In 1979, the Department of Defense started its journey toward electronic health care documentation with computerized physician order entry which allowed physicians to record prescribed medications and view alerts for drug allergies or adverse interactions

The Composite Health Care System development began in 1988. The Department of Defense's initial health record system made the technological leap from paper to electronic order entry. It also focused on delivering a military treatment facility-centric electronic health record that supported computerized physician order entry and integrated outpatient ancillary services. CHCS worlwide deployment began in 1992.

The Composite Health Care System was deployed worldwide in 1996. CHCS integrated laboratory, radiology and pharmacy; and provided the first hospital-centric clinical support system.

The end of the Gulf War resulted in recognition that an electronic health record was needed. President Bill Clinton directed creation of "a new Force Health Protection program. Every Soldier, Sailor, Airman and Marine will have a comprehensive, life-long medical record..."

The concept of the Composite Health Care System II is born. CHCS II would become the largest system of its kind designed to use structured documentation to collect patient health care information. By 2003, CHCS II deployed to seven facilities for operational testing.

The Composite Health Care System II deployed worldwide in 2004 and was rebranded as the Armed Forces Health Longitudinal Technology Application. Today, AHLTA is still in use in 77 military treatment facilities.

Essentris®, the military’s inpatient electronic health record, was first launched at Landstuhl Regional Medical Center in Germany in 2007 as a counterpart to the Armed Forces Health Longitudinal Technology Application. Essentris provides worldwide documentation of inpatient care for all beneficiaries and a secure, bidirectional data system link for real-time, viewable electronic health information between the Department of Defense and the Department of Veterans Affairs.

Worldwide deployment of the Armed Forces Health Longitudinal Technology Application 3.3 begins. The software was enhanced based on user requests and lessons learned, and improvements focused on upgrading operational availability, speed, provider capabilities and interoperability with the Department of Veterans Affairs.

The services added their own input to Armed Forces Health Longitudinal Technology Application improvements. The Army created the MEDCOM AHLTA Provider Satisfaction program, or MAPS, which made it possible for providers to reduce time required to record notes. The Navy piloted voice recognition and spell check software applications. The Air Force launched the Clinical Optimization Military Provider AHLTA Satisfaction Strategy, or COMPASS, which focused on streamlining the workflow process.

To expedite Department of Defense and Department of Veterans Affairs interoperability efforts, Congress mandated in the FY2008 NDAA that the DOD and VA establish a joint interagency program office to act as a single point of accountability in the development of the electronic health record. As work progressed, it became increasingly clear that the architecture of the Armed Forces Health Longitudinal Technology Application wouldn't provide a suitable platform for a joint EHR. Plans begin for a new EHR. In March 2011, the DOD and VA recommitted to the joint common EHR platform known as the integrated EHR (iEHR).

On Feb. 5, 2013, the Secretary of Defense, Leon Panetta, and Secretary of Veterans Affairs, Eric Shinseki, announced changes in their approach to increasing interoperability between the Departments. Joint actions were identified to accelerate seamless transfer of information across the Departments and replace systems by using a "core" set of applications from existing electronic health record technology. The DOD announces that it is reviewing available commercial and governmental options and the VA decided to use VistA as its core.

The Department of Defense awards Cerner, Leidos, Henry Schein and Accenture the electronic health record contract, and the EHR is branded as MHS GENESIS.

In 2017, the Initial Operating Capability sites go live in the Pacific Northwest with MHS GENESIS. The new, modern electronic health record for patients and health care professionals is designed to transfer a beneficiary's medical information within the Military Health System and with the Department of Veterans Affairs. Lessons learned are recorded from the IOC sites for future deployments.

On Sept. 7, 2019, MHS GENESIS went live at military treatment facilities in California at Travis Air Force Base, Naval Air Station Lemoore, and the Presidio of Monterey, and at Mountain Home Air Force Base in Idaho, as part of Wave TRAVIS, named for the largest wave participant site. Lessons learned from the Initial Operational Capability sites, rigorous testing and improvements to training and change management played a huge role in the successful deployment at those four sites. 

