Duke Grand Rounds Nov 2011

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Duke Grand Rounds Nov 2011

  1. 1. Headquarters U.S. Air ForceIntegrity - Service - Excellence Future Family Care Initiatives Lt Gen C. Bruce Green Air Force Surgeon General 21 Nov 2011 1
  2. 2. We’re All In! AF Mission The mission of the United States Air Force is to fly, fight and win#in air, space and cyberspace AFMS Mission AFMS VisionSeamless Health Service World-Class Healthcare Support to USAF and for Our BeneficiariesCombatant Commanders Anywhere, Anytime Through Global Vigilance, Reach, and Power! Integrity - Service - Excellence
  3. 3. VIDEOIntegrity - Service - Excellence 3
  4. 4. AFMS Framework Provides Focus and Alignment, Strategies OverlappingMission Areas Transform Deployable Capability Rapid Response to Any Worldwide Contingency Fit Force Build Patient-Centered Care Continuity & Prevention to Optimize Health Invest in Education, Training & Research Sustain Our Future Capabilities Strategy Common Practice Culture Integrity - Service - Excellence
  5. 5. In Pursuit of Lighter & Leaner Medical Response Humanitarian Assistance Health Response Team (HRT) Rapid Response Team (HARRT) Airlift Deployment Requirements: Earthquakes Indonesia < 24 HRS + C-17’s Rapid Response Medical Capabilities: Emergency, Resuscitative, & Surgical Care Earthquakes Chile Transition from Alaska Shelters to Utilis AK Shelter Compatible; Decreased Build Time Joint Program Testing w/ Collective Protection Developing “Portable” Functional Supply Earthquakes System (ER/OR/ICU/Peds/GYN/etc) Improved Storage/Shipping Haiti Secure/Weather Proof Versus Triwalls/Ropak Standardized Packing Portable Drawer ModulesMSC/Technician Role: Plans, Logistics, & Development Integrity - Service - Excellence
  6. 6. Future Based Agile Thinking for 2045 Drivers Scope the TrajectoryDrivers are key factors that influence the future. FBAT researchedto fully define and characterize each driver, its polar description, itsconstituent elements, and its current status and indicated trajectory Identify key Determine Adjust Maintain Build drivers of strategic Organization Learning & Scenarios change implications Strategy MonitorPrimary Drivers- Knowledge: Science & Technology AFMS Vector or String- Geopolitics- Culture- Resources: Economic & HumanColoring Drivers 2 0- Environmental Change 1 2 0 2- Human Factors 5 2 0 2 7 3 0 5 4 5 Integrity - Service - Excellence 6
  7. 7. AFMS Strategies – Medical Home Family Health Clinics Implemented – 61 DATE MAJCOM MTF Purpose Enrolled FH Population – 622,224 Seymour 01 Oct ACC PCMH Sr Consultant visit Johnson Pediatric Clinics Implemented – 11 3-5 Oct PACAF Eielson PCMH visit #2 Enrolled Population – 26,531 4-6 Oct AMC Dover PCMH Sr Consultant visit 10-12 Oct AETC Vance PCMH visit #1 Total Population Enrolled – 648,755 Altus 12-13 Oct AETC PCMH Sr Consultant visit 57% of AFMS Enrollment 13-15 Oct AFMC Tinker PCMH Sr Consultant visit 83% FH Enrollment 18-20 Oct AFGSC Whiteman PCMH Sr Consultant visit 11% Pediatric Enrollment 24-26 Oct USAFA USAFA PCMH visit #2 26-Oct ACC -ellis PCMH Sr Consultant Visit 1- 5 -ov PACAF Anderson PCMH visit #2 1 -5 -ov PACAF Kadena PCMH visit #2 1-5 -ov PACAF Osan PCMH visit #2 2 -ov AFSPC Peterson PCMH Sr Consultant visit 2 -ov ACC Dyess PCMH visit #111/29/2011 Integrity - Service - Excellence Data effective 1 Oct 11 from DSS enrollment numbers Sep 2011 7
