June 02, 2025 | By Robert Hammer, OASD for Health Affairs/Military Health System
Interoperability is one of the biggest challenges facing service members and veterans in their lifelong health care experience, Dr. Stephen Ferrara, Acting Assistant Secretary of Defense for Health Affairs, said recently to a group of military and veteran healthcare leaders.
To address this, he said the Department of Defense’s ongoing collaboration with Department of Veterans Affairs, Department of Health and Human Services, and other federal partners remains vital to improving continuity of care for service members. “We are all focused on a mission that cuts across every sector represented: Delivering smarter, integrated, and data-driven health care for service members, veterans, and their families,” he said.
“This is more than a technical conversation—it’s an operational imperative,” he continued. “The nature of warfare is changing. So is the nature of care. From polytrauma and blast injuries to long-term behavioral health challenges and environmental exposure risks, the people we serve need a healthcare system that is resilient, proactive, and agile enough to adapt in real time.”
Addressing the complexities of the MHS, Ferrara stressed, “Our purpose remains constant: To deliver world-class, operationally relevant, and future-ready health care—not just in hospitals and clinics, but on ships, in operational medical units across combat zones, and increasingly in the digital space.”
He talked about the urgency of having “a single, secure electronic health record across all military treatment facilities—one that spans operational, deployed, and garrison environments.”
In 2024, DOD completed a seven-year, multi-billion dollar project to deploy MHS GENESIS at all military hospitals and clinics as the DOD’s single electronic health record. “This is the backbone of a connected system that allows service members’ medical history to follow them from basic training to the battlefield and ultimately into the VA EHR system,” Ferrara said.
MHS GENESIS will ultimately provide a seamless healthcare experience for service members moving from the MHS to the VA by providing “access to their complete clinical history, from battlefield treatment notes to neuroimaging records, and mental health encounters.”
“That is not just a matter of convenience; it is the difference between proactive, effective care and fragmented follow-up. It is also how we ensure that we are supporting the warfighter beyond the battlefield, providing continuity of care that spans service and system boundaries,” said Ferrara.
Ferrara noted three areas of focus to modernize the EHR experience:
- Artificial intelligence-powered decision support tools to identify early signs of posttraumatic stress disorder, traumatic brain injuries, and suicide risk
- Remote monitoring systems for chronic disease and post-operative care
- Expanded virtual health capabilities that allow surgical consultations from deployed hospital units and behavioral health visits from remote duty stations
He said with these capabilities, it would allow the MHS to “deliver care in what is being called the ‘fourth space’ of health care—beyond hospitals, clinics, and home. In this new digital space, information moves faster than geography, connecting care teams and patients across domains, countries, and conflict zones.”
Ferrara said that digital integration is crucial “so we can help our warfighters even when they are in the farthest corners of the globe. Integration helps us maintain clinical currency, train the next generation of military medical professionals, and support real-time care in dynamic environments.”
Taking advantage of the “vast and growing health data available” is vital, he said, by “not just documenting what has happened, but to anticipate what is next. We are now moving from health data collection to data-informed readiness.”
Ferrara discussed the integration of wearable technology to assess “warfighter performance and injury risk,” as an example of how the MHS is leveraging this health data for “real-time tracking of sleep patterns, heart rate variability, and exertion, combined with clinical records, to help flag early indicators of musculoskeletal injury or psychological stress.”
He described how the MHS is leveraging machine-language models to identify potential patterns that may exist and tie into common events experienced by service members, which was previously impossible, such as the individual longitudinal exposure record. “ILER is a critical tool allowing clinicians to access personalized exposure histories at the time of care, while simultaneously supporting population-level research on long-term outcomes like cancer or neurodegenerative disease,” said Ferrara. “The point here is not simply about having data—it’s about building systems that translate data quickly into insight and action, delivering better outcomes at the point of care and across the care continuum.”
He added, “This is how we support the warfighter not just during deployment, but across a lifetime, and how we strengthen our healthcare chain with evidence-based policy, clinical guidance, and surveillance systems that endure.”
Collaborating for the Future
He advocated for the need to create partnerships with government, academia, and domestic and foreign partners to ensure future readiness and healthcare innovation. “None of this work can succeed in silos. Our public-private partnerships are essential—not just for developing new tools, but for testing, scaling, and governing them responsibly,” said Ferrara. “We are deeply engaged with the VA, Health and Human Services, and other federal partners to create interoperable platforms and to help ensure continuity of care across the life of a service member.”
He also noted collaborations with NATO, allied medical forces, and humanitarian organizations “support interoperability during coalition operations and disaster response.”
“Domestically, we rely on civilian trauma partnerships, like the military-civilian partnership for trauma readiness, to certify that our providers remain trained in high-acuity, high-volume trauma care. These partnerships directly improve our operational response to mass casualty incidents and combat situations.”
He emphasized the need for the MHS to be “laser focused on thinking about fighting the next war, not the last war.”
“The mission of the MHS is clear,” he continued, “Deliver a truly integrated, digitally enabled, globally partnered system of readiness and care.”
“It is a future in which data is no longer a barrier, but a bridge. That is the promise of our work. And that is the path we are walking together to support the warfighter, sustain our skills, and strengthen the healthcare chain that unites military, veteran, and civilian care.”
