The Department of Defense (DoD) ensures mission readiness by equipping service members with the tools and support needed to maintain peak performance and operational strength. The U.S. Army builds and sustains a resilient, combat-ready force, prioritizing Soldier well-being to enhance effectiveness in any mission. The Directorate for Prevention, Resilience, and Readiness (ARD) strengthens Army readiness by addressing behavioral health challenges and implementing programs that enhance resilience, mental fitness, and overall force preparedness. Supporting this mission, TIAG delivers targeted solutions that enhance prevention, resilience, and readiness initiatives—ensuring soldiers remain strong, focused, and ready to meet the demands of any operation.

Since 9/11, suicide has claimed the lives of more than four times the number of active-duty personnel lost in combat-related operations. Suicidality, depression, anxiety, and PTSD disproportionately affect Soldiers, making behavioral health a critical priority for Army leadership. Ensuring Soldiers are equipped to manage the psychological demands of military service and warfare is essential to maintaining operational readiness and resilience. When the COVID-19 pandemic restricted in-person interactions, ARD faced an urgent challenge. Behavioral Health Officers (BHOs) traditionally administered and manually analyzed the Unit Behavioral Health Needs Assessment (UBHNA)—an 11-page, 116-question survey developed by the Military Psychiatry Branch at the Walter Reed Army Institute of Research (WRAIR) in collaboration with psychiatrists from the Office of the Surgeon General (OTSG). Designed to evaluate behavioral health trends and risks across Army units, the UBHNA played a vital role in identifying issues affecting Soldiers’ mental well-being. However, with traditional survey methods no longer feasible, the Army’s ability to collect and analyze behavioral health data was significantly hindered at a time when such insights were more critical than ever. Without a viable alternative, the Army risked losing visibility into key indicators of Soldier wellness, potentially impacting force readiness and delaying essential support for those in need. The situation underscored the urgent need for an innovative solution to ensure continued behavioral health assessments without disruption.

ARD partnered with TIAG to develop Behavioral Health Pulse (BH Pulse). This secure, rapidly deployable, and mobile solution enables Soldiers to complete behavioral health assessments remotely while providing command staff with clear, data-driven insights. By replacing manual processes with a cloud-based platform, BH Pulse allows leadership to quickly assess trends, identify risk factors, and implement targeted interventions to support Soldier well-being.

TIAG leveraged Agile development methodologies, DevSecOps principles, and a Continuous Integration/Continuous Deployment (CI/CD) pipeline to develop a solution that met the Army’s security, scalability, and usability requirements. This approach ensured that BH Pulse was designed, developed, and deployed within just eight months, significantly improving the efficiency and accessibility of behavioral health assessments. By incorporating human-centered design principles, TIAG prioritized intuitive usability and Soldier engagement, integrating extensive user research and iterative prototyping to refine the application.

A key feature of BH Pulse was the implementation of unit-specific QR codes, which streamlined data collection and reduced the time required for survey administration and analysis. What once required months of manual effort could now be completed in days, with some battalions finalizing assessments in under 48 hours. This transformation accelerated data aggregation, improved response rates, and ensured Soldiers could complete assessments quickly and securely.

The platform was built on a cloud-native infrastructure, utilizing microservices architecture and Kubernetes for container orchestration, allowing for Army-wide scalability and real-time analytics. Security remained a top priority, with BH Pulse adhering to Iron Bank compliance and leveraging automated security controls to protect sensitive behavioral health data.

By integrating CI/CD pipelines, TIAG enabled rapid iteration, automated testing, and seamless updates without service disruptions. This approach ensured that new features and enhancements could be efficiently deployed, supporting the Army’s evolving behavioral health initiatives while maintaining the platform’s reliability and security.

“This capability has been in the Force for some time now, but TIAG made it more useable for commanders to truly pulse their formations and gain insights into the health of their units.” COL Matt Weber, Ready and Resilient Division Chief.

The deployment of BH Pulse was highly effective, with nearly 15,000 Soldiers across 12 locations in five countries enrolled within just three months. To date, 80,000 Soldiers, including the entire U.S. Army Alaska, have utilized BH Pulse, benefiting from its ability to provide real-time behavioral health insights at scale. The application’s ease of use, rapid deployment, and automated reporting were instrumental in meeting the Army’s urgent need for a secure and efficient behavioral health assessment tool, particularly during the COVID-19 pandemic, when traditional survey methods were not feasible.

