The success of health care, especially in the military, depends on the ability of patients to interact with doctors, nurses and providers. And that success in the future will include streamlining and enhancing the effectiveness of electronic devices and the electronic health records that connect everyone, including the consumers of health care.

“Part of the driver for change in the health care arena is going to be our patients,” said Navy Vice Adm. Raquel Bono, director of the Defense Health Agency. “We want our patients to be a part of their health care. The more patients become interested and involved in their health data, the more they’re going to be driving some of the impetus for change.”

That’s why Bono was the keynote speaker during the Armed Forces Communications and Electronics Association (AFCEA) Bethesda, Maryland chapter Health IT Day 2016, a gathering of approximately 1,000 workers, including the Departments of Defense, Veterans Affairs and Health and Human Services, as well as private information technology industry representatives. Bono explained to attendees that interoperability – sharing health information back and forth between providers and patients, from stateside clinics to battlefield treatment centers – is critically important in health care.

“Our patients are very mobile, and the care we can provide to our patients is also very complex,” said Bono, pointing out that interoperability starts within military hospitals and clinics and cited her own personal experience when she was a hospital commander. “If I can’t move to greater interoperability within my hospital walls, it’s going to be a lot harder for me to do that beyond my hospital walls.”

Bono said military members have to be ready to go anywhere in the world on short notice. To help solve the complexity of care with that readiness aspect, Bono pointed to the Military Health System’s (MHS) new electronic health record, MHS GENESIS, as key to helping conversations between doctors and patients, no matter where people are. MHS GENESIS is a single, integrated medical and dental electronic health record for use across the MHS. The commercial-off-the-shelf system is being rolled out starting in February in the Pacific Northwest, with full implementation throughout the system in about six years. “We had a wonderful exchange in building the requirements for this with industry,” said Bono. “It really alerted us to some of the solutions that were out there we were looking for, recognizing that we have some unique challenges with our globally distributed patient population and also our providers and military treatment facilities. We wanted to launch a product that from day one worked for providers, but especially for our patients.”

Bono said the ability to take care of military members and their families relies on the success of MHS GENESIS and making sure it’s fully operational.

“It’s about engaging the patients and having them be part of the team and part of their health care,” said Bono. “

Bono said the level of injuries from the past decade and a half of warfare has been worse than anyone could imagine. But she said the survival rate of those hurt is the highest in the history of warfare. Taking care of the invisible wounds of war, such as some forms of traumatic brain injury, and the impact of those injuries to the families back home, has been more challenging.

“It wasn’t enough just to have all the clinical experts taking care of our wounded warriors,” said Bono. “We realized a critical aspect of taking care of our patients meant involving their support network and their families. Information we were able to share within their network was often times what advanced and amplified the care we were trying to give. We looked at the electronic health record as an enabler for that kind of engagement. We are now able to create shared decision making of that care.”