Building a Digital Biobank for Air Force Medical Data

What if we could unleash the power of data to build an active duty military precision medicine program? It’s a groundbreaking opportunity Booz Allen was determined to explore through the creation of the Air Force Medical Service (AFMS) Digital Biobank platform, combining the best of science and technology to support service members’ health, performance, and military readiness.

The Air Force was producing a large amount of valuable genomics data from its healthcare beneficiaries, but it was often inaccessible for reuse due to storage in on-site hard drives. Considering security, scalability, and cross-system interaction, how could the AFMS take this data and create insights that could impact patient care? Since data collection was just the first step with much larger potential, the AFMS set out to:

• Link the genomics information to other databases within the Military Health System (MHS) and Department of Veterans Affairs;
• Enable automated bioinformatics and actionable analytics;
• Support service member readiness and health through genomics-informed preventative medicine.

Equipped with a deep understanding of the AFMS that comes from having supported the organization in a variety of capacities for over a decade, Booz Allen assembled a multidisciplinary team to devise and execute a tailored solution. The team included computer scientists, health and genomics PHDs, and cloud developers with experience in multiple government organizations. 

There were a number of important issues on the table for discussion: 

• The high quantity and growth of data
• The need to scale rapidly
• The opportunity to link systems of information
• The benefits of a solution flexible enough to adjust to variable utilization. 

Together with the AFMS, Booz Allen’s team decided to move from an on-site IT system to an entirely cloud-based platform for the Digital Biobank. This adoption and embrace of cloud computing was a new approach for the Defense Health Agency (DHA).

Booz Allen and the AFMS co-facilitated a series of technical exchange forums that helped arrive at this solution. They brought together government, academic, and industry experts in the fields of genomics, precision medicine, informatics, and security and privacy to share insights, recommendations, and lessons learned. Key ideas from the forums included the adoption of cloud computing, the investigation of blockchain technology to facilitate data sharing between systems, and insights into specific military-focused precision medicine use cases. 

The next phase required combining scientific understanding with computational knowledge to make the AFMS tools and data structures more usable through specialized software.

Booz Allen worked with the AFMS to create the Digital Biobank platform, which would foster research and enable genomic data storage, automated bioinformatics, and querying and linking across health data types, including genomic, clinical, and military-relevant data. The Biobank supports scalable and secure hosting, the management and processing of genomic data, and the analysis of large amounts of health data—including de-identified health and military service records, genomic data, exposure data, electronic health records, and lifestyle information.

By linking genomics and clinical information, the Biobank empowers the AFMS to help reintegrate service members based on their physical, mental, and spiritual well-being. For example, one of the largest complaints in the Air Force is hearing loss, specifically noise-induced. With the Biobank, the AFMS will be able to identify genetic markers of noise-induced hearing loss and make actionable decisions for who should be wearing what level for hearing protection. 

Optimization, cost containment, and security requirements directed the development of the Biobank toward use of the cloud, scalable data storage, full-text search capabilities, and open-source libraries for genomic data visualization. From advancing pharmacogenomics to integrating clinical data for rich insights, the potential of the Biobank is significant for researchers and clinicians. The Biobank will provide a new model to MHS policymakers to frame clinical and technology issues regarding genomic-based precision medicine.

Booz Allen will seek accreditation (a first for the DHA) for the Biobank, based on the Risk Management Framework requirements to attain an Authority to Operate in DHA’s Amazon Web Services GovCloud environment, forecasted for September 2018.  

Looking ahead, the Biobank will enable the AFMS to more efficiently and effectively provide clinical care and improve health outcomes—supporting targeted health prevention modalities, more efficient research studies, and greater modernization of clinical practice guidelines. The Digital Biobank provides the U.S. military with a platform for the storage and analysis of genomic information. Recognized with a 2018 FedHealthIT award, this effort to combine science, healthcare, and innovative cloud technology within a tightly regulated environment has opened doors for other MHS policymakers and the Air Force Medical Support Agency.