Back to Top Skip to main content Skip to sub-navigation

MHS quickly adapted to improve patient experience during pandemic

Image of Military health personnel waiting for the next phone call on the COVID-19 advice line. Regina Andrews, a registered nurse at Fort Carson’s Evans Army Community Hospital Department of Surgery in Colorado, awaits her next phone call Aug. 5, 2020, from the COVID-19 patient advice line (Photo by: Emily Klinkenborg, Fort Carson Evans Army Community Hospital).

Recommended Content:

Coronavirus and the COVID-19 Vaccine | Coronavirus

Faced with the onslaught of the COVID-19 pandemic, the Military Health System (MHS) responded swiftly to fight the novel coronavirus and deliver necessary medical care, routine health care and services to maintain a medical ready force.

"At the beginning, the goal was to continue providing medically necessary and readiness-related care, which could not be delayed in order to protect patients and staff from unnecessary exposure to COVID," said Regina Julian, chief of the Healthcare Optimization Division at the Defense Health Agency (DHA). Julian cited dialysis services, the delivery of babies, well-infant examinations, emergency surgeries, and cancer-drug infusions as examples.

"We did these services in safe cohort areas" at military medical treatment facilities (MTFs), she said.

"We based our model on what we learned from our own high-performing MTFs and consistent with what civilian hospitals such as Brigham & Women's (in Boston), Columbia-Presbyterian (in New York) and Cedars-Sinai (in Los Angeles) were doing," Julian said.

"This ability to develop standard processes based on best practices and then to codify those practices in DHA guidance to continue care that is medically necessary and necessary to keep the force operating fully is all part of DHA being a high-reliability organization," she said.

"We were able to be nimble by leveraging and modifying our existing DHA Healthcare Optimization Division guidance for primary and specialty care, access, referrals, patient experience and virtual health for all MTFs world-wide" to reflect new COVID-19 processes, Julian said.

Because of this, "the Direct CareDirect care refers to military hospitals and clinics, also known as “military treatment facilities” and “MTFs.”direct care system remained open throughout the pandemic" and delayed elective care, Julian said. "We took advantage of being able to shift additional patient visits to telephone visits, video visits, the Nurse Advice Line and asynchronously using secure messaging and e-visits.

To establish standard processes during the COVID-19 pandemic, DHA released more than 37 new clinical and operational guidance documents. The lessons learned during COVID-19 and the rapid implementation of new guidance enabled continuous process improvement. As a result, DHA will incorporate these new best practices into permanent DHA guidance by October 2021.

"Our focus was on the safety of patients and staff," said Army Col. Timothy Switaj, the Healthcare Optimization Division's Primary Care lead and the chair, Department of Family and Community Medicine, Brooke Army Medical Center (BAMC) at Joint Base-San Antonio in Texas.

"We transitioned a lot of care to virtual primarily via telephone to minimize the number of people who needed to physically come to the medical treatment facilities," Switaj said.

"Our biggest focus was on safety, but a close second was ensuring adequate communication with our patients via any medium informing them of what care we were providing, how we were providing that care, and the safety protocols put in place," Switaj said.

Survey data demonstrated patients appreciated the care MTFs took to ensure their safety and the convenience of virtual care, which demonstrated the MHS' efforts to communicate with patients was successful.

Switaj leads the primary care effort in San Antonio with collaboration from primary care leaders at all MTFs. The ongoing collaboration "ensured everyone spoke with one voice in primary care," he said.

"We would send changes in operations out to patients as soon as possible," Switaj said. "For patients worried about potential COVID-19 symptoms, we established a local nurse information line (for all of San Antonio). They used standard scripts, algorithms, and protocols to triage patients helping to determine who should be tested, and for those who had been tested, how to interpret their results, what precautions they should take, and how to manage their symptoms.

"Additionally, the nurse information line provided general information such as testing site locations, hours, and, later, vaccine information as it became available," he said.

The BAMC market has approximately 250,000 beneficiaries, and primary care services are provided to more than 150,000, Switaj said.

"Initially we transitioned about 90% of care to virtual means so that we could minimize the number of patients and staff in the clinics," he said. "By June 2020, we started gradually transitioning back to more face-to-face appointments, ultimately looking for the right balance for more long-term operations."

Switaj said in the first four to six months of the pandemic there was hesitancy from patients to return to in-person visits, "but, at this point, we are not seeing any issues."

As the world returns to a new normal with the advent of vaccines and better treatments for COVID-19, DHA is developing a patient-facing application for use on any device to enhance patient access, improve patient outcomes, experience, and engagement, said Beth Adoue-Polk, a member of the patient experience branch under Julian.

"We are working to leverage this patient-facing application to improve access and convenience for patients to manage their appointments, access pharmacy services, receive reminders/notifications and also to send secure messages to their health care teams," Adoue-Polk said. "We will have subject matter experts as well as patient feedback to develop the features and requirements for this app."

