A Roadmap for Medical TransformationThere are three pillars in our strategic plan. They work synergistically to create value for our stakeholders and customers and must work together for the MHS to be successful as a whole. They are: 1. Provide a medically ready and protected force and medical protection for communities – We continuously monitor health status, identify medical threats and find ways to provide protection and improve health for individuals, communities and the Nation. These surveillance activities focus our delivery of Individual Medical Readiness services to improve health and enhance human performance and make the environment safer so service members can withstand health threats in hostile settings. We develop countermeasures to protect against medical threats for the military force and the nation. 2. Create a deployable medical capability that can go anywhere, anytime with flexibility, interoperability and agility – We monitor globally accessible health information and rapidly develop and deploy innovative medical services, products and superbly trained medical professionals. Our involvement in the full range of military operations includes assistance in civil support and homeland defense. 3. Manage and deliver a superb health benefit – We build partnerships with our beneficiaries in an integrated health delivery system that encompasses military treatment facilities, private sector care and other federal health facilities including the Department of Veterans Affairs (VA). Globally accessible health and business information enables patient centered evidence-based processes that are both effective and efficient. Our professionalism engenders beneficiary trust resulting in a partnership with shared responsibility for promoting health.MHS uses a Balanced Scorecard (BSC) approach with four major perspectives: stakeholders and financial (S), customer (C), internal perspective (IP), and learning and growth (L). A resource (R) perspective is also reflected in the sequence indicators for MHS's objectives. The stakeholder and customer perspectives are as follows: Stakeholder Perspective -- S1 - Forces are medically ready to deploy, their performance is enhanced through medical interventions, and both the force and communities are protected from medical threats. The MHS will identify and make available relevant information and methods necessary to promote health and improve performance so that service members are fit and mission ready. Appropriate medical countermeasures will be delivered to service members and communities ensuring maximal protection and homeland defense. S2 - Death, injuries and diseases are reduced, function is restored, and performance is enhanced during and after military operations. The MHS will ensure that when service members are sick or injured, they will be treated and returned to duty, or stabilized and safely evacuated in a timely manner. Continuing care will maximally restore function and ensure seamless transition to ongoing support (e.g., VA or Reserve). This system will maximize fighting/training strength. S3 - Beneficiaries are satisfied with their health care. The medics will get it right the first time by having an efficient and effective medical system that is user-friendly to the beneficiaries. The system will self-solve problems that arise at the lowest level and minimize administrative burdens for the beneficiaries. S4 - The MHS creates healthy communities. The system will promote health through education and partnership with beneficiaries, protect communities from environmental and industrial hazards, and provide high quality care. Customer Perspective -- C1 - "I am a partner with my healthcare team. We know and care about improving my health." My provider will listen to me, treat me with dignity and provide me with the information I need to manage my health. My healthcare team will be available to me when I need them. C2 - “It feels like the Military Health System was designed just for me.” I will be able to get care when I need it, the facility will be easy to get around and when I need a specialist I will be able to get in. My health team will help me maximize my health. C3 - “I have responsive, capable and coordinated medical services anywhere, anytime.” I will know how to get medical care for myself and my troops anywhere, anytime, and I know it will be high quality. Any Service, or approved provider, will meet my medical needs. C4 - “The MHS supports me in achieving individual medical readiness and enhancing performance.” We will have a streamlined process for assuring IMR takes the least amount of time away from other mission priorities, and the customer will understand the value of IMR as part of the mission. The customer will support it because the information is available to he/her and the measures will be relevant to him/her as a warfighter.Military Health SystemMHS_3d1f2eac-2e7c-11e0-8a6b-82377a64ea2aSecretary of DefenseOur STAKEHOLDERS Expect the Best Medical Support for the Warfighter Our stakeholders include the Secretary of Defense, Service Secretaries, Joint Chiefs of Staff, Combatant Commanders and Congress. They value and expect us to simultaneously accomplish five interconnected outcomes: * A fit, healthy and protected force * Reduced death, injuries and diseases during military operations * Satisfied beneficiaries * Creation of healthy communities * Effective management of health care costs In 2006, we will spend 37 billion dollars to achieve these five outcomes and will continuously monitor specific performance initiatives, metrics and strategies to meet our stakeholders’ expectations.Service SecretariesJoint Chiefs of StaffCombatant CommandersCongressCommanders and Service MembersOur Two CUSTOMER Groups Have Different Expectations We serve two major customer groups with different needs and must simultaneously employ two strategies to focus