Federal health leaders, including the director of the Defense Health Agency and the acting assistant secretary of defense for health affairs, discussed areas for synergy and collaboration between military and civilian health care partners at a virtual roundtable held by the American Hospital Association April 12.
During a federal health update panel, DHA Director Army Lt. Gen. (Dr.) Ronald Place emphasized the importance of smarter data and information sharing in support of the health care mission.
"We often talk about our interest in creating a more integrated health system, not simply within the Department of Defense, but within the broader American health system," he said.
In doing so, the DHA is looking at multiple and different ways to integrate data sharing both from the Military Health System as well as from outpatient physicians' offices, Place explained.
As an example, Place highlighted MHS GENESIS, the new electronic health record (EHR) system being deployed across the MHS, which the Department of Veterans Affairs will also incorporate.
"In support of that, we're also growing our participation in health information exchanges so that we can more easily share clinical information within our network, with the network, and with other hospitals," he said.
Having one centralized MHS database will facilitate the continuum of care for service members, veterans, and their families across different duty locations and after they retire. It will also provide a centralized repository of medical records that can be shared with DOD and civilian facilities and providers for more efficient, standardized care.
"Integrating health care information is an important attribute for a highly mobile population like ours (military), but really the majority of Americans," said Place.
He added that expanding network capacity and increasing military-civilian partnerships are important areas of mutual interest with potential for collaboration. Getting those right would mean making care available to anyone who needs it, said the DHA director.
"I continue to think there is significant opportunity to develop partnerships that contribute to our readiness and strengthen and deepen our community relationships," he said. They're good for readiness, but they're also good for our relationships with communities as well, he added.
Dr. Terry Adirim, acting assistant secretary of Defense for Health Affairs, expanded on MHS GENESIS in a broader discussion on the MHS Transformation efforts amid responding to the COVID-19 pandemic.
"COVID-19 has been a challenge for all of us, including the Department of Defense and military medicine," she said. "We not only have to respond to our beneficiaries within DOD, but we've also provided a response to our fellow Americans."
For example, she highlighted DOD's active engagement in vaccinating.
"Our Defense Health Agency has led our military medical departments in establishing a program and all the policies, and we've administered already over 2.6 million doses of the COVID-19 vaccine" among DOD personnel, she said. "We've also administered several million doses in our support of the FEMA (Federal Emergency Management Agency) mission to vaccinate fellow Americans."
Like the civilian sector, she noted, the DOD community has suffered infection rates and deaths as well as seen an increase in mental health impacts from the pandemic, particularly on children. It has likewise incurred major financial costs due to the need to invest in personal protection equipment, pay for testing, and provide health care.
"Despite all these impacts, the DOD has responded admirably and has maintained a high level of readiness, so I have to give a shoutout to my military colleagues," she added.
Adirim also underscored DHA's impact on the civilian sector under Place's leadership, particularly in establishing a joint registry for COVID-19.
"That's been an invaluable resource for collecting and assessing clinical information for COVID patients, and we've been able to share what we've learned with the civilian community," she said.
She explained how the MHS Transformation is based on a congressional mandate to make changes in the military health structure, most notably to consolidate all DOD military medical treatment facilities (MTFs) under the DHA. And MHS GENESIS, as the sole EHR across DOD, is part of the transformation.
With MHS GENESIS, Adirim said, "we're going to see a lot of improvements in our ability to standardize care, to facilitate care, implement best practices, provide our clinicians with support in their decision making, etc."
However, "while the COVID pandemic has really stressed the MHS, it has provided opportunities and opened some doors with our EHR," she said. "Like everybody else, we had to singularly focus on COVID, so early in the pandemic we paused a number of these actions to complete the transition, but this winter we were able to resume," she said.
Despite the COVID-19 pandemic, Adirim said she is confident DHA will achieve full implementation of MHS GENESIS across all MTFs by 2023.
"The DHA has already implemented all the policies and procedures that our hospitals and clinics need to follow," she said. "They've been able to standardize the patient experience, standardize care, and be able to achieve some efficiencies."
This is another area for collaboration with civilian partners, she added.
"We're hoping that when we're done with this, we'll be able to share some of those with our civilian-sector colleagues," Adirim said.