On Sept. 26, 2020, MHS GENESIS went live at military treatment facilities in California at Beale Air Force Base, Edwards Air Force Base, Fort Irwin, Los Angeles Air Force Base, Marine Corps Air Ground Combat Center Twentynine Palms, Marine Corps Mountain Warfare Training Center Bridgeport, Port Hueneme Naval Base, and Vandenberg Air Force Base and in Nevada at Nellis Air Force Base and Naval Air Station Fallon as part of Wave NELLIS, named for the largest wave participant site. The new MHS GENESIS Patient Portal allows TRICARE beneficiaries to exchange secure messages with their care team; schedule medical and (active-duty) dental appointments online; and access notes, labs and medications, and request prescription renewals online.

On Oct. 31, 2020, MHS GENESIS deployed at Wave PENDLETON locations, including military treatment facilities in California at Camp Pendleton and in Alaska at Eielson Air Force Base, Fort Wainwright and Joint Base Elmendorf-Richardson, after months of extensive preparation, undertaken while also navigating through a global pandemic. The transition included intensive training for staff, internal infrastructure changes, communicating to beneficiaries, and equipment upgrades, all completed while continuing to serve those who serve.

On Feb. 26, 2021, MHS GENESIS deployed at Wave SAN DIEGO. This wave consists of Naval Medical Center San Diego and its ancillary clinics across Southern California; and 1st Dental Battalion. NMCSD is the largest military medical treatment facility to deploy the new electronic health record to date. The transition included intensive training for staff, internal infrastructure changes, communicating to beneficiaries, and equipment upgrades, all completed while continuing to serve those who serve.

On April 24, 2021, the Military Health System deployed the MHS GENESIS electronic health record to 25 military hospitals and clinics across 12 states, bringing the MHS GENESIS deployment to nearly 30% complete. MHS GENESIS offers a single system to provide improved access to health care information, and enables a more efficient and timely delivery of care. Wave CARSON+ is the largest deployment to date. This fall, Wave TRIPLER in Hawaii will go live.

On Sept. 25, 2021, MHS GENESIS arrived in paradise with Wave TRIPLER! Military hospitals and clinics in Hawaii now using the Military Health System’s new electronic health record include Tripler Army Medical Center, the 15th Medical Group at Joint Base Pearl Harbor-Hickam, the Desmond Doss Health Clinic at Schofield Barracks, the Naval Medical Clinics-Hawaii and 3rd Dental Company both located at Marine Corps Base Hawaii. MHS GENESIS provides enhanced and secure technology to assist beneficiaries in managing their health information.

On Jan 22, 2022, MHS GENESIS deployed to hospitals and clinics in Waves BAMC and LACKLAND, including the largest military medical center in the Military Health System. The Brooke Army Medical Center, along with hospitals and clinics at Lackland Air Force Base, Randolph Air Force Base, Fort Sam Houston, Dyess Air Force Base, Goodfellow Air Force Base, Laughlin Air Force Base, and Naval Air Station Corpus Christi. In 2022, MHS GENESIS will deploy to an additional 47 military hospital and clinic commands in eight more ‘Waves’.

On March 19, 2022, Waves BRAGG & HOOD consisting of 14 military hospital and clinic commands across five states deployed MHS GENESIS. Adding in Fort Liberty (formerly Fort Bragg), Seymour-Johnson Air Force Base, Marine Corps Base Camp Lejeune, Marine Corps Air Station Cherry Point, 2nd Dental Battalion, Fort Cavazos (formerly Fort Hood), Fort Johnson (formerly Fort Polk), Fort Sill, Barksdale Air Force Base, Little Rock Air Force Base, Tinker Air Force Base, Altus Air Force Base, Vance Air Force Base and Naval Air Station Belle Chasse increased the total number of military hospital and clinic commands to 68, and also reached the halfway point for total military hospital and clinic commands currently using the new electronic health record system.

In June 2022, the Military Health System increased the number of military hospital and clinic commands using MHS GENESIS to 73 as Waves BEAUMONT and GORDON deployed the new electronic health record. The MHS added Fort Bliss, Holloman Air Force Base,  Fort Gordon, Fort Moore, (formerly Fort Benning), Fort Stewart, Naval Submarine Base, Kings Bay and Marine Corps Logistics Base Albany to the list of bases. Eleven “Waves” are currently preparing to deploy the new EHR.

