This presentation utilizes a global Use Case of patient movement to describe interoperability challenges from the battlefield to rehabilitative care. With our current conflicts in Iraq and Afghanistan, it is common for a patient to move from the point of injury to a state-side medical treatment facility within 48-72 hours. During this short time span there are numerous hand-offs as the patient is treated by multiple teams and facilities... As the Use Case describes, using multiple systems at various stages during transitions of care challenges our best attempts to semantically share data with our internal DoD and external civilian and VA partners...