Three years ago, the world braced for the impacts of an unforeseen global pandemic. While this time proved challenging, it also highlighted the Department of Defense’s flexibility, resilience, and innovation in the face of a health care crisis.

Prior to the pandemic, the DOD began deploying MHS GENESIS, the new federal electronic health record, to improve health care outcomes for our service members, veterans, and their families. Critical enterprise needs quickly came to light to combat the impacts of the COVID-19 disease.

The Enterprise Intelligence and Data Solutions program management office quickly built population health management capabilities. EIDS and the DOD Center of Excellence for Trauma Joint Trauma System office established the COVID-19 registry.

This new registry collected COVID-19 patient data—including vaccination data—from MHS GENESIS and all relevant legacy systems into one patient view. JTS brought more than two decades of trauma registry experience to this effort. The new registry began collecting COVID-19 data in May 2020.
According to U.S. Air Force Col. Stacy Shackelford, JTS chief during the pandemic and clinical lead for the COVID-19 registry, "Data from the registry, although not perfect, filled a knowledge gap that improved leadership awareness of the effects of the pandemic within the DOD and guided clinical practice."

JTS and EIDS tracked clinical performance improvement metrics and trends throughout the pandemic. The COVID-19 registry did not replace the public health functions of tracking total numbers and patient contacts. The registry allowed DOD to monitor evolving treatment priorities and critical at-risk patients more closely, while tracking surveillance data on all identified COVID-19-positive patients.

Prior to the pandemic, COVID-19 data standards did not exist. Thousands of providers across the world coded COVID-19 tests and diagnosis codes differently until the clinical community established coding standards and common reporting protocols. The lack of COVID-19 data standards, use of different electronic health records, and reporting of laboratory results in the notes section of a patient’s record made it difficult to search for one name or one code to obtain a comprehensive list. This disparate reporting caused another problem in standardization which the COVID-19 registry aimed to resolve.

The COVID-19 registry, built on the best available data definitions and codes at the time, was stood up within approximately 60 days of defining initial requirements. As the data matured, the COVID-19 team remained flexible, continuously evolving their analytics to include nomenclature in the manner captured.

“The COVID-19 registry is a success story for our team. It demonstrates our ability to standardize and be flexible and nimble to any impending health care crisis,” explained Shackleford. “Most importantly, our systems pivoted quickly, leveraging existing capabilities and creating new capabilities to support the needs of this once-in-a-lifetime pandemic.”

The COVID-19 registry is a useful tool, allowing population health officials to look at treatments and outcomes. Used in conjunction with other larger data sources, it enables improved clinical decision-making and better patient outcomes.

According to Chris Nichols, program manager of EIDS, “We are proud to have partnered with JTS experts to create a solution that refined reporting variance and standardized accounting across data sources around COVID-19 providing actionable pandemic response insights.”