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Tidewater Market Saves by Integrating and Optimizing Pathology Services

Image of Laboratory Technician Andrienne Collier works with wound cultures to isolate microorganisms while working at the Naval Medical Center Portsmouth laboratory. As part of the Defense Health Agency’s Tidewater Market, the NMCP laboratory provides a comprehensive range of anatomic pathology, blood bank, and clinical pathology services to eligible beneficiaries in the Tidewater region. (U.S. Navy photo by Mass Communication Specialist 2nd Class Dylan M. Kinee/Released). Laboratory Technician Andrienne Collier works with wound cultures to isolate microorganisms while working at the Naval Medical Center Portsmouth laboratory. As part of the Defense Health Agency’s Tidewater Market, the NMCP laboratory provides a comprehensive range of anatomic pathology, blood bank, and clinical pathology services to eligible beneficiaries in the Tidewater region. (U.S. Navy photo by Mass Communication Specialist 2nd Class Dylan M. Kinee/Released)

In a Defense Health Agency Market that serves more than 390,000 beneficiaries, U.S. Navy Capt. Stacie Milavec is the subject matter expert on all matters concerning clinical laboratory and anatomic pathology services. Her work to establish a laboratory/pathology collaboration in the Tidewater Market, in southeast Virginia, streamlined efficiencies, cut costs, and created an unprecedented partnership across military hospitals and clinics in the region.

Naval Medical Center Portsmouth Commanding Officer U.S. Navy Capt. Shelley Perkins asked Milavec to look for ways to optimize services within the newly established Tidewater Market. With more than 23 years of experience in military medicine, she took on the challenge and immediately began to identify opportunities.

"One of DHA's goals with setting up a market structure is to find efficiencies and optimize and standardize processes and services wherever possible," said Milavec. "We’ve been able to do exactly that by collaborating within our working group."

In 2022, Milavec established a Tidewater Market Laboratory/Pathology Integration Working Group with representatives from NMCP, the 633d Medical Group at Joint Base Langley-EustisMcDonald Army Health Center, and members from DHA's Tidewater Market office.

The working group began meeting monthly to discuss collaborative efforts and identify ways to cut costs by sharing resources. As a full-service medical center laboratory, NMCP had the capacity to take on pathology caseloads from the Market. The laboratory at NMCP began taking on head and neck pathology cases, human papillomavirus testing for all Market military hospitals and clinics, and breast biopsy and PAP cases. These services were previously supported by other means and, in some instances, through commercially contracted laboratories for analysis at a price.

The working group’s efforts saved the Tidewater Market an estimated $80,000 during fiscal year 2022. The military hospitals and clinics working geographically close to one another also equated to quicker turnaround times for test results.

Beginning this month, NMCP will take on additional clinical chemistry tests from the 633d Medical Group at Joint Base Langley-Eustis, which up until recently were sent to commercially contracted laboratories off base.

“[Through collaboration between the MTFs] We’ve been able to successfully transition civilian marketplace send-out testing back into the military market by utilizing market resources,” said U.S. Air Force Capt. Dianna Chormanski, a staff pathologist and laboratory medical director with the 633d Medical Group at Joint Base Langley-Eustis. “I’m a big fan of cooperation and working together, and that’s what a Market should be.”

Derived from the National Defense Authorization Act for Fiscal Year 2017, DHA established the market-based structure to consolidate the management of military hospitals and clinics into regions and to support the sharing of patients, staff, budget, and other functions across facilities to improve readiness and the delivery and coordination of health services.

The Tidewater Market, established in 2021, is the nation's fifth Military Health System market established to manage military medical treatment facilities that support the delivery of integrated, affordable, and high-quality health services for active duty service members, retirees, reservists, guardsmen, and their families enrolled at Naval Medical Center Portsmouth, McDonald Army Health Center, the 633d Medical Group at Joint Base Langley-Eustis, U. S. Naval Hospital Guantanamo Bay, Cuba, as well as 14 health clinics in the Tidewater region.

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Continuing Implementation for Reform of the Military Health System

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This memorandum directs the continued implementation of the Military Health System organizational reform required by law, extending the authority, direction and control of all military hospitals and clinics not currently under Defense Health Agency authority to the DHA, to include military hospitals and clinics in overseas areas.

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Last Updated: March 10, 2023
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