The Military Health System is about to undergo a transformation. But what exactly does that mean for the current system? The current military health system includes a wide range of healthcare services, which is not ideal and is in dire need of an overhaul. The transformation will also affect the structure of the Defense Health Agency (DHA) and the way it delivers care, which is a crucial part of the military’s overall readiness.
Military Health System
The Department of Defense’s Military Health System is undergoing a transformation. This restructuring will make medical innovations more widely available to the force and will improve care for warfighters. The Defense Health Agency (DHA) will take operational oversight of military medical treatment facilities and implement best patient experience practices to provide better care. The DHA will establish standards of care, hold MTF and market directors accountable for implementation, and provide standardized guidance.
The transformation plan includes integrating military and civilian health care, resulting in improved outcomes and improved patient experience. The transition plan includes the conversion of over 50% of U.S. hospitals into DHA-controlled hospitals by October 2020 and overseas hospitals by October 2021. These changes will make the MHS a more effective medical force, improve operational readiness, and lower operating costs.
Currently, the Defense Health Agency manages 17 geographically-defined markets. The organization’s newly launched markets include San Antonio, Colorado, the Tidewater (Virginia), and the National Capitol Region. There are about 75 military treatment facilities in these regions.
What is the current Military Health System?
The Military Health System (MHS) supports the National Defense Strategy by providing medical care for our armed forces. This system also ensures that our medical personnel is ready to respond to any emergencies that may arise. Over nine million active-duty and retired service members and their families receive medical benefits through the MHS.
The MHS oversees the delivery of health care for military-connected beneficiaries at military hospitals and in civilian facilities. The goal of the MHS is to improve readiness, ensure the highest quality of care for military personnel, and modernize TRICARE health care. To accomplish this, the Department of Defense plans to transform the system through five lines of effort.
The current MHS focuses on combat readiness and active-duty readiness. Twenty-three percent of beneficiaries are active-duty personnel, while forty-three percent are retirees. The number of retirees has increased significantly since 2000, with nearly half of all beneficiaries being older than 20 years old.
The MHS has implemented various initiatives over the past decade to improve healthcare services and improve the health status of beneficiaries. However, the system continues to face the same challenges that any other US healthcare system faces.
DHA Market Structure
The DHA Market Structure for Military Health System Transformation aims to bring greater efficiency and effectiveness to the delivery of military health care. It will standardize the business and clinical aspects of health care and ensure a consistent patient experience. The DHA is currently assigning each military healthcare facility to a specific market segment based on size. These markets will be managed by the same office that manages smaller markets.
The DHA’s mission is to provide improved health care for the military population while reducing costs. This transformation will require a new organizational structure. The DHA’s goals are fourfold: improve patient outcomes, lower costs, and improve military readiness. These are all measurable goals for the transformation of military health care.
To achieve these goals, the DHA has established a market structure that will manage its hospitals and clinics. Each market will provide shared administrative services and be responsible for ensuring the medical readiness of active duty service members. In the DHA’s market structure, the BJACH will be a part of an SSO MTF (Small Market and Standalone MTF Organization). The SSO MTFs will focus on inpatient community hospitals and specialty care for a specific region.
The military health system is undergoing a transformation that will save the military $2.4 billion over the next six years. A recently released DoD report details how the organization plans to achieve this transformation, which will require infrastructure changes. This transformation will include the consolidation of all IT services, infrastructure, and management for the new Defense Health Agency. Consolidating all of these services will allow the Defense Health Agency to provide 24/7 care to military members and their dependents while lowering the cost of encounters by 80 percent.
In order to implement this transformation, the Department of Defense is focusing on three areas of its healthcare IT infrastructure: enterprise services architecture, medical device cybersecurity, and wide area network infrastructure. This new healthcare IT system will be used to support 9.5 million beneficiaries and 205,000 military health system personnel. It will replace legacy DoD EHR systems.
The MHS transformation has been a long process, starting with the consolidation of individual medical departments and the standardization of IT infrastructure. ECS began a strong customer relationship with the DHA early on and has continued to support them through this new integrated infrastructure. ECS has also played a key role in Med-COI since its inception and is continuing to support the program.
The Manpower Changes for Military Health System Transformation program includes recommendations for repurposing the MHS workforce to focus on quality of care, health outcomes, and safety. The proposed changes will ensure that the health system aligns with national quality measures and reduces undesired variability. The new system will also implement evidence-based best practices to ensure quality. The future MHS will incorporate the input of patients and military personnel through advisory committees. These groups will help to create an integrated system of health and readiness and add insights and perspectives on the patient experience.
Currently, the Army, Navy, and Air Force provide healthcare services independently, or with varying degrees of integration. By transforming the MHS into a single, integrated system of health, the Army, Navy, and Air Force can better focus on readiness and provide a consistently high-quality experience for patients. The transformation also aims to modernize the TRICARE health plan to better meet the needs of patients.
Currently, there are seven21 military treatment facilities that serve the 9.5 million beneficiaries under TRICARE. These facilities are clustered in 21 large markets and 16 small market regions and include clinics and hospitals.
The MHS GENESIS program will make electronic health records available to the entire spectrum of military and VA healthcare facilities. This seamless availability will eliminate the need to transport records from one location to another and repeat tests. This will also allow the MHS to better coordinate care among its various entities.
The Department of Defense has awarded a $4.3 billion contract to implement the new system, which will replace the aging legacy EHR. The system has been in development for about a year, with the first sites launching in February and July of 2017. Two more sites are scheduled to launch in fall 2017 and early 2022, and full deployment will be completed by 2024.
MHS GENESIS is a new electronic health record that will connect inpatient and outpatient care. It will also improve security and integrate an identity management capability. It will also help military personnel manage their health and military readiness. The MHS GENESIS system is a fully integrated system that will be able to capture and share medical, dental, and other health information.
MHS GENESIS has been deployed to military treatment facilities in California. Four of the five states are participating in this deployment. The four sites include Travis Air Force Base, Naval Air Station Lemoore, and the Presidio of Monterey.
Electronic Health Record
The military is at the forefront of the development and deployment of electronic health records. Various DOD and VA commissions have recommended a more coordinated data sharing and coordination effort. In response to these recommendations, the DOD and VA have implemented capabilities to exchange patient health information. However, these capabilities have not yet been fully integrated and are still being evaluated by Congress. In 2008, Congress passed several mandates requiring the development of an interoperable EHR and the creation of an interagency program office.
In July 2015, the Department of Defense awarded a $4.3 billion contract to a contractor to develop a new MHS-wide EHR system. The system, called MHS Genesis, is expected to replace an aging legacy EHR. Deployments began in February 2017 at two sites, with the full deployment scheduled to take place by 2022.
To be successful, MHS must have robust interoperability capabilities. A system that can be used by multiple providers can improve quality and responsiveness.