediatrician, remarked: “I took my last MHS GENESIS training class yesterday. It was actually kind of fun.” Boaah serves as hospital director and Navy Medicine Readiness and Training Command Twentynine Palms commanding officer.  
Marine Corps Sgt. Maj. Jason Gillespie, sergeant major for the Marine Air Ground Task Force Training Command, Marine Air Ground Combat Center, and his wife took part in the ribbon-cutting ceremony. The Palm Springs Bob Hope United Services Organization supported the event with coffee, donuts, and welcoming smiles at the main hospital and the Adult Medical Care Clinic. Later in the morning, the NHTP Morale Welfare and Recreation Committee continued the celebratory theme and provided NHTP staff with a barbeque.
By Monday, the new EHR had been front-line tested. A new baby had been born on the combined Multi-Service Ward/Labor & Delivery Ward. Navy Lt. Cmdr. Angela Evans, department head, noted that documentation and patient notes went smoothly. “It was just a matter of getting used to the new screens,” Evans said.
At the battalion aid station for the 11^th Marine Regiment, 2^nd Battalion, 1^st Marine Division, administering the flu vaccine provided an ideal opportunity to test MHS GENESIS. “This is the first operational unit to do a mass immunization under the MHS GENESIS system. We have 40 people getting immunizations today. It’s a smaller mass immunization in the grand scheme of things but I think it will be good for us to test the system,” said Navy Lt. Benjamin Briar, battalion surgeon.
Briar noted that he’s getting a lot of support from the MHS GENESIS team, the Bureau of Medicine and Surgery, Naval Medical Forces Pacific, and the Defense Health Agency. “All of the different players are giving us a lot of support,” Briar said.
And where the needle meets the skin, Navy Hospital Corpsman 3^rd Class James Hackney sat at a computer terminal documenting his Marine unit’s immunizations. “The new system is really fluid,” Hackney said. “It’s easy to access. As soon as you watch the vaccine go in, you can be done. So it's really quick and easy."
“This new system is going to make our lives a lot better,” noted Briar.