See other articles about the Department of Defense (DoD) medical data controversy here.

A friend over at Pandata took the initiative to call the people who put together the Medical Surveillance Monthly Reports (MSMR) which publishes an annual snapshot of the DoD's ambulatory and hospitalization data from the Defense Medical Surveillance System (DMSS). They claim that the reason for the changes in the 2016-2019 data is that telemedicine data was added to the database.

Is that for real?

Examining the Committed Position: Telemedicine Data

I've been waiting for the DoD to commit to a position about why the data changed.

Understand that this won't be the last article examining the change because I and others plan to see what information about telemedical data we can track down. But I'm not inclined to believe they're telling the whole correct story. Let's take a look at some visuals.

Some thoughts and questions:

The changes in the 2016-2019 data look awfully uniform from year to year. Telemedicine is a new trend that has grown rapidly from almost nothing over the past decade. I would be shocked if the result of adding these records pushed each of the four years 2016-2019 up by almost exactly the same amounts (between 13% and 14%).
Was the DoD adding this data to internal reports separately for five years rather than having the database process updated one time? Don't they pay over $30M (note: edited amount from original article) a year to Unissant to run this database? (Um, can I bid on that contract, now?) Or did the DoD just look at incomplete data for such a matter that most everyone classifies as a top military (and national security) priority?
Health problems in the military were trending downward since 2012, and the old snapshots fit that trend. I recognized that trend elsewhere in the DoD health data—in places that were separate from the ambulatory reports.

What About the R-Codes?

I keep an open mind to the possibility that the DoD is not lying about the telemedicine data. After all, I'm pretty sure they weren't lying about the glitch. The problem is that they weren't saying much at all. To me, the appearance was of sins of omission.

But now I point out that there was one diagnostic category with additional and massive changes after the 2021 MSMR report during which the telemedicine data would have been added. These are the R-Codes, which can be simply summarized as, "Illnesses of unknown causes".

And even if this is the only data that has been manipulated, the impact is enormous. The rise in R-code ambulatory reports alone would represent around a 6% increase in all-cause illness among the active duty military. The average change of the R-Code ambulatory reports for the years 2016-2020 between the May 2021 MSMR and February (post-glitch-fix) queries run by one of the whistleblowers is 46.6%, which took what looked like relatively flat data and sculpted it into an upward trend during a time period in which there were no upward trends in any of the DoD health data I laid my eyes on after several hundred hours of work. From what I have heard, the R-Code data is the prime suspect behind increases in the Massachusetts data, and the rapidly climbing insurance data.

Obligatory Reminder: Mortality Increased

Another reason that I find the DoD's consistent casual dismissal of all the questions difficult to swallow is that the DoD does indeed have a problem on its hands with unexplained rising mortality.

If all of that is supposedly due to COVID-19, we should at least stop and ask why COVID-19 cases become more severe through the vaccination program in the military while case fatality rates were declining all over the world.

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