The TRICARE Online Patient Portal (TOLPP) was very responsive and receptive to the changing needs of DHA during the COVID-19 pandemic, she noted. TOLPP very quickly added virtual appointments, new prescriptions activation, laboratory appointments, and COVID-19 vaccination appointments, Adoue-Polk added. Since starting in March 2020, more than 260,000 virtual visit appointments have been booked via TOLPP across the MHS, according to DHA.

Enrollment and utilization also increased for TOLPP Secure Messaging, which continued to provide patient access to their health care team during the COVID-19 crisis. Using broadcast/blast messaging, MTFs were able to communicate quickly and effectively to inform patients about any changes in operations. More than 2.6 million broadcast messages went out in March 2020. These broadcast messages are now being used as part of the COVID-19 vaccination campaign.

While being nimble helped the MHS to adapt quickly to the COVID-19 crisis, it also helped the system identify new ways of caring for patients, according to Julian.

"If there is a bright silver lining to COVID-19 and to honor those who suffered, it required us to stop looking at the past, and to look to even better ways to establish a new normal," she said.

You also may be interested in...

Future of Nursing: Telehealth, More Innovation and Maybe Some Robots

Article
5/13/2022
Second Lt. Nina Hoskins, 81st Surgical Operations Squadron operating room nurse, briefs Col. Debra Lovette, 81st Training Wing commander, and other base leadership on robotics surgery capabilities inside the robotics surgery clinic at the Keesler Medical Center June 16, 2017. (Photo: Kemberly Groue, U.S. Air Force)

The future of nursing is here due in part to changes brought by the COVID-19 pandemic.

Recommended Content:

Nursing in the Military Health System | Coronavirus

‘I Love the Intensity’ – One Nurse Recalls Three COVID-19 Deployments

Article
5/5/2022
In 2020, Air Force 1st Lt. Tiffany Parra, an ICU nurse at the 633rd Medical Group, on Joint Base Langley-Eustis, Virginia, was deployed to a North Dakota hospital to support a FEMA COVID-19 mission. In the photo, she trains on equipment used for critical patients in a North Dakota ICU. (Photo: Courtesy of Air Force 1st Lt. Tiffany Parra)

Nurses are unique, they follow a calling to care for others. Military nurses do that as well as serve their nation. For Nurses Week, the MHS highlights some of their own.

Recommended Content:

Nurses Week Toolkit: United In Service, Rooted in Strength | Nursing in the Military Health System | Coronavirus

How One Military Nurse Persevered Through the COVID-19 Response

Article
5/5/2022
Air Force Capt. Courtney Ebeling, a medical-surgical nurse at Joint Base San Antonio-Randolph Family Health Clinic, Texas, was deployed to support the COVID-19 response in Afghanistan in 2021. They administered vaccinations to U.S. citizens, service members, and foreign military members as well as supported the preparation to withdraw from the country. (Photo: Courtesy of Air Force Capt. Courtney Ebeling)

Nurses across the Military Health System have played a vital role in providing routine patient care and meeting the needs of the COVID-19 pandemic.

Recommended Content:

Nurses Week Toolkit: United In Service, Rooted in Strength | Coronavirus | Nursing in the Military Health System

Pandemic Spotlights the Vital Role of Military Lab Workers

Article
5/2/2022
U.S. Air Force Staff Sgt. Ashley Solomon, 18th Medical Support Squadron NCO in charge of microbiology, unloads blood samples from a centrifuge at Kadena Air Base, Japan, Jan. 31, 2019. (Photo: Tech. Sgt. Matthew B. Fredericks, U.S. Air Force)

MHS clinical labs produce results.

Recommended Content:

Coronavirus and the COVID-19 Vaccine | Coronavirus

Helping Your Child to Cope with Grief and Losses Related to COVID-19

Article
4/28/2022
Shirley Lanham Elementary School students perform Taiko drumming during a Month of the Military Child celebration aboard the Naval Air Facility Atsugi, Japan, April 6, 2022. (Photo: Petty Officer 2nd Class Ange-Olivier Clement, Naval Air Facility Atsugi)

Many military children have lost loved ones to COVID-19. How parents can help with the grief.

Recommended Content:

Month of the Military Child - Celebrating Military Kids | Children's Health | Psychological Fitness | Coronavirus and the COVID-19 Vaccine | Coronavirus

How to Help Military Children Reconnect After Two Years of the Pandemic

Article
4/25/2022
Airman 1st Class Rocio Romo, Space Launch Delta 30 public affairs specialist, and her son pose for a photo at Cocheo Park on Vandenberg Space Force Base, California, March 25, 2022. During the month of April, we celebrate Month of the Military Child to highlight the sacrifices military children make on the home front while their parents serve the United States. (Photo: Airman Kadielle Shaw, Space Launch Delta 30 Public Affairs)

How parents can help children stressed by more than two years of COVID-19.

