The hospital serves the Fort Campbell community, including more than 72,000 soldiers, retirees, and their family members enrolled to BACH services and more than 92,000 who are eligible for care in the Fort Campbell TRICARE service area.

"In our current model, we estimate we are capable of vaccinating over 700 individuals per day," said Army Col. (Dr.) Patrick Birchfield, BACH commander. "As we move into later phases of administering the vaccine, we will facilitate a larger venue on post, enabling 1,000 vaccinations daily with the capability of scaling this number higher if needed."

Most MTFs are vaccinating beneficiaries in phases 1A and 1B, however, commanders have the independent capability to move down the population schema after maximum outreach to the current tier, explained Rans.

"I am extremely proud of our team and how incredibly well they are conducting vaccine administration at Blanchfield Army Community Hospital, how they are working closely with unit leaders to ensure the eligible soldiers are receiving the vaccine," said Birchfield. "The process is flowing smoothly but, perhaps, most importantly, the process is safe and comfortable for our patients and eligible beneficiaries.

For the DOD to exceed the 1 millionth vaccination is a significant and encouraging milestone, he said. "Protecting our most vulnerable population, along with the military service members who are deploying and other high-risk populations here at Fort Campbell is critical in winning the fight against the COVID-19 virus."

Technology's role

In addition to the whole-of-community effort to make vaccination administration a success throughout DOD, technology has played a significant role in reaching the vaccination administration milestone. MHS GENESIS, the DOD's new electronic health record system, has played an important role in communication and centralized record keeping.

"Because we have standardized all data sources to a central collection point, we're now able to rapidly gather information about activity in the field to quickly assess where the vaccine has gone, and how it has been used," said Air Force Col. (Dr.) Thomas Cantilina, DHA's chief informatics officer. "This in turn has allowed us to establish a means of determining where the vaccine is most needed, and who has resources to distribute it."

The new EHR system is being implemented across MHS through 23 waves to provide enhanced, secure technology to manage health information and keep all beneficiaries' records centralized.

"Currently, we wish we were further along in the deployment of MHS GENESIS, as the system allows for documentation during administration of the vaccine," said Cantilina. "This capability is done through MHS GENESIS ability to leverage automation such as barcode medication administration, which ensures critical patient health information is made available to our providers as this shot is given, such as patient allergies and potential drug interactions, risk factors or wrong timing of the dose."

From his perspective, reaching the 1 millionth shot in arm milestone is major and signifies two things: "First, we have a strong sense that we're on the right path as far as processes and procedures at both a local and enterprise level. Second, we know our patients are taking the risk of contracting COVID-19 seriously, and there's an understanding that receiving the vaccine reduces your chances of both contracting and spreading this deadly virus."

"Coupled with the challenges so many faced in changing the way they performed their jobs while practicing social distancing makes it even more significant," he said. "You can really appreciate how this milestone is the culmination of so many people who are committed to eradicating this virus, and caring for our families, colleagues, neighbors and friends. I'm proud of the men and women on the front lines that have made this possible."

Lessons Learned

Despite unforeseen weather-related and logistical challenges resulting in delayed delivery of vaccine shipments to MTFs, "good communication allowed facilities to either change planning factors or contact scheduled participants and reschedule their immunization date," said Army Lt. Col. Carmen Bell, program manager of special projects and readiness for DHA's Plans and Exercises Division.

There were also issues in communication and data. Birchfield explained they anticipated challenges between the accuracy of data in legacy electronic health records and that with MHS GENESIS. "We've now fixed many of those issues through improvements to provider workflows, reengineering the logic of how data flows, and mandating documentation at the point of vaccine administration," he said. "Today, we have much more accurate and reliable data from MHS GENESIS and our legacy electronic health records."

"Highlighting that "the military and the Military Health System employ a wealth of experience in dealing with major challenges and are able to overcome them by strategically planning and implementing those plans," he concluded that, "the training to tackle a mission confidently and with persistence is key to overcome the inevitable challenges.

Bell echoed the sentiment. "There has been an immense number of lessons and experiences," she said. "As we reflect from our observations, we will create better policies and practices that we will communicate and disseminate throughout the organization to then practice and reevaluate until we learn and effectively change our behaviors."

As the DOD continues undertaking the mission to deliver and administer vaccines safely and effectively to all MHS beneficiaries, it's clear team effort, flexibility, coherent and consistent communication and coordination at all levels, and the military's can-do attitude will continue to be crucial. Until then, it's important that all MHS beneficiaries continue to do their part following CDC guidelines and DOD orders to protect themselves, their loved ones, and their communities.