On Sept. 24, 2022, three days before Hurricane Ian made landfall on the west coast of Florida and subsequently impacted South Carolina, Waves EGLIN & JACKSONVILLE deployed MHS GENESIS. These two large waves added in 23 more military hospitals and clinics at Eglin Air Force Base (2), Naval Air Station Pensacola (2), Patrick Space Force Base, Tyndall Air Force Base, Hurlburt Field, Fort Novosel (formerly Fort Rucker), Redstone Arsenal, Keesler Air Force Base, Maxwell Air Force Base, Columbus Air Force Base, Fort Moore (formerly Fort Benning), Fort Gordon, Jacksonville Naval Complex, Fort Jackson, Charleston Air Force Base, Naval Weapons Station Charleston, MacDill Air Force Base, Moody Air Force Base, Robins Air Force Base, Shaw Air Force Base and Marine Corps Air Station Beaufort. The Military Health System has now completed deployment to 92 of 138 MTF Commands.

In January 2023, Waves DRUM & PORTSMOUTH deployed MHS GENESIS to nine military military hospitals and clinics across six states. These two waves included facilities at: Fort Drum and the U.S. Military Academy (West Point) in New York; Dover Air Force Base in Delaware; Joint Base McGuire-Dix-Lakehurst in New Jersey; Naval Station Newport, in Rhode Island; Hanscom Air Force Base in Massachusetts; and Naval Medical Center Portsmouth and Joint Base Langley-Eustis in Virginia. As of January 2013, the Military Health System has completed deployment to 103 military hospitals and clinics across the United States.

On March 25, 2023, MHS GENESIS deployed to military hospitals and clinics in the National Capital Region. Wave WALTER REED & Wave BELVOIR went live simultaneously and include: Walter Reed National Military Medical Center at Naval Support Activity, Bethesda; Facilities on Fort Belvoir; Fort Meade; the U.S. Naval Academy; Joint Base Andrews; Joint Base Anacostia-Bolling; Naval Air Station Patuxent River; Marine Corps Base Quantico; and Local National Guard and Reserve units.

On June 3, 2023, MHS GENESIS went live at Wright-Patterson Air Force Base, Blanchfield Army Community Hospital, Ireland Army Community Hospital, Kenner Army Health Clinic, Scott Air Force Base, Sheppard Air Force Base, and the Naval Branch Health Clinic Crane. These seven deployments in Wave WRIGHT-PATTERSONH conclude the installations of the new electronic health record for all U.S.-based military hospitals and clinics. Now, only overseas hospitals and clinics await deployment of the new EHR.

On July 23, 2023  MHS GENESIS was deployed to the first two overseas waves. Wave LAKENHEATH consisted of military hospitals and clinics at RAF Lakenheath, Aviano Air Base, Ramstein Air Base, Incirlik Air Base, Naval Hospital Naples, Naval Hospital Rota, and Naval Hospital Sigonella. Wave LANDSTUHL added military hospitals and clinics at Landstuhl Regional Medical Center, Ramstein Air Base, MEDDAC-Bavaria, and Spangdahlem Air Base.

On Oct. 28, 2023, the final MHS GENESIS “wave” deployed to multiple sites in the Pacific Rim. Wave OKINAWA consisted of hospitals and clinics at Kadena Air Base, Misawa Air Base, Yokota Air Base, Camp Zama, Naval Hospital Okinawa, 3rd Dental Battalion, Naval Support Facility Diego Garcia, and Yokosuka Naval. Wave GUAM / SOUTH Korea added more hospital and clinics at Kunsan Air Base, Osan Air Base, and Camp Humphries. The deployment to Andersen Air Base and Naval Hospital Guam has been delayed to the impacts of Super Typhoon Mawar.

On Mar. 9, 2024, MHS GENESIS (known as the Federal Electronic Health Record) deployed to the final Department of Defense military medical treatment facility. The Captain James A. Lovell Federal Health Care Center (Lovell FHCC) and its subordinate clinics in North Chicago, Illinois successfully deployed the new EHR at the first joint Department of Veterans Affairs / DOD facility.