Recommended Content:

Month of the Military Child - Celebrating Military Kids | Children's Health | Psychological Fitness | Coronavirus and the COVID-19 Vaccine | Coronavirus

COVID-19 Booster Effectiveness Remained High During Omicron Surge

Article
4/18/2022
Hospital Corpsman 1st Class Mary Ashcraft, assigned to the combat ship USS Tulsa, administers a COVID-19 vaccine booster to Aviation Machinist Mate 1st Class Anthony Johnson Jan. 10, 2022, at Apra Harbor, Guam. (Photo: Mass Communication Specialist Petty Officer 1st Class Devin M. Langer, Command Destroyer Squadron 7)

Two new studies of active-duty service members show COVID-19 booster vaccines are effective, but uptake rates in the military community lagged behind the civilian population.

Recommended Content:

Coronavirus and the COVID-19 Vaccine | Coronavirus | COVID-19 Vaccine Efforts

8 Tips to Help Kids Adjust to Change during the New Pandemic Phase

Article
4/15/2022
A parent comforts his child while she receives a pediatric dose of the COVID-19 vaccine at Kadena Air Base, Japan, Jan. 28, 2022. (Photo: Airman 1st Class Anna Nolte, 18th Wing Public Affairs)

Parents should prepare their kids for the new normal of the ongoing pandemic, recognizing that the status of the disease can change quickly as new variants of COVID-19 emerge.

Recommended Content:

Coronavirus and the COVID-19 Vaccine | Coronavirus | Children's Health

Military Medical Officials Back FY 23 Budget Before Senate Appropriations Committee

Article
4/6/2022
Marines with Marine Wing Headquarters Squadron, 3rd Marine Aircraft Wing take precautionary measures by cleaning and disinfecting their hands during field day on Marine Corps Air Station Miramar, Calif., March 20, 2020, to mitigate the spread of COVID-19 while continuing to perform mission-essential tasks. (Photo: Marine Corps Lance Cpl. Jaime Reyes)

Military Medical officials, including Army Lt. Gen. (Dr.) Ronald J. Place, Defense Health Agency director, back FY 23 Budget before the Senate Appropriations Committee, March 29, 2022.

Recommended Content:

Public Health | Coronavirus

How COVID-19 Made the Military Medical Community Stronger

Article
3/21/2022
Image of a service member being treated

Lessons learned from the COVID-19 pandemic has made the military medical community stronger and will help when confronting the next crisis, whether that’s another pandemic, a new conflict or natural disaster

Recommended Content:

Combat Support | Coronavirus and the COVID-19 Vaccine | Coronavirus

COVID-19 Responses Underscore Importance of Patient Safety

Article
3/14/2022
Every day, patient safety is one of the top priorities for the Defense Health Agency. Patient safety means providing ready, reliable care to service members, veterans, and dependents no matter the circumstances. (Photo: Defense Health Agency)

Patient safety is a topmost concern of MHS, and Patient Safety Awareness Week 2022 focuses on Ready, Reliable Care.

Recommended Content:

Patient Safety | Patient Safety Awareness Week | Coronavirus and the COVID-19 Vaccine | Coronavirus | Patient Safety Awareness Week

Answering Your Questions About COVID-19 Testing

Article
2/25/2022
Military personnel performing a COVID-19 Test

COVID-19 continues to spread, now as the Omicron variant. Getting vaccinated is the most effective way to protect you and your family from getting seriously ill, getting hospitalized, or dying. You should also make sure you’re up to date with your vaccines. Testing is another important step you can take to protect yourself and others.

Recommended Content:

Coronavirus and the COVID-19 Vaccine | Coronavirus | At-Home COVID-19 Tests

Defense Department Announces Distribution of COVID-19 Tests for Military Beneficiaries

Article
2/25/2022
A Soldier assigned to the Connecticut National Guard helps load a shipment of at-home COVID-19 testing kits into a truck at a regional distribution point in North Haven, Connecticut, Jan. 3, 2022. These kits were picked up by representatives from local towns and municipalities to be handed out to their communities.

The Department of Defense will offer at-home COVID-19 tests for military beneficiaries at military hospitals or clinics, on a supply available basis, in the coming weeks.

Recommended Content:

Coronavirus and the COVID-19 Vaccine | At-Home COVID-19 Tests | Coronavirus

Military Medical Units Support Civilian Hospitals Strained By COVID-19 Surge

Article
2/14/2022
Air Force Staff Sgt. Bradley Gorman, a medical technician assigned to a military medical team deployed to Yuma, Arizona performs a nasal swab at the Yuma Regional Medical Center’s COVID testing drive-thru in Yuma, Jan. 17, 2022.

Thousands of service members have been supporting civilian hospitals with testing, vaccinations and treatment of seriously ill patients.

Recommended Content:

Coronavirus

Do You Have COVID-19? Influenza? Or is it RSV? Here’s What to Look For

Article
1/24/2022
Military personnel preparing a COVID-19 test sample for processing

Knowing the symptoms of COVID-19/RSV/Flu will help your medical treatment

Recommended Content:

Coronavirus and the COVID-19 Vaccine | Seasonal Influenza Vaccine Toolkit | Coronavirus
<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 21
Refine your search
Last Updated: May 19, 2021

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.