The success of BH Pulse has been widely recognized, earning the 2023 FedHealth IT Disruptive Tech Program and Change Agent Award for delivering timely, actionable data to Army leadership. By replacing manual processes with a real-time, data-driven approach, the platform has transformed behavioral health assessment and suicide prevention strategies across the force. BHOs can now tailor unit-specific resilience training and interventions, enabling commanders to assess behavioral health trends and risk factors better. Through anonymous, unit-level insights, BH Pulse provides critical visibility into behavioral health challenges such as family violence, sexual harassment/assault, and anger management issues associated with suicidality, allowing for more effective prevention and response efforts.

This enhanced capability has directly impacted Army readiness and resilience, particularly within Air Defense Units and other formations. The effectiveness of BH Pulse has also influenced Army policy discussions at the highest levels, including with the Vice Chief of Staff and the Secretary of the Army. As a result, the application is positioned to become a core component of the Army’s enterprise resiliency strategy, shaping the future of behavioral health policies and programs.

Looking ahead, BH Pulse continues to evolve, with ongoing enhancements to expand its functionality. Future developments focus on linking assessments to actionable resources, improving accessibility, and facilitating timely interventions. The platform’s success has not only strengthened the Army’s suicide prevention and behavioral health strategies – it has also set a new standard for digital behavioral health assessment across military services and organizations.

To support the Uniformed Services University of the Health Sciences (USUHS) mission of advancing military health through education, research, and service, the Consortium for Health and Military Performance (CHAMP) launched Operation Supplement Safety (OPSS). OPSS offers evidence-based information on dietary supplements, empowering military personnel, their families, healthcare providers, and leaders to make informed choices about supplements. This initiative enables them to confidently pursue their fitness goals while prioritizing safety and adherence to military health standards.

CHAMP leadership and staff aimed to provide service members with a comprehensive understanding of the risks and benefits of supplement usage, but the OPSS.org website needed help with navigation, screen hierarchy, and mobile responsiveness. Users struggled to find critical features from the home page, and accessibility issues further hindered engagement. The design did not comply with modern web accessibility standards, making it difficult for users to find the needed information and potentially excluding some users from accessing critical information. Recognizing the need for improvement, CHAMP revamped the OPSS.org website to meet user needs better and offer an enhanced digital experience.

TIAG created an innovative, human-centered design to tackle these challenges and modernized the OPSS.org website. TIAG implemented a comprehensive strategy, starting with in-house user research and baseline assessments. The team analyzed usage trends, behaviors, and drop-out rates, which informed the creation of personas representing soldiers using supplements. These personas were instrumental in developing a goals-driven design roadmap tailored to soldiers’ specific needs.

• Development Strategy & Approach We started development by finalizing design blueprints and prioritizing features to create a clear roadmap, focusing on delivering the Minimum Viable Product (MVP).
• Agile Development Using Agile methodology, we implemented a sprint-based process with regular stakeholder feedback for continuous improvement. Tools like JIRA, Bitbucket, and Jenkins powered our CI/CD process, ensuring seamless development and deployment.
• Design & Prototyping We utilized Adobe XD and Figma to create intuitive, user-friendly designs, enabling real-time collaboration and iterative prototyping.
• Content & Website Management With Drupal CMS and PowerMapper, we ensured scalable content management and optimized site accessibility, addressing broken links and browser compatibility issues.
• Mobile Optimization & Accessibility We prioritized mobile performance by optimizing resources and implementing WebAim to ensure WCAG 2.1 compliance and enhancedaccessibility for users with disabilities.
• Security & Compliance Our coding standards followed strict guidelines, including STIG and NIST SP 800-53, ensuring top-tier security and regulatory compliance.
• User Testing & Maintenance We conducted continuous User Acceptance Testing (UAT) during each sprint to meet MVP criteria. After launch, our team transitioned to ongoing site maintenance, optimizing performance, security, and functionality enhancements.

