September 14, 2023

Warren, Blumenthal Seek Information on Military Electronic Health Record System Amid Concerns of Recruitment Delays and Privacy Violations

Text of Letter (PDF)

Washington, D.C.  – U.S. Senators Elizabeth Warren (D-Mass.) and Richard Blumenthal (D-Conn.), members of the Senate Armed Services Committee, sent a letter to Secretary of Defense Lloyd J. Austin III, expressing concerns about the implementation of the contract the Department of Defense (DoD) awarded to Leidos Partnership for Defense Health (Leidos) for the Military Health System (MHS) Genesis electronic health record system, after reports that the use of MHS Genesis may be contributing to delays in military recruiting, creating barriers to accessing benefits information, and invading the privacy of service members and military recruits. 

“Amidst these growing concerns, we request further information about the program’s implementation and urge you to evaluate the impact it is having on recruitment and beneficiaries’ privacy,” wrote the senators. 

In 2015, DoD awarded a contract to Leidos to create MHS Genesis, an electronic health record (EHR) system meant to be interoperable between the DoD and the Department of Veterans Affairs (VA). DoD and the VA began rolling out this system in 2017 and plans to complete its rollout in a series of 23 waves by the end of 2023. In February and March 2022, U.S. Military Entrance Processing Command launched MHS Genesis at all of its Military Entrance Processing Stations (MEPS).  Recruits go to MEPS after they undergo initial screening with a recruiter, take an aptitude test known as the Armed Services Vocational Aptitude Battery (ASVAB), and select their jobs.  

Recent reporting has indicated that senior recruiting officials have raised concerns that the use of MHS Genesis during this process is “making medical screenings longer” and “has added an element of complexity to the accessions process for initial entry applicants”, contributing to unnecessary delays of recruits’ enlistment processes. In some cases, MHS Genesis is delaying the enlistment of individuals with long-healed or manageable injuries. For example, one recruiter reported that a healthy applicant had to wait two extra months to process her application because she had sprained her wrist when she was a child.

Vice Admiral Rick Cheeseman, Deputy Chief of Naval Operations, Personnel, Manpower and Training, reported the Navy’s average processing time from the applicant’s final interview to their first contract increased from 33.8 days to 63.4 days after MHS Genesis was put in place. Even after addressing some inefficiencies, the processing period was still delayed to an average of 59.9 days, almost double the average prior to MHS Genesis’ implementation. 

“These concerns have also been independently verified. The DoD Inspector General (IG) found that challenges associated with MHS Genesis led to ‘delays in medical waiver processing times ranging from 9 to 40 days’ for the Army, Air Force, and Marine Corps. U.S. Army Recruiting Command analysis found that ‘it could take up to 70 days or longer for the necessary consultations required to determine a waiver.’ Although the services overcame these longer review times by prioritizing active duty waiver reviews and reassigning personnel, it is not clear if this is a sustainable solution for the total force. DoD IG also recommended that the Army, Navy, Air Force, and Marine Corps track medically disqualified applicants to ensure they are notified of their options to pursue a medical waiver and to better understand reasons why they may choose not to request a waiver,” continued the senators.  

The senators then expressed concerns about reports that in order to access MHS Genesis, individuals are being asked to provide credit card information – placing an unnecessary burden on service members, veterans, and families who may not have a credit card but have a right to access these benefits. 

Finally, the senators highlighted serious privacy concerns with MHS Genesis. “The Leidos Partnership for Defense Health consists of four core partners – Leidos, Accenture, Oracle Health, and Henry Schein One – in addition to about 30 supporting businesses. In June 2022, Oracle purchased the company Cerner.  Today, the MHS Genesis system is based on a Cerner Millennium product,  and the Oracle Cerner electronic health record system is ‘a key platform used by doctors to access the medical records of current and former military personnel.’  Oracle’s purchase of Cerner has led to privacy concerns that Cerner’s database of patient data could ‘be combined with Oracle’s trove of consumer data to create more complete consumer profiles that then could be used to, for example, help companies develop more targeted advertising.’ Additionally, Oracle faced a class-action lawsuit in 2022 for “deliberate and purposeful surveillance of the general population via their digital and online existence” in its role as a data broker,” wrote the senators. 

