Navigating the Journey to Implementing a Modernized EHR

Jeff PlummerJeff Plummer is a retired Navy Captain and senior healthcare executive with 31 years of diverse experience and extensive success as Chief Executive Officer, Chief Operating Officer and Senior Corporate Executive for the Military Health System (MHS).

He concluded three decades of active duty service as the key architect of U.S. Navy engagement strategy during the unprecedented changes in the MHS that lead to the creation of the Defense Health Agency and MHS governance. He joined the team last summer as the Chief of Medical Business Systems.

Jeff shared his thought leadership on a wide range of topics important to the partnership during a recent visit to the Vienna, Virginia office.  And we learned how his passion for the water has been an undercurrent in his life’s journey. 

Of your many healthcare leadership experiences and military assignments, what’s most transferable and valuable to the execution of the Chief of Medical Business Systems position you now hold within the partnership?

The Military Health System (MHS) is a complex system of systems. Throughout my career in military medicine, I am grateful for the opportunity to have served in several senior leadership positions in MHS.  During each of those experiences there was one activity that served me well in numerous settings: listening to people at all levels of an organization, asking questions and talking with them in their spaces as they work, and then communicating back, up and across the things that I learned and what it means to our mission.  In the partnership, we work in a very matrixed way that requires a skill in listening and communicating across the many work streams and stakeholders.  These same type of executive communication skills will serve us well no matter where we sit.

Communication of what we do (the mission), where we are going (the vision), and how we will get there (the strategy) empowers an organization for success.

Uniquely in the military, we were charged to command a hospital with turn-over of one third of our staff every year. That degree of change, coupled with the diversity of the people – in both skill and background – working together to provide healthcare to service members, their families, and civilian employees – requires simple, clear communication.

Whether you are building a hospital or installing a new computer system, change of this magnitude requires that leaders at all levels communicate in a way that creates the behavior in people to make that change stick.

What is your primary role on the project and what do your responsibilities entail?

My primary role is Chief of Medical Business Systems, which brings a functional perspective to our diverse teams of experts in engineering, design, testing, and program management, especially related to the unique environment where our people will be working as we deploy MHS GENESIS to the field.

Much of the beginning phases of the project were an engineering effort – taking the commercial, off-the-shelf product and configuring it for our new client.

I’m a healthcare administrator by experience; a user of information technology vice an implementer.  Leidos and partnership leadership recognized a need for people like me with experience in MHS operations to help shape development and deployment activities as we navigate the phases of this complex program, and then to collaborate with the DHMSM PMO and MHS stakeholders during the journey.

Knowing and teaching others about how the MHS operates helps members of our partnership learn relevant situational awareness across the projects they support, such as the Revenue Cycle Expansion Project, Referral Management 2.0 Project, and the HealtheIntent data management and reporting project.  Ultimately, I see my responsibility to facilitate adoption and the realization of the full benefit of industry best practices, which lays the groundwork for program success beyond implementation.

What improvements to health outcomes for both the patient and provider side do you foresee with the implementation of MHS GENESIS?

In my view, the program is operating remarkably well given the size, scope, and scale of the effort.

One of my goals is to help the partnership and the government move beyond implementation to where we really start to experience the value of this modernized EHR.  For patients, that means collectively working to simplify how they access care and navigate the system.  While MHS GENESIS is a best of suite tool, it is the people and their processes that must drive how we use the tool, and that takes leadership.

For our providers, our focus needs to be on augmenting their clinical skill with a tool that delivers evidence-based outcomes in an efficient manner.  MHS clinical staff need to be confident that their diligent commitment to document electronically in the EHR will be repaid in the value of the information they get out of the system to drive improvements in patient outcomes.  Leading that type of change goes beyond the buttonology of operating a new system. Leadership is change management in action, and that’s what it will take across the entire program to succeed after go-live. 

What do you feel is the greatest strength of the Partnership?

The team began working together two years prior to award.  There is a trust at the leadership level and a complement of government and commercial healthcare experience augmented by teammates who have served for decades in military health.

In my view, that’s our greatest strength – a collective willingness of the partnership to work together to solve problems and focus on our customer rather than individual corporate goals. A program of this complexity and scale requires a team designed to deliver. And this team is uniquely able to meet the challenge.

Having served at six of the DoD’s military treatment facilities (MTFs), and as a senior executive at two of the Navy’s MTFs, what, in your opinion, is unique about implementing electronic health records in a military setting versus the private sector? Does the military environment create any particular challenges for EHR implementation?

The American healthcare system is very complex and our MTFs operate within the same framework as all other U.S. hospitals.  In addition, they have the added complexity of concurrently operating a military command and training the active duty staff for an operational mission, where a significant portion of staff could be deployed in a moment’s notice. No private sector client implementing the Cerner or Henry Schein One software comes close to the depth of that complexity.

In the military model, the patients don’t really pay for their care. It’s provided as a benefit.   It’s not about money, it’s about taking care of the patient.  We don’t have to worry about the insurance and the money as much in our setting.

The other thing is that our providers, nurses, corpsmen, and medics are taking care of patients and delivering a benefit while they’re training for their wartime mission.  They sometimes leave for six to 12 months at a time where we are called to deliver good medicine in dangerous places.  That’s the big difference.

So the challenge for EHR deployments (or any big change effort) in the MHS setting is optimizing the commodity of time for staff members who are busy delivering healthcare, AND sharpening their skills at the rifle range, training on deployable platforms, maintaining heightened physical standards like an athlete, while also trying to live a meaningful family life. Again, their commodity is time, so we must be laser-focused on the time we demand of them to learn and adopt the system.

As the MHS GENESIS program matures, what impact do you think it will have on the commercial health industry?

With the MHS GENESIS project we can impact the way the country looks at the use of clinical data to make population health decisions.

American medicine is very fragmented.  We have an incredible amount of data: we are data rich, information poor. I think that this project can be a model for how the nation looks at integration and data.

Two federal agencies – two of our nation’s largest healthcare systems – are going to use the same electronic health record and the same data repository/warehouse – HealtheIntent. If we are successful at driving the user adoption necessary to efficiently get clinical information into the EHR, and as a result leverage that information to make optimal decisions to improve the outcome of care, then MHS GENESIS can become a model for how the U.S advances our healthcare system by creating clinical knowledge “in executable form.”

I genuinely believe that if we stay focused on outcomes, this program will become a national model and framework for reducing fragmented care, improving patient safety, advancing population health, streamlining healthcare operations, and improving the work environment for healthcare professionals across our complex industry.