Post-redesign, stakeholders reported an impressive 50% to over 100% increase in usage for some of the site’s most popular pages and features. TIAG’s comprehensive software development process for OPSS, grounded in Agile methodology and stringent coding standards, resulted in a robust, secure, and user-centric digital product. The iterative and feedback-driven approach, supported by powerful tools like JIRA, Azure DevOps, Adobe XD, Figma, Drupal CMS, PowerMapper, and WebAim, ensured the final product met user and stakeholder needs. The transition to maintenance ensured ongoing optimization and enhancements, providing a sustainable and continually improving digital solution.

The Department of Defense (DoD) protects national security through global defense operations, advanced technology, and military readiness. As the nation’s rapid-response force, the United States Marine Corps (USMC) conducts land, sea, and air operations to secure naval bases and support military objectives. The Cybersecurity and Information Technology Support Services (CITSS) contract strengthens Marine Corps operations by enhancing cybersecurity, IT infrastructure, and mission resilience. Leading the Navy’s information warfare efforts, the Naval Information Warfare Center (NIWC) Atlantic develops advanced technology solutions to secure military operations and empower warfighters. In partnership with NIWC Atlantic, TIAG supports CITSS with cutting-edge cybersecurity and IT solutions that drive the success of the Marine Corps mission.

The U.S. Marine Corps required enhancements to its Maritime Operational Reach Tool (MORT) to improve operational readiness and efficiency in maritime and littoral operations. MORT, a sophisticated logistics simulation tool, integrates components such as machine learning algorithms, logic systems, and preset variables to create comprehensive and dynamic simulations. These simulations assist in planning amphibious assaults by evaluating navigability, determining operation capacity and timing, and identifying optimal assault routes. Additionally, the tool serves as a training platform for service members, allowing them to experience various conditions in a controlled environment, enhancing their readiness and decision-making capabilities. NIWC was selected for its industry connections and expertise in providing warfighters with tactical advantages through enterprise IT services, including on-premise and cloud services, cyber sensor and alerting systems, 5G battlefield mobility, and continuous agile processes like DevSecOps. 

TIAG provided NIWC with an environment to consolidate MORT components such as machine learning algorithms, logic, and preset variables. This involved refactoring existing tools to boost operating power and efficiency, standardizing data ingestion processes, and creating a user interface for visualizing and reporting scenarios.

TIAG leveraged Python, the language native to the calculation engine, for an enhanced and modernized integration approach. The team developed initial API and data layers in Python, enabling rapid production of working architecture modules that seamlessly integrated with the existing codebase. This modular architecture facilitated the use of specialized software technologies and languages for future iterations. The team modernized data ingestion and output processes by transitioning from local file storage to a normalized SQL schema implemented via a PostgreSQL database. This shift replaced existing local file I/O with streaming data services, integrating the data ingestion process into web APIs and improving performance within the calculation engine by up to 80%. TIAG connected data from the new database schema into a modular persistence layer using an object-relational mapper, providing standard CRUD (Create, Read, Update, Delete) methods for the API. They defined RESTful API endpoints to OpenAPI standards, ensuring shared server and client integration contracts, integrated documentation, and ad-hoc testing.

TIAG integrated into NIWC’s existing Agile team, contributing effectively from the first sprint. The team introduced best practices, including unit and integration testing and refactoring existing code to fit the new modular architecture. Additionally, they recommended improvements to current sprint processes to better align with Agile methodology. This included more robust and frequent sprint meetings (Sprint Review, Sprint Retrospective, Sprint Planning, and Backlog Grooming) and encouraging cross-functional teams to prevent single points of failure.

Developing a user-friendly interface for visualizing and reporting scenarios enabled NIWC to make informed decisions based on comprehensive and easily interpretable data. This enhancement improved the overall user experience and increased the tool’s operational effectiveness.

The new system architecture resulted in an 80% increase in performance within the calculation engine, streamlining the data ingestion process and reducing processing times. TIAG successfully modernized and enhanced MORT, providing a robust, efficient, and reliable logistics simulation tool that meets the organization’s dynamic needs.

