Military Health System Has Courage to Change, Official Says

By Cheryl Pellerin
American Forces Press Service

WASHINGTON, Feb. 2, 2012 – On the final day of the 2012 Military Health System Conference here, the Defense Department’s top health affairs official spoke today not about the undisputed excellence of the system and its caregivers, but rather about the need for more collaboration, transformation and organizational courage.

Dr. Jonathan Woodson, assistant secretary of defense for health affairs and director of the TRICARE Management Activity, addressed 3,000 attendees at the conference.

“Our people have always exhibited great personal courage over the years, and this has been shown many times on the battlefield,” he said. “There is no shortage of personal courage. Now, it’s about exhibiting organization courage -- specifically, the courage to change.”

To keep pace with the future, Woodson said, the military health system must have the courage to become more joint, more collaborative and integrative, and broader in focus to leverage all the talent in the system, irrespective of service or rank.

“We need the courage to [re-examine] how we incentivize behavior in our system. … We need to face up to the shortcomings of our information systems, our patient engagement strategies and our approaches to changing the behavior of our population in terms of health risks,” he said.

The system also must engage in a strategy of collaboration with all of its federal partners, Woodson said, particularly the Veterans Affairs Department.

The $53 million military health system includes more than 133,000 military and civilian doctors, nurses, medical educators, researchers, health care providers, allied health professionals, and health administration personnel around the world. Woodson said the system must assess its performance and relevance in terms of value and not cost alone, and must communicate this value to its stakeholders, especially the larger Defense Department community.

“On Feb. 13, [President Barack Obama’s] budget will be released, and as you would expect, … there will be a significant focus on the numbers. The budget’s numbers are important, but they don’t convey the story that was described to you this week by so many speakers,” Woodson told the conferees. “The story of the MHS is not about $53 billion or how many prescription drugs were purchased or [the number of] co-pays or deductibles. It’s about the value we provide to the people we serve. That’s the story we need to tell over and over again in all of our communities.”

Fiscal challenges should not be allowed to distract the men and woman of the military health system, he said. “Instead,” he added, “we should seize upon the opportunity to become stronger, better and more relevant.”

From the conference presentations, Woodson said, he’s taking away messages about leadership development, knowledge sharing and innovation.

“In most eras, the military has never been wanting for leaders, because that is what we do. … [But] the development of good leaders with updated competencies requires constant attention,” he said. “Military health system leaders need special competencies to manage health care issues effectively in the 21st century.”

During a conference session with senior enlisted advisors from each service, the assistant secretary said, he learned that one of their critical concerns is that the skills acquired by enlisted medics who performed so brilliantly on the battlefield not be allowed to atrophy as the kinetic wars subside and they return to peacetime duties.

“The integration of enlisted medics could be the critical shaping factor for our future,” Woodson said, “and may provide the answer to how we establish and staff effective patient-centered medical home teams with extended capabilities to meet our patients’ needs.”

The military health system also must focus on leadership development of officers in the post-war environment, he added.

“Our military treatment facility commanders and staff have borne a substantial burden in trying to balance the needs of deployment, readiness, training and running garrison health systems over the past decade,” Woodson said.

In addressing knowledge sharing and innovation, the assistant secretary described the need for a broader strategy of developing a culture of innovation, nurturing the innovative spirit and “rewarding the innovators in our midst.”

Woodson said he is convinced that MHS expertise is comparable to the best expertise anywhere in the world, “but we need to improve the access to this expertise.”

During one of the conference sessions, Dr. Denis A. Cortese, director of the Arizona State University Healthcare Delivery and Policy Program and a former Mayo Clinic chief executive officer, talked about internal knowledge-sharing systems in use at premier institutions such as Mayo, the Cleveland Clinic, the Intermountain system of hospitals and Johns Hopkins University.

“We have to do this, too,” Woodson said, “and we will.”

The conference has been not just an opportunity to share information and distribute knowledge across the enterprise, Woodson said.

“It’s also how we cull innovation and how that feeds into the generation of new knowledge,” he added. “This year and in the coming years, we will have the opportunity to change. The years will be challenging, the tasks will be hard, and we have the responsibility to get it right.”