Given these concerns, the senators are asking Secretary Austin, who is ultimately responsible for the  implementation and oversight of the MHS Genesis program, to answer a detailed set of questions about MHS Genesis’s impact on military recruitment, access to benefits, and service members’ privacy by October 11, 2023. 

Senator Warren has led efforts to protect service members’ access to health care and military recruiting and retention challenges: 

  • In September 2023, at a hearing of the Senate Armed Services Committee, Senator Warren questioned Chief of Staff of the Air Force nominee General David W. Allvin on the impact and national security risks of Senator Tommy Tuberville’s (R-Ala.) hold on military promotions and detailed how this hold hurts America’s ability to recruit, train, and retain service members.
  • In July 2023, chairing a hearing of the Senate Armed Services Subcommittee on Personnel, Senator Warren called out DoD for wasting billions in taxpayers dollars due to price gouging by defense contractors for services and  in health care, and identified opportunities for cost savings when DoD buys personnel-related goods and services. 
  • In July 2023, Senator Warren sent a letter to Secretary Austin and Director of the Defense Health Agency, Lieutenant General Telita Crosland, regarding a series of DoD Inspector General  reports  finding that DoD is failing to prevent price gouging and overpayments to contractors in the TRICARE health program.
  • In July 2023, Senator Warren opened an investigation into a disturbing report on Google’s confidential effort to secure exclusive access to millions of tissue samples held at DoD’s Joint Pathology Center.
  • In July 2023, at a hearing of the Senate Armed Services Committee, General Charles Q. Brown, Jr., President Biden’s nominee to be the next Chairman of the Joint Chiefs of Staff, spoke to the negative effects Senator Tuberville’s holds on over 250 senior military nominations have on retention across the services and the burden they pose on military families, warning “we will lose talent.”
  • In June 2023, Senators Warren (D-Mass.), Bernie Sanders (I-Vt.), and Mazie Hirono (D-Hawaii) introduced the Junior Reserve Officer Training (JROTC) Safety Act of 2023 to better protect JROTC following reports of program instructors sexually assaulting and harassing high school students. recruits The legislation would also increase oversight of the agencies charged with running the program and prohibit mandatory enrollment of students into the program
  • In May 2023, Senators Warren and Hirono and Representatives Jamie Raskin (D-Md.), Robert Garcia (D-Calif.), Stephen F. Lynch (D-Mass.), Sylvia Garcia (D-Texas), and Chrissy M. Houlahan (D-Pa.), applauded the Government Accountability Office (GAO) for launching a review of the Junior Reserve Officers Training Corps (JROTC) program.
  • In May 2023, at a hearing of the Senate Armed Services Committee, Senator Warren questioned the Secretary of the Air Force about the risks to national security and military readiness posed by the nominations holds. The Secretary warned about “negative impacts” on military families and military retention. 
  • In March 2023, chairing her first hearing of the Senate Armed Services Subcommittee on Personnel, Senator Warren highlighted the importance of addressing existing failures in the Junior Reserve Officers’ Training Corps (JROTC).
  • In February 2023, at a hearing of the Senate Armed Services Committee, Senator Warren raised the importance of investing in the U.S. military’s greatest strength – its military personnel, and committed to defending investments in military personnel and working to address recruiting and retention challenges. 
  • In February 2023, Senators Warren, Hirono, Ron Wyden (D-Ore.), and Sanders sent a letter to DoD and the Department of Education amid reports of students being forced to join the JROTC program.
  • In September 2022,  during a hearing of the Senate Armed Services Committee, Senator Warren questioned top DoD personnel officials on disturbing reports of widespread patterns of sexual misconduct by instructors in the JROTC program, where they admitted DoD’s lack of adequate oversight to prevent sexual misconduct by instructors and ensure the safety of students.
  • In September 2022, Senator Warren, along with Senators Kirsten Gillibrand (D-N.Y.), Richard Blumenthal (D-Conn.), and Hirono opened an investigation into the JROTC program, following  reports of widespread patterns of sexual misconduct by instructors in the program.

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