A Message from MHS Leadership: Patient Centered Medical Home

From Military Health System Leadership

After more than a decade of war and in a period of national evolution in concepts of health care, the Military Health System (MHS) must reengineer processes by which we bring health to the 9.6 million beneficiaries we serve. 

We have embarked on a shared strategy to prepare the MHS to successfully meet the future challenges of the missions we support while providing progressive, highest quality care to those for whom we provide care.  In support of this strategy, we are making significant progress. We have activated the Defense Health Agency and are improving the process by which we set strategy and make decisions in the MHS. 

Continuous improvement of patient-centered delivery of health services within MHS military treatment facilities is key to our strategies to achieve and sustain Readiness, Better Care, Better Health and Best Value. 

The Patient Centered Medical Home (PCMH) is central to our strategy to form a partnership with each patient for whom we provide primary care to help them successfully sustain health and function.  By redesigning our primary care around multi-disciplinary teams sustaining a continuous relationship with their patients and implementation of interactive technology, PCMH is showing early results and promise.  Positive results from our established PCMH sites include improved access to care, improved continuity of care, more timely preventive measures, improved coordination of care for chronic conditions, and reduced need for emergency department care.

We know PCMH is a journey in which success will hinge on continuous improvement. We must empower the teams to find the processes that work best and share what is learned to continuously improve our standard processes.

This will not only optimally serve our patients but also give our primary care teams the professional experience that retains the best in the MHS.  We are confident that continued progress in applying the principles of PCMH will produce the outcomes defined in the Quadruple Aim: ensuring a medically ready Force, delivering a consistently positive experience of care, timely prevention and encouragement of healthy behaviors, and creation of value through continuous reduction in waste and inefficiency.

Streamlined, patient-centered processes are likewise essential to our specialty and inpatient operations in our MTFs. Our hospitals and ambulatory specialty MTFs are embarking on projects to sustain and enhance highest quality care while gaining efficiency to increase the volume of care provided to our beneficiaries.  Examples of such improvement projects include operating room management, emergency department flow, inpatient flow, acceptance of transfers, facility layout, and medical logistics support, to name a few. We are standing up six Enhanced Multi-Service Markets under a single market manager to produce coordinated provision of services in large markets containing an MHS hospital and multiple medical treatment facilities. These activities and more are essential to ensuring MHS hospitals into the future meet the strategies within the Quadruple Aim, including the readiness of our deployable medical forces.

The consolidation of shared services under the Defense Health Agency will be vital to the transformation of the MHS.  Experts in each of the shared services are working with leadership across the MHS to reengineer processes to produce standardization and less duplication in support services that will include health information and technology, health facilities, medical logistics and contracting, medical research and development, education and training, pharmacy, the TRICARE health plan, and resource management.  While consolidated support services to our medical treatment facilities may be new, the MHS has a strong legacy of joint operations at war and in humanitarian operations.  While a great deal of work lies ahead to achieve the full benefits of shared services, we know our legacy of providing care jointly will serve us well in this important endeavor.

An important transformation is underway in the MHS based upon a strong, shared strategy.  We appreciate the focus by every member and every team in the MHS on continuous patient-centered improvement.  Our success as an MHS is built upon your hard work, team work and innovation.

Sincerely,

Jonathan Woodson, Assistant Secretary of Defense for Health Affairs

Lt. Gen. Patricia Horoho, Surgeon General, United States Army

VADM Matthew Nathan, Surgeon General, United States Navy

Lt. Gen. Thomas Travis, Surgeon General, United States Air Force

Lt. Gen. Douglas Robb, Director, Defense Health Agency