ILNdc - Military Health System

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ILNdc - Military Health System

  1. 1. May 2, 2013ILN BriefingInnovation in the Military Health SystemRachel C. Foster, FACHEMHS, Chief Innovation Officer &Director, Financial Performance & PlanningHealth Budgets and Financial Policy
  2. 2. - 2 -UIntroductionRachel C Foster, FACHEMs.  Foster  is  the  Director  for  Financial  Performance  and  Planning  in  the  Department  of  Defense,  Health  Affairs  office  of  Health  Budgets  and  Financial  Policy  (HB&FP).    In  this  posiCon,  she  directly  supports  the  Deputy  Assistant  Secretary  of  Defense  for  HB&FP.    AddiConally,  Ms.  Foster  was  recently  appointed  the  first  ever  Military  Health  System  Chief  InnovaCon  Officer  (CINO),  directly  reporCng  to  the  Assistant  Secretary  of  Defense,  Health  Affairs.    As  the  CINO,  Ms.  Foster  spearheads  the  acCviCes  of  the  MHS  InnovaCon  Strategy  and  team.    Her  main  responsibiliCes  include  creaCng  a  sustaining  culture  of  innovaCon  across  the  Enterprise  and  supporCng  innovaCons  in  the  areas  of  recapture  of  specialty  and  inpaCent  care,  obesity  and  tobacco  use  reducCon,  and  knowledge  sharing.      Her  appointment  as  the  CINO  subsumed  and  is  the  natural  progression  for  the  InnovaCon  Investment  Process  (IIP)  –  an  iniCaCve  geared  toward  idenCfying  cost  savings  for  the  Military  Health  System  (MHS),  of  which  Ms.  Foster  was  the  program  manager.    Some  key  iniCaCves  undertaken  by  the  IIP  include  the  CONUS-­‐wide  Nurse  Advice  Line  for  all  TRICARE  beneficiaries  and  the  purchase  of  a  single  anesthesia  reporCng  and  monitoring  device  for  worldwide  installaCon  across  the  MHS.          From  April  2009  through  January  2011,  Ms  Foster  was  the  AcCng  Deputy  Assistant  Secretary  of  Defense  for  HB&FP.    In  this  posiCon,  her  responsibiliCes  included  chairing  the  Chief  Financial  Officer  IntegraCon  Council;  overseeing  the  Planning,  Programming,  BudgeCng  and  ExecuCon  Process;  and  aligning  financial  processes  with  the  Military  Health  System  Strategic  Plan.    During  that  Cme,  she  led  the  2010  Quadrennial  Defense  Review  (QDR)  Medical  Working  Group.    Prior  to  this  2010  effort,  Ms.  Foster  chaired  the  2006  QDR  Medical  TransformaCon  IntegraCon  Working  Group,  which  developed  business  transformaCon  iniCaCves  for  the  MHS  and  the  Medical  Readiness  Review  Resources  Subgroup.          Ms.  Foster  is  board  cerCfied  in  Healthcare  Management  and  is  a  Fellow  of  the  American  College  of  Healthcare  ExecuCves.    She  holds  a  Bachelor  of  Arts  in  Economics  from  the  University  of  Texas,  AusCn;  a  Master  of  Public  Policy  and  AdministraCon  degree  from  Columbia  University  in  New  York;  and  a  Post  Master’s  degree  in  Health  Services  AdministraCon  from  the  George  Washington  University  in  Washington,  DC.    Ms.  Foster  has  served  on  the  Board  of  Trustees  for  the  Metropolitan  Area  PrevenCon  of  Blindness  Society  since  2002.    In  June  2011,  Ms.  Foster  accepted  an  Ex-­‐Officio  membership  on  the  Health  Services  Division  NaConal  Governing  Board,  Federal  Bureau  of  Prisons.        
