Background: As the Joint United Nations Programme on HIV/AIDS, the Global Fund,
and the US President’s Emergency Plan for AIDS Relief focus on reaching 90-90-90 goals, military
health systems are scaling up to meet the data demands of these ambitious objectives.
Methods: Since 2008, the US Department of Defense HIV/AIDS Prevention Program (DHAPP) has
been working with military partners in 14 countries on implementation and adoption of a Military
eHealth Information Network (MeHIN). Each country implementation plan followed a structured
process using international eHealth standards. DHAPP worked with the private sector to develop a
commercial-off-the-shelf (COTS) electronic medical record (EMR) for the collection of data, including
patient demographic information, clinical notes for general medical care, HIV encounters,
voluntary medical male circumcision, and tuberculosis screening information.
Results: The COTS software approach provided a zero-dollar software license and focused on sharing
a single version of the EMR across countries, so that all countries could benefit from software
enhancements and new features over time. DHAPP also worked with the public sector to modify
open source disease surveillance tools and open access of HIV training materials. Important lessons
highlight challenges to eHealth implementation, including a paucity of technology infrastructure,
military leadership rotations, and the need for basic computer skills building.
Conclusion: While not simple, eHealth systems can be built and maintained with requisite security,
flexibility, and reporting capabilities that provide critical information to improve the health of individuals