“How do we as a health care system value you, your health, and your well-being? It’s my singular focus,” said U.S. Army Lt. Gen. Telita Crosland, the director of Defense Health Agency, at last week’s 2024 annual meeting of AUSA, the Association of the United States Army.
Crosland joined Dr. Jonathan Woodson, president of the Uniformed Services University of the Health Sciences, and U.S. Army Lt. Gen. Mary Izaguirre, U.S. Army Surgeon General and commanding general of the U.S. Army Medical Command, on the Warfighter and Family Forum panel titled “Transforming Combat Ready Care.”
They discussed a range of topics focused on evolving military health for patients and medical forces, including digital health transformation, artificial intelligence, and the next-generation TRICARE contracts starting January 2025.
“Over the last several years, I've had an opportunity as a senior leader to hear from many of you on our health care system,” Crosland said. “There is a consistent message—we all have an expectation that our health care system is designed to fit into our actual lives.”
Izaguirre outlined areas of strategic focus key to transforming combat ready care.
“We need to make sure we address the culture of how we are caring for each other, our soldiers, and our families, past and present, across the spectrum,” said Izaguirre. “It is foundational to our ability to move forward and be able to do the tough jobs we're asked to do every day.”
“That all involves people … how we are caring for people both within our system and the people who (work in) our system,” she continued, “We've seen how important that is over these past five years as we've gone through COVID-19 and other events.”
Partnerships are another important area of focus.
“We need to make sure we have robust partnerships built before the time of need, so our families, soldiers, and beneficiaries can get the care they require to maintain their status of health,” said Izaguirre. “[We want] people to not only have a longer lifespan, but ideally, a longer joy span. Meaning, they’re able to live fully and appreciate the freedoms we are all fighting for.”
She added, “I could not be more excited to be partnering with General Crosland and all the great work she's doing.”
TRICARE Enhancements
Crosland addressed enhancements to TRICARE in 2025 as a next generation contract – referred to as T-5 – goes into effect.
“The T-5 contract has been 10 years in the making and will roll out on 1 January,” she noted.
“The goal I have for our transition is to be as seamless as possible,” said Crosland. “There are some things we did differently in this contract. For example, there was a frustration with the directory. So, in the T-5 contract, we financial incentives to drive more accurate provider directories.”
Crosland said managed care support contractors will also help beneficiaries better navigate the networks for specialty care referrals.
“When you get a referral, they're going to help you get your first appointment for specialty care in the network if you need assistance,” she said.
(For more on how TRICARE contracts will change in 2025, visit the TRICARE.mil Newsroom for updates)
Digital Transformation and Workforce Shortage
Woodson highlighted the need to educate the next generation to be adaptable in the face of rapid advancements in technology.
“The world is changing,” he said. “It's changing in terms of technology and requirements. Our challenge is to always stay ahead of the curve so our students are relevant to the future in terms of military medicine and will become the best military medical officers the country deserves. As we go forward, we'll be working very closely with the services to determine how we should support the generation of the force going on into the future.”
Woodson said the digital health transformation can support workforce burnout, especially when facing a shortage of health care professionals in the MHS.
“We know there is a pervasive problem of work force shortage,” he noted. “A projected nurse shortage of 195,000, physician shortage of 124,000, health aid shortage of 400,000, and projected shortages in our allied health professions as well.”
People are at the heart of delivering care, said Woodson, “whether it's in a deployed environment or in garrison. The question is, going forward, how do we allow individuals to do more, and the capacity of the system as a whole, to do more? We’ve got to leverage technology to support the workforce, not only to allow them to deliver more care, but to support their work environment so that they don't get burned out.”
AI is being explored to look at ways it can improve support to the workforce, he said.
“We're looking very aggressively within health care to give the individual health care individual provider the tools to assimilate the information, provide better care at the point of contact with the patient, and give greater capacity to the whole system,” explained Woodson. “We're revising our curriculum across the schools and colleges to ensure that workforce has the competency to work in the digital age.”
My Military Health
Crosland said she is leading the DHA to leverage technology in an innovative way to improve access and convenience. My Military Health is a new model of care, transforming how DHA interacts with patients. My Military Health leverages new technologies and tools to improve access to care and health information, improving processes for patients and providers to deliver high quality care anytime, anywhere, always.
“We identified five locations … to test My Military Health, and in January, they started moving out,” Crosland shared. “We gave them three capabilities to get a sense of how we can use, utilize, and scale it to improve primary care and behavioral health.”
The five locations, referred to as venture sites, are:
- Martin Army Community Hospital, Fort Moore, Georgia
- Naval Hospital Jacksonville, Jacksonville, Florida
- Naval Medical Center Portsmouth, Virginia
- 96th Medical Group, Eglin Air Force Base, Florida
- 88th Medical Group, Wright-Patterson Air Force Base, Ohio
The capabilities include Virtual Visits, a secure platform for scheduled and on-demand virtual video appointments with health care teams; SilverCloud, a self-paced online wellness platform designed to boost resilience and increase well-being; and Care Companion, a secure, personalized automated chat platform that helps patients manage and monitor specific health conditions between medical appointments.
“I had a doctor's appointment from my office in Virginia with a provider at Wright-Patterson,” said Crosland, speaking about her own experience with Scheduled Virtual Visits. “I got a link to my personal cell … when I touched that link two hours later, there was my intake, the provider appeared on the line, and I was taken care of—it saved me three hours.”
At its core, My Military Health is focused on the patient.
“When we launched these new initiatives, we started with patient journeys. We mapped out what it looks like from the lens of a patient coming into our system, and we challenged ourselves to take out things that are not value added,” she said.
“I just want you to hear this isn't more of the same,” she continued. “This is truly driving us to change how we deliver care. It's a mindset change. Leveraging the technology is cool, but the real hard work, and the thing I'm most proud of, is the mindset change.”
Crosland urged attendees to look to the future with a sense of optimism.
“Change is hard,” said Crosland. “We know how to do hard. We are, in fact, doing hard together, with the Army, Navy, and Air Force as well. And I am optimistic because we've never come up short, and we're not about to start.”