The Defense Department’s electronic health record program, a part of the Federal EHR Modernization (FEHRM) project, has a goal of replacing and updating legacy IT systems to better maintain lifetime health records under a single common longitudinal health record.  

As of July, the Defense Health Agency deployed MHS GENESIS to 119 parent hospitals and clinics through 19 waves and the Initial Operating Capability. MHS GENESIS is the electronic health record for the Military Health System (MHS) – it provides enhanced, secure technology to manage military health information. MHS GENESIS integrates inpatient and outpatient solutions that will connect medical and dental information across the continuum of care, from point of injury to the military treatment facility.  

More than 164,000 DHA providers are using MHS GENESIS to provide health care to more than 6.6 million potential beneficiaries. Goals of this program include enhancing readiness and safety, developing quality of outcomes to advance objectives, standardizing clinical processes across DoD services and enabling beneficiaries to be fully engaged in health care.  

Patient records that are captured from when a servicemember recited the military oath through their inclusion in the Department of Veterans Affairs improves support for everyone. These electronic records provide greater insight to medical professionals to improve decision-making when it comes to sustained care during deployment, data management during evacuation, and more.  

Their value goes beyond service to the individual. Complete records will provide new insights into population health and the medical readiness of the military and its branches, enabling data-driven improvements. These can include insights into treatments or the impact of factors over the course of an individual’s life and medical needs.  

The DoD EHR program, MHS GENESIS, is a crucial step to ensuring service members, their families and retirees are fully supported by receiving the care and services they need while the DoD maintains the technology modernization journey. From properly treating soldiers on the battlefield to capturing data trends that could impact the entire population, a human-centered design (HCD) approach and proper data optimization are key considerations for a successful DoD EHR program.  

EHRs on the battlefield

For medics on the battlefield or during an evacuation, knowing a soldier’s medical and treatment history, allergies and other details on impacting treatment is mission critical. Accurate EHRs ensure medics are well-equipped and soldiers are treated properly within an emergency and throughout the normal course of duty. However, the battlefield comes with its own unique challenges.  

Low communication and no communication environments are common on the battlefield and impair teams’ efforts to constantly stay in touch and share medical information. Having a system that optimizes data, is designed with this environment in mind, and provides teams with instant updates can enable success, even when communication and connectivity problems occur.  

This starts with a data hierarchy – for example, knowing what key points are imperative during evacuation. During an evacuation, medics can function without access to X-ray scans or deep medical history, but they need the most critical information, like wound location on body, state of servicemember, pain relief provided and known allergies. This information must be prioritized in low/no communication environments.  

Communication and tracking of data must go both ways. Updates from the front line must also make their way back to the EHR system to solidify future care, including logistical information, like when a resupply of materials or tools is needed.   

With a proper data solution in place that provides a 360-degree view of soldier battlefield experiences, medical history and updates, DoD medical teams and leaders will have a better understanding of how to properly serve those in need.  

From joining the military ranks to VA  

EHRs’ impact shouldn’t be limited to time in service but follow individuals from initial entry to the military throughout their lives. This also includes soldiers recovering from an injury or illness sustained during deployment.  

Without tracking servicemembers’ health data appropriately, missing medical history could result in poor experiences, ranging from prescribing an inappropriate medication or simply asking questions that the physician could have already answered. Substandard tracking leads to bad experiences for servicemembers, in turn deterring their trust in government services.  

Best serving the warfighter throughout their military lifecycle starts with a human-centered design-based journey map. Creating this map requires an examination of what a soldier or veteran may experience throughout the course of their service. This process enables medical professionals and DoD leaders to plan for critical moments and ensure IT systems are designed to support them.  

EHRs and data possibilities  

It’s clear the DoD’s EHR improvements aid service members, their families and retirees, but this wealth of health data, when anonymized, provides insights on population health that aren’t available elsewhere. These insights are only available through proper data optimization.  

Data optimization requires a focus on efficient data extraction, analysis and storage. When it comes to patient tracking, defense teams will need to extract essential data for analysis of trends in care and health-related topics on the battlefield, to help medics react faster and with more accurate information in the future.   

Starting with a journey map based on an HCD methodology is crucial. This approach can enable the data to be used for insights beyond individual medical treatment, including how a researcher may use this data to inform how it’s stored or what groups can access it.  

Storage often requires a blend of on-premises and cloud environments to allow DoD teams to access and update data whenever needed while maintaining security and privacy. Data must remain secure, following security requirements set forth by the DoD, the National Institute for Standards and Technology, the Office of Management and Budget, the White House or other IT-focused mandates to support consistency from service to the VA.  

As the current leaders in DoD continue to develop and deploy the EHR systems across units, medical facilities, branches and more, it’s critical to understand why this IT modernization project is important and approaches that will make it most effective at each step. Not only does it support today’s soldiers, but it impacts veterans and their families for years in the future.  

Adam Byer is chief delivery officer at iTech AG. 

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