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Applying COVID-19 innovations to the future of MHS medicine

Virtual health visits are expanding in response to COVID-19. Virtual health visits are expanding in response to COVID-19.

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“I would do anything to help my patients” and “I look forward to business as usual after COVID-19” – declarations many Military Health System providers worldwide would wholeheartedly agree with during the coronavirus pandemic. We give our best every day to ensure infected and non-infected alike get the treatment they need.

As we envision health care in a post-pandemic world, we can’t ignore that COVID-19 has already irrevocably changed how we deliver care and will continue to do so. We must use the terrible clarity these unprecedented circumstances provide to honestly evaluate our tools and practices, and apply that wisdom to make real, lasting improvements to health care.

This mindset of embracing innovation for the sake of our patients is already a hallmark of MHS providers. We find creative, clinically sound ways to treat our patients no matter the obstacle.

We are also in a prime position to lead by example in keeping the best of what we’re learning during COVID-19. The MHS is one of the largest health care systems in the world and has the tools, experience, logistical capacity and operational flexibility to do what many other health systems cannot. Our experience with global, 24/7, life-and-death medical crises means we can lead in innovation when it’s most needed.

A MHS health care provider holds a virtual health visit with a patient.
A MHS health care provider holds a virtual health visit with a patient. 

Case in Point: Virtual Health

One way MHS providers can start adopting innovative practices right now during COVID-19 is through virtual health, also known as telehealth or telemedicine. The MHS offers ready-to-use virtual health capabilities that are effective, secure, accessible and compliant. In fact, the MHS Virtual Medical Center (VMC) has rapidly expanded scalable virtual health tools for military patients and medical personnel across the Services to ensure continuity of care during the COVID-19 pandemic.   

The VMC serves as a hub for virtual health, enabling medical personnel in the field to connect with patients. It provides operational experience in delivering care around the world, working across international time zones, specialties and military service branches to get the right treatment to the right patient at the right time. The VMC is uniquely prepared to help providers and patients understand and use virtual health.

Working with the VMC allows providers to hit the ground running with tested tools and easy access to subject matter experts and training. The VMC workflows also efficiently connect providers with patients. Once they use virtual health, many providers find that they can do many appointments through a virtual health platform, with greater convenience and satisfaction for both them and their patients.

Extensive Resources

The resources available right now for incorporating virtual health into your practice include:

  • The VMC: Any MHS provider or care team can request access to military virtual health platforms by accessing the VMC SharePoint site.
  • Telemedicine Privileging:It is permissible for most MHS providers (to include personal services contract providers) to virtually care for patients located in a different state during COVID-19. Virtual care can occur outside a military medical treatment facility (MTF), such as at a patient’s home. A unique advantage for military medical personnel is that you can both be credentialed at your local facility and have privileges at the VMC. This pairing enables you to virtually access patients and their electronic health records at any MTF worldwide, a huge force multiplier.
  • Your local MTF: Talk to your local MTF virtual health point of contact. If your MTF does not have one yet, the VMC can connect you to experts.
  • ADVISOR Help Line: The Advanced Virtual Support for Operational Forces system, or ADVISOR, provides on-demand telephone and secure video consultations with specialty providers during emergencies. Originally designed for field personnel, ADVISOR now enables any MTF to get 24/7 live help with COVID-19 cases. Operators route calls to on-call MHS providers with operational experience in:
  • Infectious disease (pediatric/adult)
  • Palliative care
  • Critical care (pediatric/adult)

Remembering for the Future

Virtual health is undeniably different from traditional practice and can take getting used to. The technological, logistical and even cultural hurdles we encounter in adopting it – or any new practice born of crisis – are worth overcoming to help ensure patients receive the care they need anytime, anywhere.

That is especially important to remember once things return to “the new normal.” One of the biggest mistakes we can make when a crisis abates is to forget why we needed to change in the first place, and to think that those changes applied just to that situation instead of informing our practice going forward.

Virtual health is going to be part of that future, to the point that in five years, we won’t be saying virtual health or telemedicine, just -- medicine.

We need to learn from our COVID-19 experience and change our tools, processes and workflows as needed so we are better prepared for all world-changing incidents, not just the next pandemic. If we do, we will show that when we say “we’ll do anything for our patients,” we really mean it.

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DoD COVID-19 Practice Management Guide Version 5

Technical Document
7/30/2020

This Practice Management Guide does not supersede DoD Policy. It is based upon the best information available at the time of publication. It is designed to provide information and assist decision making. It is not intended to define a standard of care and should not be construed as one. Neither should it be interpreted as prescribing an exclusive course of management. It was developed by experts in this field. Variations in practice will inevitably and appropriately occur when clinicians take into account the needs of individual patients, available resources, and limitations unique to an institution or type of practice. Every healthcare professional making use of this guideline is responsible for evaluating the appropriateness of applying it in the setting of any particular clinical situation. The Practice Management Guide is not intended to represent TRICARE policy. Further, inclusion of recommendations for specific testing and/or therapeutic interventions within this guide does not guarantee coverage of civilian sector care. Additional information on current TRICARE benefits may be found at www.tricare.mil or by contacting your regional TRICARE Managed Care Support Contractor.

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