Healthcare Records System

An information system aims to convert data into information to produce knowledge that can be applied when making decisions (Roch, 2022). Because they assist organizations in improving population health, biomedical and health informatics plays a particularly significant role. Over 205,000 military healthcare staff worldwide and 9.5 million beneficiaries of the Department of Defense (DoD) use the electronic health records system MHS Genesis (Woody, 2020). It is a server-based information system that users can access at any moment from anywhere around the world using laptops, desktops, smartphones, and mobile tablets. This system facilitates inpatient and outpatient clinical care services, expedites commercial activities for healthcare providers, and offers unique assimilation of military medical preparedness and mission readiness needs (Woody, 2020).
This information system makes it possible to handle information stored in databases in a more secure, economical, and high-quality manner, an essential concern for the DoD and the military personnel it intends to assist. By removing the necessity for data sharing, Mendez (2019) notes that these cutting-edge capabilities guarantee that the system satisfies the strictest requirements for cost-effectiveness and quality while operating in a challenging security environment worldwide. The system is accessible by patients and healthcare professionals for sending patient portal messages, scheduling appointments, maintaining records, new prescriptions and pharmacy refills, lab operations, radiology imaging requirements, and various supplementary amenities. MHS Genesis offers improved competence and care for medical professionals and beneficiaries.
Characteristics of the Users of the System
MHS Genesis offers veterans, active-duty military personnel, and their families a single health database. The Military Health System (MHS) counts medical care providers, DoD personnel, U.S. Coast Guard personnel, Department of Veterans Affairs (VA) personnel, and their dependents among the system’s users (Martin et al., 2021). These people use this system because the MHS has worked hard to streamline its healthcare system to boost patient safety, lower costs, and improve coordination of care across the MHS and VA due to the rise in healthcare costs in the military. MHS Genesis efficiently monitors clinical decision-making, which lowers healthcare expenditures. It facilitates codified workflows, seamless healthcare delivery, and data standardization to improve and protect the electronic transmission of medical and patient data.
Server-Side Hardware Requirements
Since it is a web and database information system, MHS Genesis employs both on-premises and cloud servers. The number of users needing to access the system and the volume of data gathered for storage determine the hardware requirements. A dedicated server is available in each military base, installed at the medical center, and linked to other facilities in various states over the Internet. The exact server specifications for MHS Genesis are not publicly available. However, a typical Electronic Healthcare Records (EHR) system serving at a similar magnitude as Genesis may require an HPE ProLiant ML350 Generation 10 dedicated tower server equipped with two 2TB SSDs, 64 BG RAM, and a 2.3 GHz Xenon Gold processor. The typical specifications for the majority of military medical facilities which employ the system include this kind of server alongside firewall hardware and network hubs. Without knowing the details of the security hardware, one can presume that each facility uses proxy firewall systems based on the servers deployed and standing military safety protocols. A proxy filtering firewall device works at the OSI model’s application layer. It is installed between distant users connecting to a private or public network over the Internet and the server designated for the network. Each facility requires a minimum of 128-bit encryption and an appropriate data disposal system to comply with the DoD technical criteria for EHR backup (Bhattacharjya, 2021). IT personnel can configure the system for local usage, as information is transferred over the Internet, so a server farm is unnecessary. The corporation that built MHS Genesis, Leidos-Cerner (Mendez, 2019), is the primary support organization hired to assist with system maintenance if something goes awry.
Server-Side Software Requirements
Although MHS Genesis developers designed it for military usage, it has similar server-side software demands as other EHR systems. Security and dependability are crucial system components. The server’s operating system is Microsoft Server 2019. Depending on the platform’s storage and access needs include Citrix Receiver, SQL Application Server, and Exchange Server (Bhattacharjya, 2021). Genesis needs a capable security antivirus program, such as Norton, to protect the server, overseen by the medical facility’s local IT staff. Other than Microsoft SQL and Exchange server, MHS Genesis does not call for any additional database software. If a redesign or update is eventually required, the system design allows it to be adaptable and compatible with various other software.
Client-Side Hardware Requirements
The user needs a desktop computer, laptop, smartphone, or portable tablet to access the program on the client side. For security reasons, access to the system requires a unique username and password or a keyboard with a Common Access or Personal Identity Verification (CAC or PIV) card reader. To quickly access medical records, scanners must read barcodes created by the system and utilized in various clinics, including inpatient wristbands, for patient identification. Label printers are necessary for lab, radiography, and pharmacy amenities. The system also needs a simple paper printer to print particular paperwork, prescriptions, or specified medical records that patients may require for use in subsequent visits.
Client-Side Software Requirements
Citrix Receiver and Citrix Workspace are necessary for the user’s side of the system. While a workstation linked locally to the server utilizes the Genesis direct program to connect to the system, a device operating from afar requires Citrix Workspace and Receiver. Windows 7 or a related Windows mobile operating system must be available on all laptops, desktop computers, smartphones workstations, and mobile tablets. Apple OS computers and smartphones can only use Genesis if the user installs Windows Virtual Machine software, connects a CAC or PIV reader, and configures the reader with the required user certificates.
Features and Usage of the System
When a user, say a patient, logs into the system, they come across a home page with a status bar where they can toggle between Home, Health Record, Messaging, Appointments, Clipboards, and Medication. The home page also features a profile button with a drop-down menu with functions like settings, patient information, help, access logs, get support id, and sign out. Three main features of the home page include Health Record, Messaging, and Appointments.