  3. 3. §  Ability  to  have  broad,  interacCve  discussions  and  collaboraCons  §  Ability  to  access  seed  money  and  data  §  Belief  that  senior  leaders  value  innovaCon  §  Freedom  to  think  outside  policy  constraints  §  Knowledge  of  the  enterprise’s  strategy  and  prioriCes  §  Rewards  for  risk-­‐taking  and  failure  Cri$cal  Success  Factors      These  include  elements  of  the  innova2on  culture  enablers  (See  Culture  of  Innova2on  Slide).  §  Accountability  for  explicit  Cmelines  with  clear  decision  points  §  MoCvated  owner/implementer  §  Process  for  rapid  decision-­‐making  §  Provision  of  seed  money  and/or  waivers,  as  appropriate  §  Support  from  senior  leadership  §  Commitment  of  senior  leadership  to  full  implementaCon  §  Full  engagement  by  owner/  implementer  §  Funding    and  resourcing  for  full-­‐scale  implementaCon  §  Tools  to  monitor  success  of  innovaCon  and  share  knowledge  2012  Innova$on  Focus  Areas  Innova&on  Value  Chain  (Innova&on  Process)  Create  Ideas  (Internally  &  Externally)   Refine  &  Develop  Idea  Take  ownership  Drac  Proof  of  Concept  Genera$on  Conversion  Diffusion  Screen  InnovaCve  Ideas  Award  Seed  Funding  /  Approve  Waivers  Test  InnovaCve  Idea  (e.g.  pilots)  Evaluate  Results  &  Make  Go/No-­‐Go  Decision  Engage  ExecuCve  Sponsor  Develop  ImplementaCon  Plan  (including  milestones)  Launch  ImplementaCon  Monitor  ImplementaCon  Share  Knowledge    &  Lessons  Learned  2012  MHS  Innova$on  Focus  Areas  By  Phase  Tobacco  &  Obesity  Re-­‐Capture  of  Specialty  Care  Pa$ent  Safety   PCMH  Innova$on  Effort:    Tri-­‐Service  Workflow    Mul$ple  Diseases  (6)   Metabolic  Diseases   Lower  Back  Pain  3  In  2011,  the  ASD/HA    made  it  a  priority  to  encourage  and  ins2tu2onalize  a  culture  of  innova2on  across  the  Military  Health  System  
  4. 4. MHS  Innova$on  Environment  Iden2fying    innova2ons  and  expanding  them  across  the  enterprise  proved  challenging  ,  as  it  would  for  any  complex  organiza2on.      Establishing  the  innova2on  infrastructure  allows  for  innova2ons  to  move  up  through  the  organiza2on    in  line  with  strategic  goals  and  objec2ves  
  5. 5. MHS  Innova$on  Strategy:    Enterprise  View  of  Innova$on  Genera$on   Conversion   Diffusion  Conversion  Genera$on   Diffusion  Genera$on   Conversion   Diffusion  MHS  Local  Strategically  Supported  Innova&on  The  overall  strategy  of  the  MHS  and  priori2es  of  the  ASD(HA)  will  determine  which  innova2ons  are  targeted  for  support  at  the  enterprise  level.    Innova2ons  that  align  with  the  strategic  focus  areas  will  be  solicited  at  all  levels  of  the  organiza2on,  allowing  innova2ons  to  “skip”  levels  for  rapid  dissemina2on  throughout  the  enterprise.    Strategically  supported  innova2ons  will  be  scalable,  tri-­‐Service  and  posi2vely  impact  the  Quadruple  Aim.  External  Partnerships  Services  5  
  6. 6. - 6 -UInnovation Deep Dives - Rapid Idea Generation and ApprovalDeep Dives bring together a diverse group of participants and innovators to collaborate in developing truly innovative solutions for strategic challenges facing the MHSM H S I N N O V A T I O N D E E P D I V E S6 Months After Deep DiveDeep Dive Event – Day 2Deep Dive Event – Day 1Prior to Deep Dive Deep Dive Event – Day 3Select a diverse group ofparticipants·∙   SMEs·∙   MTF Leaders·∙   ExternalRepresentativesParticipants submit initialinnovations/ideasKick-off calls introduce theDeep Dive format and focusareaB u il d in g  M o men t u mId ea  S o l ic it a t io nK n o w l ed g e  E x c h a n g eParticipant  ReviewExecutive  Cell  ReviewSenior  MHSLeadership  ReviewWar Room provides subject matterexpertise and data to help refine initiativesParticipants develop selected ideas forreview by Executive Cell (comprised ofrepresentatives of the Surgeon Generals)Executive Cell provides feedback, identify/address potential threats & weaknesses,and provides recommendations to finalizebriefing to Senior MHS LeadershipImplementation leads and pilot sites aredeterminedImpr o v ed   S y s t em  P er f o r ma n c eF a il in g   F a s tD ef in e   S c o pe   o f  P r o bl em  S t a t emen tId ea   S el ec t io nR a pid   D ec is io n  M