our efforts on what is most important to each group. Our customer groups are not mutually exclusive. Commanders and Service Members partner with us to achieve individual medical readiness and enhanced performance. They expect and deserve responsive, capable, coordinated medical services anywhere, anytime. No other health system in the world can provide what the MHS must provide. Because we face a rapidly changing national security environment we must excel at developing and deploying innovative products and services that meet mission requirements. This is our “product leadership” strategy. BeneficiariesOur beneficiaries desire health services that are convenient and tailored to their individual health needs. If we provide superb, evidence based care in a seamless way across our health system of military providers and strategic partners, our beneficiaries will develop a strong partnership that will result in behavior that promotes health and conserves resources. The key success factor is our ability to do the simple things well every time. Stated simply, if our beneficiaries are delighted with us every time they “touch” our system, they will be much more likely to help us help them manage their health over the long term. This is our “total customer solution” strategy.Our People Our PEOPLE: Unleashing the Potential of Our Most Valuable Asset -- Our people value the opportunity to serve the warfighter – to do meaningful work and to make a difference. They are the key to our success, and therefore our most precious asset. To achieve our shared goals and fully develop our people, the MHS has aligned with the three strategic objectives of the DoD Human Capital Strategy: 1) maintaining a decisive force; 2) aligning the total force which includes active duty, reserves, government civilians and contract employees; and 3) enhancing agility. These initiatives will enable our transformation to a performance based culture where leaders inspire, managers improve processes and all of our people are encouraged and empowered to come up with innovative solutions everyday.Department of the Navy_3d1f3de8-2e7c-11e0-8a6b-82377a64ea2aDepartment of the Army_3d1f400e-2e7c-11e0-8a6b-82377a64ea2aDepartment of the Air Force_3d1f41f8-2e7c-11e0-8a6b-82377a64ea2aA world-class health system that supports the military mission by fostering, protecting, sustaining and restoring health._3d1f42d4-2e7c-11e0-8a6b-82377a64ea2aTo enhance the Department of Defense and our Nation’s security by providing health support for the full range of military operations and sustaining the health of all those entrusted to our care._3d1f439c-2e7c-11e0-8a6b-82377a64ea2aSelfless ServiceWe are honored to serve the warfighters and beneficiaries who trust us to always meet their needs, anytime, anywhere.Healing and Creating HealthWe are healers who have a life-long obligation to the health and well-being of all those entrusted to our care. We are compassionate and committed to doing the right thing for our patients to eliminate disease and achieve health.CourageOur high calling demands the courage to take risks, do what is right and go into harm’s way in unison with the warfighters.Leadership and TeamworkWe lead with passion, respect, and loyalty because this is the best way to achieve our goals and meet our high expectations. We work jointly in close collaboration with line leadership to meet our operational and health support mission.ProfessionalismWe achieve excellence through consistent application of our knowledge, skills and high standards; therefore education, training and mentoring are a high priority.StewardshipWe know effective management and wise use of resources is necessary to achieve our goal of meeting the needs of our customers.Capability and ReadinessEnhance deployable medical capability, force medical readiness and homeland defense by reducing the time from “bench to battlefield” for more effective mission focused products, processes and services._3d1f4464-2e7c-11e0-8a6b-82377a64ea2a1 Our strategy of product leadership for our Commanders and Service member requires us to anticipate their needs and rapidly respond with innovative solutions. We will identify new opportunities and provide high performance services and products. We will have a strong medical surveillance system to detect emerging medical challenges. We will focus and coordinate our research and development infrastructure to rapidly design, develop and deploy “bench to battlefield” solutions for the warfighter. We will employ synergistic partnerships with the VA and other federal, academic and private sector partners to create mission-focused health care solutions and extend them into new applications. These capabilities require a culture of innovation that rewards creativity.Care Delivery Joint, interoperable, and interdependent processes effectively deliver care anytime, anywhere _3d1f473e-2e7c-11e0-8a6b-82377a64ea2aIP5Staff will be trained and postured to provide world class operational health care in theater, en route, in garrison and in partnerships. All deployable medical equipment and training will be interoperable and support mission requirements. Patients will move from the area of operations to a definitive care setting while continuously receiving full spectrum medical care. Homeland Defenses, Civil Support and Military Medical OperationsDoD homeland defenses, civil support and military medical operations, are effectively supported _3d1f4824-2e7c-11e0-8a6b-82377a64ea2aIP7Environmental surveillance, combined with development of effective medical countermeasures will support homeland defense, civil support and military medical operations. Products, Processes and ServicesNew products, processes and services will be rapidly developed and deployed to support the mission – “Bench to Battlefield” _3d1f495a-2e7c-11e0-8a6b-82377a64ea2aIP8The MHS will lead and coordinate DoD efforts to