Assessing the Effect of MHS Genesis on Emergency Department and Follow-Up Routine Visits

Abstract

In 2015 the Department of Defense (DOD) purchased MHS GENESIS, an electronic health record (EHR), to modernize and standardize medical and dental records across the Military Health System (MHS). This thesis evaluates MHS GENESIS’s impact on appointment utilization patterns, focusing on emergency department (ED) revisits, routine follow-ups after ED visits, and telehealth visits. Using a difference-in-differences analysis I compare three military treatment facilities (MTF) that experienced MHS GENESIS implementation between 2016 and 2022 to a control MTF. Findings suggests that after the initial 6-month transition period, MHS GENESIS is associated with increases in ED revisits in San Diego and a decrease in 30-day ED revisits at Travis. Decreases in routine follow-up visits and telehealth visits rates are found across Madigan, Travis, and San Diego. Recommendations include continued evaluation of MHS GENESIS beyond the studied outcomes with consideration of other facility performance measures. Further studies should also account for variables such as manning and capability. Ongoing analysis is crucial to assess MHS GENESIS’s continued impact on the MHS as standardization progresses and data integrity improves.