The Defense Health Agency (DHA) ensures the medical readiness of nearly 130,000 civilian and military personnel across the Army, Navy, and Air Force, enabling them to execute combat operations and humanitarian missions worldwide. Managing the Military Health System (MHS), the DHA delivers healthcare to 9.6 million service members, retirees, and families while advancing medical excellence and system modernization. As part of this effort, the Defense Healthcare Management System (DHMS) modernizes healthcare delivery and enhances data sharing through an advanced electronic health record system. Within DHMS, the Enterprise Intelligence and Data Solutions (EIDS) program strengthens decision-making across the MHS by providing timely, relevant, and actionable data. Naval Information Warfare Center Atlantic (NIWC) leads the Department of Defense’s information warfare capabilities, driving innovation and ensuring a warfighter information advantage. In partnership with NIWC, TIAG supports EIDS by integrating cutting-edge technology and expertise to optimize data-driven solutions and streamline mission-critical processes.

MTFs struggled with managing patient appointments and generating real-time reports, leading to scheduling inefficiencies that affected patient care and operational performance. They needed a system that provided real-time data, managed provider schedules, and optimized appointment bookings based on historical patient flow and patterns. Additionally, MTFs had to comply with the Interim Procedures Memorandum 18-001, which specifies standard appointing processes, procedures, hours of operation, productivity, performance measures, and appointment types for primary, specialty, and behavioral healthcare. Lacking real-time reporting capabilities, MTFs required a solution to continuously monitor provider schedules and ensure availability for patient bookings within the Composite Health Care System.

TIAG created the Direct Access Reporting Tool (DART), a web-based application designed to enhance access to care for the DHA and address the challenges MTFs face by integrating several access-related activities and serving as a robust reporting tool. This comprehensive approach leveraged the InterSystems CACHE interface to Military Health Systems globally. It used SQL Open queries and CACHE system connections to continuously monitor provider schedules and ensure appropriate slots are open for patient bookings. Critical features developed include:

• Virtual ATC analyst, a reporting tool for all MTFs, and an efficient, automated process to implement best practices. 
• Single Sign On (SSO) access through the Carepoint Application
• Real-time reporting and a harvested system to deliver real-time reporting capabilities and historical modeling to help facility staff create optimal provider schedules based on past patient flow and patterns.
• Centralized collection and continuous monitoring of patient scheduling, provider schedules, and appointment data for all MTFs to maintain optimal patient access and improved access in non-scheduling-related processes within the Direct Care System (DCS).
• User-friendly interface to facilitate easy access to real-time data and reporting tools.

DART revolutionized how the DHA manages Access to Care-related activities by integrating multiple operations into a streamlined, near real-time reporting system that empowers MTFs with actionable insights. By providing decision-makers with up-to-date data every 60 minutes, DART enhances the ability to assess and improve scheduling efficiency at the clinic level. Key benefits include:

• Minimizing delays in data reporting, allowing swift action based on the latest insights.
• Empowering decision-makers and analysts to manage operations more effectively, identify trends, and forecast future needs.
• Eliminating redundancy in data collection while improving accessibility for both internal and external stakeholders.
• Rapid deployment of user-friendly reporting tools to support evolving needs.
• Automating best practices for analysts, ensuring the DHA consistently operates at the highest efficiency level.

The Defense Health Agency (DHA) ensures the medical readiness of nearly 130,000 civilian and military personnel across the Army, Navy, and Air Force, equipping them to execute combat operations and humanitarian missions worldwide. Managing the Military Health System (MHS), DHA delivers healthcare to 9.6 million service members, retirees, and families while advancing medical excellence and system modernization. The DHA Hearing Center of Excellence (HCE) drives the prevention, diagnosis, treatment, and rehabilitation of hearing loss and auditory impairment, including conditions related to traumatic brain injury. Committed to optimizing operational performance and enhancing quality of life, HCE leads collaborative efforts in hearing and balance health initiatives. A top priority is tracking and analyzing patient data through the Joint Hearing Loss and Auditory System Injury Registry (JHASIR) to improve care and readiness. As part of its modernization efforts, the Defense Healthcare Management System (DHMS) advances healthcare delivery through a secure, interoperable electronic health record system for service members, veterans, and their families. Within DHMS, the Enterprise Intelligence and Data Solutions (EIDS) program strengthens decision-making across the MHS by delivering timely, relevant, and actionable data. Naval Information Warfare Center Atlantic (NIWC) leads the Department of Defense’s information warfare capabilities, driving innovation and ensuring a warfighter information advantage. In partnership with NIWC, TIAG supports EIDS by integrating cutting-edge technology and expertise to optimize data-driven solutions and streamline mission-critical processes.