The Health Record page presents a series of options on the left side of the screen. Under Health and Immunizations, for instance, the patient can review their current immunization medication, which they can also input a request to renew. This page also provides a list of immunizations that the patient has undertaken in the past. The Health Record page also features options like laboratory results and measurements, updated thirty-six hours after the patient has undergone a test; documents, medications, procedures, visit summaries, radiology, pathology, and clinical notes; and a health library. The screen grab below shows the visit summaries feature on the Health Record page, with the user’s sensitive information blurred. Users can download or send their visit care summaries and transition of care documents as needed.

Users can view received or sent messages to their team, care provider, or medical facility on the Messages page by clicking the send message button on their inbox tab. The user must input the provider’s name in the text box under the “To” tab, although they can input a keyword and select from a drop-down list of system-saved providers. The system immediately delivers messages the user sends to the recipient’s inbox. The user must be as precise as possible in their message to avoid any potential miscommunication. The system does not transform sent messages in any way but delivers them as sent. The user can also attach any relevant files they want the recipient to review. The user can additionally access this feature using the send message button on the Home page.

Through the Appointments tab, the user can view their upcoming appointments, schedule a new appointment or view available online appointments, although the latter feature currently only presents a COVID-19 questionnaire. To schedule an appointment, the user selects a reason for their visit from a drop-down menu, as seen in the screengrab below;

The user will then select Request Appointment (Other) Online. On the subsequent page, the user enters the details of the medical provider to whom they would like to send their request, when they would like to schedule the visit, their preferred day, preferred time, and reason for the appointment. This information is vital for the provider to plan appropriately for the visit. The user also inputs their preferred contact method in case a follow-up is necessary. The system uses this information to generate an optimum visit date and time convenient for the patient and their medical provider.

Conclusion
Information systems are of vital importance to any organization. In healthcare, in particular, the accuracy and reliability of EHR systems can mean life or death. MHS Genesis provides modern data storage and records administration tools combined with a thorough workspace that is user-friendly and scalable to accommodate the majority of non-electronic and electronic medical demands. Patients and providers can use most web-based electronic records management systems to maintain records, arrange appointments, and run tests. MHS Genesis expands on this idea by enabling clients, patients, and providers to administer vaccinations, transmit communications, and request prescription drug refills. In the not-too-distant future, patients can also participate in scheduled appointments and order their healthcare requirements through a single application or web page, based on what platform they use to connect to the health system.
 
References
Bhattacharjya, A. (2021, September 3). HIPAA requirements for EHR data backup. MedicalRecords. https://www.medicalrecords.com/2021/09/03/blog/hipaa-requirements-for-ehr-data-backup
Martin, M. M., Petros, M., & Welter, C. (2021). Exploratory case study of barriers and facilitators associated with the pilot implementation of a new electronic healthcare record in the military. Military Medicine, 187(3–4), e486–e492. https://doi.org/10.1093/milmed/usab053
Mendez, B. H. P. (2019, October 28). MHS Genesis: Background and issues for Congress. Congressional Research Service. https://apps.dtic.mil/sti/pdfs/AD1169614.pdf
Roch, S. (2022, February 24). Information systems for business and beyond. Pressbooks. https://ecampusontario.pressbooks.pub/informationsystemscdn/
Woody, E. A. (2020). MHS Genesis implementation: Strategies in support of successful EHR conversion. Military Medicine, 185(9–10), 1520–1527. https://doi.org/10.1093/milmed/usaa184