DHS being the Defense Health Service of the DoD. Someone had the brilliant idea of requiring the use of CACs (ID cards) to log in to terminals used by military medical personnel worldwide. This would satisfy the HIPAA requirements, keep Security happy, make it easy to log who was seeing what, and generally be a Good Thing.
Then it was pointed out that using a CAC for login required a connection to validation servers. And field hospitals in Afghanistan, Iraq, and other places generating lots of patients might not have good connections... Oh, and Navy ships at (and especially under) sea can also lack good connectivity.
Amazingly, the Powers That Be agreed that the Idea, while Good, was not practical, so using the CAC is now recommended rather than required.