The Office of the Assistant Secretary of Defense for Health Affairs maintains two separate management databases, one for inpatients and one for outpatients. They are global in scope and cover all three military departments. The general purpose of these databases is to match health care assets to patient demands. The Army, Navy, and Air Force each have their own health care management databases for the same general purpose. (The Navy provides health care services for the Marine Corps.)
DoD’s global Defense Medical Surveillance System (DMSS) (accessible on the Internet at http://amsa_army_mil) is assigned organizationally to the U.S. Army Center for Health Promotion and Preventive Medicine (USACHPPM) in Aberdeen Proving Ground, Maryland, and is maintained at the Walter Reed Army Medical Center in Washington, DC. It was established in 1994 in the aftermath of the first Persian Gulf War. It is an operational database serving operational needs and is supported by operational funds, but it has proven to be very useful for conducting research. The database receives information according to a specific reporting protocol on every inpatient and outpatient visit to any DoD health care facility worldwide. Every event is to be documented with the appropriate International Classification of Diseases (ICD-9) code. DMSS publishes monthly reports, both electronically and in print, and performs analyses for medical leadership. DMSS also has a component called the Reportable Medical Events System, which publishes monthly reports on communicable diseases in the military of public health significance, in parallel with the civilian reporting system of the Centers for Disease Control and Prevention. DMSS does not link directly to personnel databases; however, it receives data from the Defense Manpower Data Center and other sources, including demographics and occupational data, to permit population-based routine medical surveillance and to answer basic surveillance questions, such as rates by gender, rates for specific deployments, rates by age, and reportable diseases.