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21 Association of the United States Navy we've got devices that are sitting in our hospitals that are five years old and they're already obsolete, so we may not even have the ability to fix them if they broke. So that's the second cut. e other piece, and this is actually a real driving force, is cybersecurity. When we look at the programs, these apps, and these devices, we have to ask ourselves "are they secure enough? Will they protect the patients' information?" And if we don't have a way of ensuring that they're secure, then those pieces won't be continued. So… that's how we make the determination which of these electronic programs or devices we're going to keep. By doing that, it's helping us drive toward better standardization, less variability, more efficiency, and—what I really like—it really helps us aggregate our supply and leverage our buying power… And then the maintenance, you can see all the benefits of doing it like this… e other thing is that our patients deserve the most modern and cutting-edge tools for their care, so we want to make sure that we're on the leading edge of that. AUSN's membership is made up primarily of Veterans – how will they be affected by these technological changes? Will they still be able to do things like use the telephone to make appointments? We still have the ability to call in and make those appointments. As a matter of fact, we have a lot of different venues. We'll continue to have the Nurse Advice Line where patients can call in… but if they still feel —or if the nurse feels—that they actually need an appointment, the nurse can go ahead and make that appointment for them. Now what you will see—and this is also part of the NDAA – is we're going to standardize how you get those appointments… across the entire MHS. The MHS captures and distributes health care data as well as data from DoD's 430+ health care facil- ities and non-DoD sources. How is DHA ensuring that this data will be protected and kept private when security breaches of personal data have become alarmingly common- place? Is this an area where private industry could be useful? And if not cybersecurity, in what other areas do you think it would be most appro- priate to work with contractors? Given that we're the military, we pay attention to cybersecurity at a heightened level and we set a fairly rigorous threshold for that. [For example], there are not very many commercial entities that have a DoD ATO—authority to operate—or security rating of some kind. MHS GENESIS does. We put them through their paces and we actually had to ask them to change some of their programming in order to elevate their cybersecurity posture. So in terms of protecting our patients' data, not only does MHS GENESIS have that height- ened level of cybersecurity, we're also having it on a network that is extremely secure. You're probably aware of ransomware—it targeted the medical community first. We saw that we were very well-po- sitioned to protect our patients and our patients' data with our [current] system. Now that doesn't mean that this is a steady state— we're constantly testing ourselves to see how well protected our data are. [With regard to contractors and vendors] I've been spending time making sure that we have greater interface with commer- cial and private industry because part of where I think the DHA and MHS need to go is better partnering with people who have solutions that are already in play, have been tested, have got a proof of concept, and then I think the challenge is how we bring that into the [MHS] and give those benefits to our patients. So, I've been going out [as well as my staff ] and talking to a lot of industry representatives to inform my own thoughts on what would be a reasonable and viable solution. We're partnering with DIUx, which is Defense Inno- vation Unit Experimental— Silicon Valley, Boston, and Austin, Texas— not only working with big industry, but also looking for start-ups and entrepreneurs,… because some of these ideas, especially in the digital and IT world, change so rapidly that sometimes the best solu- tions… are coming out of small businesses or start-ups. So we're trying to increase our interface and have those conversations across a wider range. You've served in the Navy for 38 years and seen many changes in the medical treatment our Sailors receive. In your current position, however, you also must think ahead and plan for the treatment Sailors in the future. What are some of the changes—technological or other- wise—you expect to see in the next 10 or 15 years? Where we need to go—and what I hope I'll be able to help make happen—is that our Sailors, our patients, are just better connected all around. And by that I mean being able to look at wearable tech Continued on page 23

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