Defense Health Agency and the deployment of the electronic health record: building an organizational framework for implementation and sustainment

Abstract

This thesis explores the Defense Health Agency's (DHA) implementation and sustainment of the newly acquired electronic health record (EHR). The Military Health System (MHS) is utilizing a disjointed taxonomy of patient health record systems to deliver health services that are cumbersome to both the end users and the health information technology specialists in its use and delivery. The acquisition of the new commercial off-the-shelf EHR in 2016 from Cerner-Leidos-Accenture offers an enterprise solution to the MHS. This advanced IT solution requires detailed, deliberate implementation and deployment planning by the DHA, which will result in the effective, efficient, and economical delivery of healthcare services to Department of Defense personnel. Utilizing a case study approach, the authors conducted interviews at two sites within the DHA EHR deployment footprint and correlated results with the application and research of Kates and Galbraith's star model. The authors conclude that with appropriate change management efforts, communication of strategy and structure, measurement of metrics, and investment in people, the DHA has the ability to implement MHS GENESIS within reasonable schedule parameters and achieve equitable sustainment.