rapidly deploy advances in biomedical science and technology that support mission requirements. Health Status MonitoringContinuous, efficient health status monitoring focuses health improvement activities _3d1f4a54-2e7c-11e0-8a6b-82377a64ea2aIP9Throughout the life cycle of a Service member, the system will capture and analyze health information and identify health hazards associated with the military environment enabling focused health promotion and disease prevention.Medical ReadinessIndividual Medical Readiness is assessed and managed to improve health and enhance performance _3d1f4b44-2e7c-11e0-8a6b-82377a64ea2aIP10Each time medical sees Service members, their IMR requirements will be checked and updated so that they are deployable-ready while minimizing the amount of time taken from duty.Biomedical R&DDoD Biomedical R&D is coordinated and focused on militarily relevant issues _3d1f4c34-2e7c-11e0-8a6b-82377a64ea2aL6Biomedical research and development has special requirements; the MHS will lead and coordinate all military bio-medical R&D to best serve the military mission. Patient Centered Care and PartnershipsSustain the Military health benefit through cost effective, patient centered care and effective long-term patient partnerships _3d1f4d38-2e7c-11e0-8a6b-82377a64ea2a2The current rate of increase in the cost of healthcare is unsustainable and we will ensure that our stakeholders and customers understand the challenges we face together in continuing to deliver the best health benefit in the world. We will create a close partnership with our beneficiaries to improve their health, not just treat illness as wellness and preventive services, effective early intervention and disease management will conserve critical resources over the long term. Since our stakeholders and our beneficiaries care deeply about preserving the benefit, they will work with our elected leaders and our MHS leadership to shape the benefit and achieve the appropriate balance between personal and governmental contributions to the cost of delivering a world class health benefit. Costs and BenefitsDoD Health Care costs are managed; Benefit is sustained and shaped _3d1f4e28-2e7c-11e0-8a6b-82377a64ea2aF1The MHS health care delivery system will be engineered to achieve optimal efficiency and mission effectiveness. The TRICARE benefit will reinforce appropriate use of resources and demand for services, and will engage the individual to actively manage his/her health.Evidence Based MedicineEvidence based medicine is used to improve quality, safety, and appropriate utilization of services _3d1f4f18-2e7c-11e0-8a6b-82377a64ea2aIP1All medical staff will know what most likely will produce the best health outcomes for beneficiaries. This knowledge will be shared with the beneficiaries to develop individual health plans that manage utilization and maximize patient self-care.Beneficiary PartnershipsBeneficiaries partner with us to improve health outcomes _3d1f5012-2e7c-11e0-8a6b-82377a64ea2aIP2Through patient education and individualized care (PCMBN), we will work with beneficiaries to improve their understanding of their individual health needs. Together we will change behaviors to promote better health.Health Care ProcessesOur health care processes are patient centered, safe, effective and efficient _3d1f5116-2e7c-11e0-8a6b-82377a64ea2aIP3We will treat every patient with dignity and respect and provide the care that the patient wants, delivered when he/she desires it, in a way that is convenient and comfortable. This will be accomplished in the appropriate setting using the appropriate resources – “Right setting, Right resources, Reasonable cost”.Health and Business InformationProvide globally accessible health and business information to enhance mission effectiveness _3d1f5224-2e7c-11e0-8a6b-82377a64ea2a3We will deploy the most advanced electronic health record in the world along with human resources, financial, logistics and other systems to create an integrated information network for the entire MHS. Our core business is DoD medical mission support so we must lead the deployment of systems that can provide globally accessible information about the health of Service members, other beneficiaries and entire communities. Our system must enable early detection of medical threats by identifying patterns of symptoms before they are even identified as a disease and it must provide real time evidence-based decision support for our providers. Finally, our systems must provide readiness, clinical, business, customer, financial and other performance information to support performance based management and continuous process improvement.IM/ITIM/IT is leveraged to enhance capabilities _3d1f5328-2e7c-11e0-8a6b-82377a64ea2aL7Requirements for new information technology will be tied to performance improvement; effective business process redesign will maximize the effectiveness of new IT systems and will precede their implementation.Medical Surveillance, Evidence Based Medicine, and EffectivenessComprehensive, globally accessible health and business information enables medical surveillance, evidence based medicine, and effective healthcare operations _3d1f542c-2e7c-11e0-8a6b-82377a64ea2aIP6A globally accessible electronic health record (EHR) containing situationally relevant medical information supporting continuity of care across the theater locale and the spectrum of medical settings will be supported by the MHS. The EHR will support the effective, efficient delivery of health care while capturing data to support medical surveillance, evidence based medicine and better decision-making capabilities. Performance Based ManagementTransform to performance based management for both force health protection and delivery of the health care benefit _3d1f553a-2e7c-11e0-8a6b-82377a64ea2a4We will provide our leaders and managers with: • Clear direction and performance