  8. 8. Create The Setting For “Right” Behaviors Percent of Patients Satisfied* Continuity of Care Other Provider $ Family Health Providers at PCMH Sites MTF Primary Care Visit Distribution* 100% Family Health / PCMH Patients 100% 21471 95% 90% PCMH Team 64954 % Satisfied 80% 42400 90% UP is 70% Good 60% PCMH PCM 85% 50% PCMH TEAM 40% 80% 30% 123681 121580 Continuity 20% Other Provider 75% 10% (Family Health Jan-11 Mar-11 May-11 Jan-11 Mar-11 May-11 0% Clinic) Non-PCMH Sites (41/322163) PCMH Sites (34/351952) PCM PCMH Aggregate Non-PCMH Aggregate (Non-PCMH Dec 2010 - May 2011 Sites) Satisfaction: Goal > 95% Continuity: Goal > 90% $ $ Monthly Emergency Department and Urgent Care Utilization* HEDIS Measures - Patients Enrolled to PCMH Clinics Per 100 PCMH Patients 10 40Average Monthly Visit Rate (per 100) 8 30 6 Score 20 4 DOWN 10 UP is 2 is Good $ Good 0 0 Dec-10 Feb-11 Apr-11 Dec-10 Feb-11 Apr-11 Dec-10 Feb-11 Apr-11 Dec-10 Feb-11 Apr-11 PCMH Aggregate Non PCMH Aggregate PCMH Aggregate Non-PCMH Aggregate ED/Urgent Care Rate: Goal < 3/100 HEDIS Aggregate: Goal > 40 Inspiring Trust & Confidence by Measuring and Rewarding Outcomes Integrity - Service - Excellence 8
  9. 9. Leveraging Medical Informatics DATA INFORMATION KNOWLEDGE WISDOM CHANGE Better CareTMDS Clinical Through Practice Evidence Based GuidelinesDEERS Practice CarePoint Medication Better HealthPDTS Health Alerts Enhanced Patient Services Registries Data Safety$ / M2 Warehouse User Home Best Value (HSDW) Interfaces Sensors Healthy BehaviorDMHRS i Better Care Expedited EHR Test Results Improved Patient ExperienceAccelerating Information Exchange with Patient Activation Integrity - Service - Excellence
  10. 10. Activating Patients & Care Teams Health Team PatientDecision Patient DecisionSupport Support CenteredPCMH Is The LynchpineTorBetter Decision Support ForlPatients & Health Teams Int g ity - Service - Excel ence
  11. 11. Investing In Education, Training, Research, & PartnershipsPhysician/Dentist Education (GME/DME) Research Stand alone programs Diabetes Masters with civilian universities Telepathology Integrated/affiliated with Federal partners Teleradiology 84 Advanced Education General Dentistry-1 slots/yr Dental Specialty certificate/Masters program opportunitiesNurse Education (Transition Program) Increasing to 241 enrolled students in FY10 New sites include: Cincinnati, OH & Scottsdale Healthcare, AZEducation, Research, Partnerships – Absolutely Critical to Building & Sustaining Medical Services Integrity - Service - Excellence 11
  12. 12. Patient-Centered CareReady: Reassure patient that you “know them”Accessible: Be there when the patient needs youPrepared: Respect patient and their timePrecise: Clarify all treatment and follow-upOrganized: Don’t ask patient what you should know or haveavailable in their medical recordRespectful: Always answer phones/resolve patient concernsThorough: Tell patient what to do if they feel worsePatient-Centered Care Begins with Access to Earn Trust! Integrity - Service - Excellence 12
  13. 13. “TRUSTED CARE ANYWHERE”13
  14. 14. Integrating New Technology Hand-held, Battery-powered, Laser Cautery & Ablation Tool From Force Health Protection To Logistics To Portable Surgical Tools AutomatedDirected InformationEnergy & DataSensors Collection (AIDC) Future CCATT Mission - Current CCATT Mission Wireless Reaching Beyond with Evolutionary Advances and Concepts Integrity - Service - Excellence 14

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