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The Military Health System Data Repository: Leveraging Closed, Familial-Linked Electronic Health Record Data for a

W Grant Day1, Matthew W Reynolds2, Luke Pittman1

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Summary

The Military Health System Data Repository (MDR) offers a robust, longitudinal real-world data source for diverse research. Its strengths include comprehensive data capture and linkage, though some limitations exist for civilian care visibility.

Keywords:
Department of DefenseMilitary Health Systemelectronic health recordsfamilial linkagefit‐for‐purpose researchreal‐world data

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Area of Science:

  • Health Informatics
  • Real-World Data Research
  • Military Health Systems

Background:

  • The Military Health System (MHS) Data Repository (MDR) is a large, longitudinal real-world data platform.
  • Its structure, strengths, and limitations are not widely understood by external investigators.

Purpose of the Study:

  • Characterize the MDR as a fit-for-purpose data source.
  • Evaluate its utility for retrospective and prospective clinical, epidemiologic, and regulatory-grade research.

Main Methods:

  • Descriptive review of the MHS clinical ecosystem and MDR architecture.
  • Assessment of data streams (direct care, purchased care, enrollment, EHR, pharmacy, etc.).
  • Evaluation of population characteristics, longitudinality, strengths, and limitations.

Main Results:

  • MDR captures data on over 9.5 million beneficiaries with decades of longitudinal information.
  • Comprehensive claims, enrollment, pharmacy, lab, radiology, and clinical note data available.
  • Strong mother-child/family linkage and integration with DoD registries/biospecimens.

Conclusions:

  • MDR offers strengths in closed-system capture, long follow-up, pharmacy data, and regulatory traceability.
  • Limitations include incomplete visibility into some non-TRICARE care and reduced granularity for private care.
  • The MDR is a powerful platform for high-impact military and civilian health research.