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Military Health System

How Standing Up Regional Markets is Improving Access to Health Care

Image of Air Force Maj. Megan George, a registered nurse assigned to the 633d Medical Group based at Joint Base Langley-Eustis, Virginia, retrieves medical supplies from a storeroom at Hennepin Healthcare in Minneapolis, Minnesota during COVID-19 response operations, Dec. 7. The DHA has seen early success in replacing deployed personnel in their assigned markets (Photo by Navy Petty Officer 2nd Class Michael H. Lehman). Air Force Maj. Megan George, a registered nurse assigned to the 633d Medical Group based at Joint Base Langley-Eustis, Virginia, retrieves medical supplies from a storeroom at Hennepin Healthcare in Minneapolis, Minnesota during COVID-19 response operations, Dec. 7. The DHA has seen early success in replacing deployed personnel in their assigned markets (Photo by Navy Petty Officer 2nd Class Michael H. Lehman).

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When the Army deployed a team of doctors from Kentucky to support Afghan refugees last summer, their home installation was initially concerned about the deployments creating gaps in care for pediatric services.  

But those concerns quickly faded after the local director of the Defense Health Agency’s new Southwest Kentucky Market reached out to the DHA’s headquarters to notify military health officials about the deployments’ potential impact on local beneficiaries. 

Within days, the DHA helped to craft a plan to provide additional pediatric care resources and eliminate the risk of any lapses in care for the local market area.

That’s just one example of the benefits of the new regional markets that the DHA formally launched throughout 2021. As of late December, all military medical treatment facilities within the United States are now fully under the authority, direction and control of the Defense Health Agency and the DHA’s network of markets.

The modernizations set in motion in 2021 will optimize care and sharing of medical resources across services and the entire Military Health System, said U.S. Public Health Service Capt. Tracy Farrill, transition director for the DHA Assistant Director for Health Care Administration.

“In situations like this, you have an entire organization to look across, from coast to coast…to find out where they can spare providers,” said Farrill.

“Now, instead of only the Army, Air Force or Navy being available for their beneficiaries, we can consolidate all of our resources.”

Markets are groups of military treatment facilities working together with their TRICARE partners, Veterans Affairs hospitals, other federal health care organizations, private sector teaching hospitals and medical universities, as well as other civilian health care partners in their area.

These markets operate as a single system to support the sharing of patients, staff, budgets, and other functions across facilities to improve readiness, and the delivery and coordination of health services. Congress mandated the creation of the markets to better integrate and improve the efficiency and effectiveness of the entire Military Health System.

In addition to sharing resources to improve care, the new markets will also increase the Military Health System’s ability to standardize care across the country and around the world. That reduces the amount of retraining that medical service members face when changing duty stations.

“They shouldn’t have to learn a new system wherever they [change duty stations]. That’s where the standardization comes into play,” Farrill said.

This system-wide standardization also benefits patients. The new electronic health records system, known as MHS GENESIS, is currently being deployed across the MHS. Once fully deployed this new EHR will standardize care for patients, and many of the administrative tasks.

“With the transition to MHS GENESIS, all the records will be available electronically. If you’re from the East Coast and go to the West Coast, access to care and how you access that care will be the same. You don’t have to learn a whole new process,” Farrill explained.

“How do you get your prescription refills? How do you get into X-ray? How do you make your appointments with your physician? It will all be very similar for the beneficiaries.”

DHA Director Army Lt. Gen. (Dr.) Ronald Place pointed to an example of how standardization is improving care and outcomes. Place noted how the MHS is working to improve maternal health care, specifically the prevention and treatment of post-partum hemorrhaging, or PPH.

PPH is the leading cause of preventable maternal deaths worldwide. Due to increased attention within the MHS, PPH rates among MHS beneficiaries have fallen well below the national average for the civilian health care system. Deaths attributed to PPH among mothers treated in the military health system are about 7.4 deaths per 100,000 live births, significantly lower than the 11.3 reported at non-MHS facilities nationwide.

To further improve care, DHA implemented system-wide protocols for MHS staff.

“The women’s health clinical community came together and looked at the entire peri-partum system, with standardization of appropriate processes along with targeted innovations throughout the enterprise,” said Place.

“That led to a DHA Procedural Instruction that they, the local users, thought was a good idea. We codified it at DHA Headquarters. Ramifications have been significant and important,” Place said.

The DHA will continue to evaluate progress on efficiencies and effectiveness.

“We’ve set the foundation for greater collaboration and resource sharing across military hospitals and clinics representing nearly two-thirds of our current patient encounters,” Place said. 

“We are strengthening the medical readiness we deliver to the Joint Force, standardizing health care delivery processes, and improving the patient experience overall,” he said.

More information about markets and what the MHS transformation means to you and your family can be found here.

While the stand up of local markets is a major milestone for the MHS, the instructional changes should be “seamless” to beneficiaries.

“Nothing changes in the way of providing good healthcare delivery with great outcomes,” Farrill said.

“If anything, beneficiaries should notice an improvement to access and some standardization. But all of this should be going on in the background while they continue to receive the high level of care that we’ve always provided.”

 

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