Military Medical Care
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1 Military Medical Care Jeannette E. South-Paul, MD University of Pittsburgh Department of Family Medicine November 11, 2009
2 National Defense Authorization Act (NDAA) 2007 SEC. 734 Develop a fully integrated program on disease and chronic care management for the military health care system that provides uniform policies and practices on disease management and chronic care management 2 throughout that system
3 National Defense Authorization Act 3 (NDAA) 2007 Meet nationally recognized accreditation standards Disease Management Association of America Components (e.g. population identification processes and evidence-based practice guidelines) Specify outcome measures and objectives Capture and report data across the services AND the purchased care arenas in order to provide the Congress comprehensive DM reports Include strategies for all beneficiaries including Medicare Conform to HIPAA laws and regulations Source: NDAA 2007 Section 734 (c)
4 DoD Health Care - Combining Military-Unique Programs, Public Health Functions and Health Plan Best Practices Responsibility for Comprehensive portfolio of health programs to support the national defense strategy and To improve the health of military communities.
5 DoD Health Care - Combining Military-Unique Programs, Public Health Functions and Health Plan Best Practices Diverse programs ranging from Traditional health care services (hospitals and clinics) Environmental health Disease surveillance in remote locations Health protection and health promotion Treatment and rehabilitative services Assessing and monitoring health status
6 Military Health Care System Strives daily to simultaneously accomplish five interconnected goals: A fit, healthy and protected force Reduced death, injuries and diseases during military operations Utmost satisfaction of beneficiaries Creation of healthy communities Effective management of health care costs
7 MEDCOM MTFs and CBHCOs Alaska WRMC Ft. Wainwright, AK Ft. Irwin, CA PRMC Tripler, HI Oregon California Washington Nevada Idaho Utah GPRMC Ft. Carson, CO Ft. Huachuca, AZ Ft. Leavenworth, KS Ft. Riley, KS Ft. Sill, OK Ft. Sam Houston, TX Ft. Polk, LA Montana Wyoming New Mexico Texas Oklahoma Minnesota CBHCO Locations Hybrid CBHCOs* * AK, HI and PR to run CBHCO-like operations from local garrisons & MTFs VT Wisconsin NH New York Michigan MA Pennsylvania Iowa Illinois Indiana Ohio NJ West DE Virginia Virginia Missouri Kentucky North Arkansas Tennessee Carolina SC Miss Georgia AL FL SERMC Ft. Benning, GA Ft. Campbell, KY Ft. Rucker, AL Redstone Arsenal, AL Ft. Jackson, SC Ft. Stewart, GA Maine NARMC Ft. Drum, NY West Point, NY Ft. Monmouth, NJ Ft. Dix, NJ Ft. Meade, MD Walter Reed, DC Ft. Belvoir, VA Ft. Lee, VA Ft. Eustis, VA Ft. Bragg, NC Ft. Knox, KY Puerto Rico Ft. Buchanan, PR
8 Military Treatment Facilities
9 Disparities what happens when things are not equal
10 Health Disparities in the US Have existed for decades Occur across the lifespan Encompass physical and behavioral health Involve a variety of clinical and scientific disciplines Demands cultural proficiency to manage Will need a diverse and well trained workforce to make changes Require focused efforts to address effectively
11 Newsweek, September 19, 2005
12 Military Health Care Goal of standardizing care for service members and families Eliminating disparities within the force Henley and Kugler s work Partnering with civilian clinicians when needed Taking the lead on military medicine not just medicine in the military
13 It takes leadership and it takes a change in the culture of war. Sen Patty Murray (D, WA)
14 Behind an able man (woman) there are always other able men (women). Chinese Proverb
15 USU A worldwide reputation as a center of excellence for military and public health professions education and research. Unique programs related directly to force health protection, tropical diseases, disaster medicine, military and public health medical readiness and adaptation to extreme environments. Commitment to preparing outstanding scientists and health care practitioners for careers in service to the nation
16 Teams Involve more people, thus affording more resources, ideas, and energy than would an individual. Maximize a leader s potential and minimize her weaknesses. Strengths and weaknesses are more exposed in individuals. Provide multiple perspectives on how to meet a need or reach a goal, thus devising several alternatives for each situation. C. G. Wilkes in John C. Maxwell, Equipping 101. Thomas Nelson Publishers, Nashville, 2003.p.5-6
17 Teams Share the credit for victories and the blame for losses. This fosters genuine humility and authentic community. Keep leaders accountable for the goal. Can simply do more than an individual. C. G. Wilkes in John C. Maxwell, Equipping 101. Thomas Nelson Publishers, Nashville, 2003.p.5-6
18 How to Invest in Your Team Make the decision to build a team this starts the investment in the team Gather the best team possible this elevates the potential of the team Pay the price to develop the team this ensures the growth of the team Do things together as a team this provides community for the team John C. Maxwell, Equipping 101. Thomas Nelson Publishers, Nashville, 2003.p.16-21
19 How to Invest in Your Team Empower team members with responsibility and authority this raises up leaders for the team Give credit for success to the team this lifts the morale of the team Watch to see that the investment in the team is paying off this brings accountability to the team John C. Maxwell, Equipping 101. Thomas Nelson Publishers, Nashville, 2003.p.16-21
20 Everything rises and fall on leadership
21 No executive has ever suffered because his people were strong and effective! Peter Drucker
22 Great leaders seek out and find potential leaders, then transform them into good leaders.
23 How are Your Values Seen? In the context of organizational and professional culture, values are embedded in the strategies and tactics through which the job gets done. When there is a contradiction between the stated values and the behaviors, we believe the behaviors. Values lead to management style and leadership preferences. Robinson-Walker C. Women and Leadership in Health Care: The Journey to Authenticity and Power. Jossey-Bass Publishers. San Francisco
24 Newsweek, September 19, 2005
25 September 11, 2001
26 Military Health Care Is About Family
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Department of Defense DIRECTIVE NUMBER 4165.50 June 26, 1991 ASD(P&L) SUBJECT: Homeowners Assistance Program (HAP) References: (a) DoD Instruction 4165.50, "Administration and Operation of the Homeowners