objectives to achieve both force health protection and beneficiary health care • Alignment of authority and accountability • A culture that promotes jointness and interagency cooperation • Accurate transparent measurement of performance and cost • The incentives, development and training needed to succeed in a dynamic environment Concurrently, we will begin replacing regulatory based controls with performance based incentive systems and accountability processes that guide and control operations, and provide leaders with increased local flexibility to manage and allocate resources. This leads to creating a culture of continuous improvement consistently doing the simple things very, very well. It frees us from the bounds of excessive rules and promotes operational excellence through customer focused front line innovation.Costs and BenefitsDoD Health Care costs are managed; Benefit is sustained and shaped _3d1f5652-2e7c-11e0-8a6b-82377a64ea2aF1The MHS health care delivery system will be engineered to achieve optimal efficiency and mission effectiveness. The TRICARE benefit will reinforce appropriate use of resources and demand for services, and will engage the individual to actively manage his/her health.Customer SuccessEmployees create success for customers_3d1f5760-2e7c-11e0-8a6b-82377a64ea2aL1EmployeesCustomersThrough incentives, staff will be developed who place customer requirements first when designing processes and accomplishing business activities.Performance Management, Innovation, and ResultsThe MHS embodies performance based management and a culture of innovation focused on results _3d1f5878-2e7c-11e0-8a6b-82377a64ea2aL2Local activities will have the capability and authority to manage to achieve results according to standard measures of success. Incentives will be aligned with desired performance.CultureCulture of jointness and interagency cooperation _3d1f599a-2e7c-11e0-8a6b-82377a64ea2aL3Tri-Service or interagency interdependence will take precedence over independence; cost effective partnerships with other federal or commercial entities will be encouraged. All new processes will be designed for interoperability. Authority and AccountabilityAuthority and accountability are aligned throughout MHS_3d1f5abc-2e7c-11e0-8a6b-82377a64ea2aL4Alignment of responsibility and accountability will be achieved through streamlined organization and governance in an increasingly joint environment.ResouresResources are predictably available, aligned and transparent _3d1f5bde-2e7c-11e0-8a6b-82377a64ea2aR11. Our Business Planning and Budget Processes will work seamlessly to predict and justify our true needs. 2. We will maintain effective relationships with our stakeholders ensuring their continued financial support. 3. Funds will be made available to MHS activities in a timely and predictable manner. 4. The use of those funds will be tracked and monitored to ensure accountability for financial management. PeopleDevelopment of our most valuable asset – our people _3d1f5df0-2e7c-11e0-8a6b-82377a64ea2a5We will ensure that our medical professionals meet specific capability requirements to allow us to respond with the right people at the right time to support the warfighters. Utilizing the National Security Personnel System (NSPS), we will reward performance linked to strategic and operational goals. By seeking opportunities for our personnel to work in civilian and other federal facilities we will more effectively maintain skills and mission essential capabilities while optimizing opportunities for professional development. And our retention and recruiting efforts will focus on needed capabilities identified in the annual medical readiness review. We will make personnel information readily available for managers at all levels by implementing the Defense Medical Human Resource System (DMHRSi). Recuitment, Training, Education, and RetentionPersonnel are recruited, trained, educated, and retained to meet requirements _3d1f5f1c-2e7c-11e0-8a6b-82377a64ea2aL5 The MHS will accurately forecast the demand for people based on mission and market requirements. Through the use of appropriate incentives, people will be recruited, selected, trained, developed, promoted, compensated, retained, transitioned to another element of the Total Force, let go, or retired. Incentives will reward innovation and improved performance.InfrastructureAlign, Manage and Transform the MHS Infrastructure _3d1f6052-2e7c-11e0-8a6b-82377a64ea2a6BRAC provides us a singular opportunity to align critical facilities infrastructure with MHS strategic goals and objectives and will lead to improved health service delivery, increased jointness and interoperability. The consolidation of medical centers in the National Capital Area and San Antonio will improve operations by reducing unnecessary infrastructure, rationalizing staff, and providing focused and tailored environments to support Graduate Medical Education (GME). The elimination of inpatient services at smaller facilities in communities with adequate civilian health care resources will produce a stronger and more efficient MHS. By bringing most medical enlisted training programs to Fort Sam Houston we will reduce the overall technical training infrastructure while strengthening the consistency and quality of training across the Services. BRAC implementation also mandates the co-location of the Service medical headquarters, reinforcing the transformation toward increased jointness.Maintenance and ImprovementInfrastructure is maintained and improved to optimize performance _3d1f6188-2e7c-11e0-8a6b-82377a64ea2aR2Facilities will be sized to meet mission and market requirements. State of the art designs will enable efficient joint operations. Sufficient resources will be available for construction and maintenance. 2011-02-01http://fhp.osd.mil/pdfs/MHS QDR Medical Transformation Roadmap.pdfOwenAmburOwen.Ambur@verizon.net