JHASIR is the only auditory-vestibular injury registry for Service members and Veterans – providing queryable and longitudinal healthcare records that help clinicians and researchers improve medical readiness, raise awareness, and identify interventions to prevent and reduce the severity of auditory-vestibular injuries for more than 900,000 Service members and veterans. HCE discovered a gap in the JHASIR registry – nearly 800,000 patient clinical encounters lacked associated audiograms or audiometric tests. This indicated these records were not digitized, and technology didn’t yet exist to meet security requirements and transform raw files into queryable records. To bridge this gap, the Congressional Gap Audiograms program was mandated. HCE had a year to locate the records, create the technology to transform raw files into a queryable structured format, and then digitize the 800,000 records.

To tackle this challenge, HCE enlisted TIAG to develop the DVEIVR, with bidirectional data exchange, to identify and track the incidence and care of hearing loss and auditory injury and utilize registry data to encourage and facilitate the conduct of research, development of best practices, and clinical education. 

• TIAG analyzed 10,000 records, discovering 108 unique formats, nearly half handwritten and illegible. 
• Developed an abstraction interface and used AWS Textract to identify records from 2020/2021, enhancing stakeholder feedback and mitigating manual processing.
• Leveraged Tableau reports for monitoring accuracy to ingest and prepare 60,000 records and 11,817 AC/BC audiogram graphs and their associated frequencies for clinical use. 
• Utilized an Adobe triage and Talend ETL to streamline enterprise operations and workflows, prioritize records based on keywords, and implement an upgraded application with advanced abstraction procedures, enabling dynamic data capture and review. 
• Established bi-directional data pulls between DOD and VA medical information systems based on medical records. This interface securely compiles current and historical medical records and provides a unique standardized data resource.
• Created a comprehensive reporting library and dashboards that can display over 60,000 raw files to provide customized information and showcase diagnostic techniques, procedures, and various demographic data collected over time, such as injury prevalence rates.

Audiogram processing time decreased by 50%, and data accuracy hit an all-time high of 99.7%. Both DVEIVR and JHASIR contain data from 2001 to the present on inpatient and outpatient direct care provided at military hospitals and clinics, purchased care from non-military treatment facilities, the VA, pharmacies, laboratories, and radiology centers for active duty service members, the National Guard and Reserve, and Veterans. The registries bridge data gaps and provide customized information on diagnostic techniques, procedures, and demographic data – creating collaboration and synergies across the DoD and DHA that have made lasting impacts: 

• Project researchers pulled demographic data and occupational hearing health data to identify risk factors that may increase the likelihood of service members sustaining auditory injury from noise exposure as part of a multi-site field study with Walter Reed National Military Medical Center called CHASMPAS (Characterization of Acute or Short-term Acquired Military Population Auditory Shifts). The study is focused on characterizing short-term changes in hearing among military personnel exposed to blasts. So far, 170 service members have participated in the CHASMPAS study from multiple U.S. Army, U.S. Navy, and U.S. Marine Corps sites.
• Supported the development of multiple clinical practice guidelines to provide expertise across the clinical spectrum of eye care for a patient titled “Ocular Injuries and Vision-Threatening Conditions in Prolonged Field Care” and “Evaluation and Disposition of Temporary Visual Interference and Ocular Injury after Suspected Ocular Laser Exposure.” 
• Because of TIAG’s work digitizing the records, the VCE, in collaboration with the DOD and VA, including the Traumatic Brain Injury Center of Excellence, championed the production of clinical recommendation aids for the care of visual dysfunction after TBI, “Eye and Vision Care Following Blast Exposure and/or Possible Traumatic Brain Injury,” “Care of Visual Field Loss Associated with Traumatic Brain Injury,” and “Care of Oculomotor Dysfunctions Associated with TBI.”
• Used in the DOD/VA TRICARE hearing aid demonstration, which aims to replicate, to the fullest extent possible, the VA’s Community Care Network model for delivery of prescribed hearing aids and associated devices for veterans, active duty service members receiving care through the supplemental health care program in designated states, as well as to qualifying Prime active duty family members diagnosed with profound hearing loss. 
• Researchers from Brooke Army Medical Center used the system to publish a study in the American Journal of Otolaryngology examining the rates of sudden hearing loss by characterizing treatment options during the COVID-19 pandemic.