WASHINGTON, Oct. 2, 2014 – A team of medical experts from both within and outside the Defense Department has found that the Military Health System (MHS) provides good, quality health care that is safe, timely and comparable to the civilian sector, but has also identified areas for improvement.
In May, Defense Secretary Chuck Hagel ordered a comprehensive review of the military health system to focus on access to care and to assess the safety and quality of care being provided both in military treatment facilities as well as in healthcare that the department purchases from the private sector.
“Overall, the DoD did an amazing job looking at a large amount of data to evaluate their quality and data,” Dr. Peter Pronovost, Johns Hopkins Medicine Senior Vice President for Patient Safety and Quality, said in the report. “Though care in MHS and civilian facilities can improve, there was no evidence that care in MHS facilities is worse overall than civilian healthcare. The MHS should be commended for its dedication to patients and to improving safety and quality.”
The review team made six recommendations for the MHS, which cares for 9.6 million beneficiaries — service members, families and military retirees and their families. Secretary Hagel has accepted these recommendations and has established milestones for their implementation.
Those recommendations are:
— Immediate action to improve underperformance.
The MHS will address the cause of outliers found among its military treatment facilities. The experiences of positive outliers will be studied and shared. If poor performance is found, corrective action plans should be quickly introduced to raise performance.
— Establish clear enterprise performance goals with standardized metrics and hold the system accountable for improvement. The MHS will create an enterprise-wide performance management system using a “core set of metrics” for health care access, quality and patient safety, the report noted. Systemwide performance measures should also be established, and regular formal performance reviews of the MHS should be conducted, with the Defense Health Agency charged with monitoring performance and supporting the health system’s governance.
— Make good decisions by relying on accurate data.
The MHS will develop an enterprisewide quality and patient safety data analytics system, to include health information technology systems, data management tools and appropriately trained personnel, the review team said.
— Show information to everyone — patients, providers and policy makers. The review team recommends transparency of information in direct and TRICARE health delivery.
— Drive the necessary change with joint MHS decision-making. Through new governance models that feature close Service, DHA and OSD collaboration, policy guidance can be developed using common goals. The report said such an effort would advance an understanding of the culture of safety and patient-centered care across the system.
— And, the MHS should also continue to create common standards and processes to improve outcomes across the system for access to care, quality and patient safety where it improves quality, or deliver the same level of quality at a better value.
Dr. Jonathan Woodson, Assistant Secretary of Defense (Health Affairs), and the senior medical advisor to Secretary Hagel said “We are entering a new phase for the Military Health System, after thirteen years of combat operations. Military medical personnel are rightly proud of their accomplishments in saving lives on the battlefield. We have more work to do to sustain the trust and confidence of the people we serve in all facets of our health delivery system.”
Secretary Hagel outlined an aggressive plan to further increase transparency, address areas where DoD falls short of national or internal standards, and establish the military health system as a model for health care access, safety and quality. As Hagel said in announcing the proposed reforms, the military health system cannot merely be “an average system, but a leading one – because that is what America’s troops and their families deserve.”
Over the next 90 days, a series of actions will be initiated to put plan in place, with regular reports to Secretary Hagel and Deputy Secretary Work.
Deputy Secretary Work pledged to “share our performance and our progress with the people we serve, with Congress, and with the American public.”