ACN 097/20 - AUG 2020 HEALTH RECORD TRANSITION TO MHS GENESIS

ALCOAST COMMANDANT NOTICE                                                CANCEL DATE 18 AUG 2021

R 191050 AUG 20
FM COMDT COGARD WASHINGTON DC//CG-11//
TO ALCOAST
UNCLAS //N06010//
ACN 097/20
SUBJ: HEALTH RECORD TRANSITION TO MHS GENESIS
A. Coast Guard Medical Manual, COMDTINST M6000.1F
B. DOD Health Record Lifecycle Management, DODI 6040.45
C. NARA Records Schedule N1-330-10-003 “Service Treatment Records,” February 18, 2010.
D. NARA Records Schedule N1-330-01-002 “Consolidated Medical Records Schedule,” January 30, 2002
E. General Records Schedule 2.7 Item 060, “Employee Health and Safety Records,” December 2017
1. This ALCOAST Commandant Notice (ACN) announces revisions to health records management policy
contained in REF (A) for CG clinics and ashore sickbays that will implement the Electronic Health
Record (EHR), MHS GENESIS. Compelled by the National Defense Authorization Act of 2017, the
Department of Defense (DOD), Veterans Affairs (VA), and Coast Guard (CG) are directed to create
a single EHR for service members, veterans, and their families. The EHR that has been created
as a result of this mandate is called MHS GENESIS. MHS GENESIS and its components provide a
permanent digital record of care for Coast Guard service members, enable a clinical decision
support system for providers, utilize applications that automate patient care functions, and
contain applications that capture workload, performance, and productivity information. The full
implementation of MHS GENESIS will be a multi-year process beginning in 2020 that will
significantly enhance the Coast Guard’s ability to provide high quality care.
2. MHS GENESIS will not only reduce dependence on paper records and allow for interoperability
with DOD and VA, but also connects patients' medical and dental information across the continuum
of care, from the initial point of accessing care to the military treatment facility. Once fully
deployed, the Coast Guard’s 43 clinics, 58 afloat sick bays and 67 ashore sickbays will access
and document health care information in the system. MHS GENESIS provides a modern health record
for the Coast Guard’s active duty, reserve and civilian workforce that facilitates care, meets
records management and security requirements, and interoperates with many care-giving partners.
3. Current deployment at the pilot sites includes roll-out to three clinics and one ashore
sickbay (Base Alameda Clinic, Air Station Sacramento Clinic, TRACEN Petaluma Clinic, and MSST
San Francisco Sickbay) where system implementation and testing are occurring. “Go-live” is
anticipated at the end of Fiscal Year 2020. Segment A follows implementation at the pilot sites
and commences with the Pacific Wave in FY2021 and concludes with the Atlantic Wave by the end
of FY2022. At the conclusion of Segment A, MHS GENESIS will be deployed at all ashore clinics
and sickbays. Subsequent ACNs will address Segment B, which includes radiology and legacy
health record digitization, and Segment C, which includes implementation at afloat sick-bays.
4. Existing policy associated with health services administrative management of paper health
records remains in effect until updated pursuant to the normal directives review schedule,
except where modified herein.Management will not implement any of the changes to the bargaining
unit employees (BUEs) until labor obligation are met.
    a. Promulgation of this ACN updates Chapter 4 of REF (A) to align with REF (B) and to
authorize the use of an electronic health record, specifically MHS GENESIS, as an approved media
for the CG Health Record. The CG Health Record includes component records that are subsets of
the entire medical record for a person. The component records include the Service Treatment
Record (STR), the Non-Service Treatment Record (NSTR), and the Occupational Health Treatment
Record (OHTR). Each component record is a defined subset of the Health Record to serve a
specific purpose. The type of component record is principally determined by beneficiary
category: Service member, federal civilian employee (for occupational health purposes), and
non-active duty beneficiary. With the implementation of MHS GENESIS, CG Health Records are
now media neutral; therefore, the health record may be comprised of both electronic and
paper components that will be consolidated when required and upon disposition. All sites
shall continue to manage paper records as per REF (A) and (B) until such time as all paper
records have been incorporated into an approved documentation management system or have been
appropriately disposed. Documentation of care must be maintained in accordance with the
National Archives and Records Administration (NARA) approved disposition schedules, REF (C)
through (E)), which determines the duration of storage of the Health Record.
    b. A Technical Directive delineating specific procedural guidance regarding the
utilization of MHS GENESIS and maintenance of health records in a hybrid paper and electronic
health record will be promulgated by HSWL SC and published at:
https://cg.portal.uscg.mil/units/hswlsc/SitePages/Unit%20Directives.aspx. Compliance to
MHS GENESIS interim procedural guidance within the TD is required.
    c. Chapter 14 of REF (A) is updated to include policy for MHS Genesis. All CG
healthcare facilities are required to follow all interim policies and procedures that
facilitate the implementation of MHS GENESIS. The HSWL Regional Practice leadership team
shall ensure all health care providers and support staff are compliant to these interim
policies and procedures established by COMDT (CG-11) and HSWL SC.
    d. In instances where specific policy or procedural guidance is absent, the CG EHR
Functional Steering Committee, chaired by the Chief Medical Informatics Officer (CMIO),
will serve as the governance body to determine appropriate policy or procedural guidance.
5. Policies not specifically addressed in this ACN remain in effect. For general policy
and procedural questions during the EHR transition, contact the HSWL SC Medical Administration
Division health records management team: D05-SMB-CGHealthRecords@uscg.mil.
6. POC: LCDR Swati Singh, CG CMIO COMDT (CG-112), 202-475-5211, Swati.Singh@uscg.mil.
7. Released by RADM D. Thomas, Director, Health, Safety, and Work-Life.
8. Internet release is authorized.