a k in gD ef in in g   S u c c es sD ev el o p   P il o t  P r o po s a l sD iv er s e  R epr es en t a t io nA ppr o v e   P il o t  P r o g r a msC o l l a bo r a t io nImpl emen t   P il o t  P r o g r a msL es s o n s  L ea r n edF u n d in gFacilitators introduce the problem and focusareaParticipants define metrics of successParticipants brainstorm and discuss aninitial list of ideasInitiative list is narrowed through participantanalysis and discussionExecutive Cell pre-briefs the AssistantSecretary of Defense and the SurgeonGeneralsParticipants present proposed solutions viadecision brief to Senior MHS LeadersSenior MHS Leaders approve promisinginnovations that are aligned with theQuadruple AimInnovations are assigned amentorExecute pilot programs overthe next six to twelve monthsProvide periodic reports onsuccess of implementationStop pilot programs that areunsuccessful and documentlessons learnedPrepare business case for fullimplementation at the end ofpilot periodInputsInputsInputsOutcomesOutcomesOutcomesL ea d in g   E d g e  S o l u t io n sId ea   R ef in emen tR ef in in g   D is r u pt iv e   &  T r a n s f o r ma t iv e  In n o v a t io n s
  7. 7. - 7 -UMHS Innovation Value Chain Accomplishments and GoalsGiven MHS Innovation’s success in generating hundreds of new ideas in 2012, and selecting 15 pilotinitiatives and 3 challenge winners, our near-term focus will be on converting innovationsRecapture of Specialty Care Obesity Management Tobacco Cessation & PreventionGenera$on  Idea  Crea&on  Group  +  Challenge  Diffusion  As  needed  Proposed Focus for 2013Innovation Value ChainInnovation Topic Areas§  MHS Innovation will focus on piloting 15approved initiatives and 3 challengewinners by:‒  Launching the Pilot Toolkit tosupport pilot owners and addressbottlenecks currently slowing theprocess‒  Partnering with InnovationCouncil and Service InnovationCells to help trouble shoot barriersfaced by innovators‒  Re-doubling efforts to find strongmentors and team members tosupport initiative owners§  However, MHS Innovation will continue tofoster new ideas by:‒  Leverage LinkedIn community foridea generation‒  Facilitating next MHS InnovationChallenge during summer of 2013‒  Holding another Deep Dive inapproximately 6-9 monthsWe propose that for future Deep Dives and Challenges that MHS Innovation continues to focus on the2012 key innovation topics.Conversion  Pilot  15  approved  ini&a&ves  and  3  challenge  winners  
  8. 8. - 8 -ULooking ahead to 2013MHS Innovation is re-balancing its efforts from identifying new ideas to developing a long-termsustainable infrastructure that will support a culture of innovation.FocusSystem PerformanceContinue to strengthengovernance and improvevisibility into local innovationsActivitiesKnowledge SharingFacilitate moving frominformation to wisdomHuman Capital ActivationEncourage, reward, andrecognize innovators‒  Create Innovation Contract to spur conversion/piloting‒  Strengthen governance through monthly Innovation CouncilMeetings and partnership with Service Innovation Cells‒  Realign MHS Support Initiatives (MHSSI) process to provideInnovation Council visibility into local recapture innovations andstreamline the approval process‒  Run Knowledge Sharing pilots and create Knowledge Sharingwhitepaper with lessons for the broader strategy‒  Continue to improve and enhance knowledge sharing via creation ofLinkedIn sub-groups to connect innovators‒  Continue to develop external partnerships through ILN‒  Continue to monitor effectiveness of Clinical Enterprise Intelligence akaHealth Services Data Warehouse‒  Evaluate opportunities to include innovation in the performancemanagement process‒  Develop a Leadership Innovation Recognition Strategy torecognize innovators, and support calculated risk takingDataKnowledgeInformationWisdom
  9. 9. Appenix
  10. 10. The  Innova$on  Framework  is  a  tool  for  classifying  innovaCon  efforts  throughout  the  Military  Health  System.    The  goal  is  a  balanced  porfolio  of  innovaCons  across  the  MHS  that  is  aligned  with  the  Quadruple  Aim  and    spans  a  range  of  different  types  of  innovaCon.  Quadruple  Aim  Readiness:    Ensuring  that  the  total  military  force  is  medically  ready  to  deploy  and  to  deliver  health  care  anyCme,  anywhere  in  support  of  the  full  range  of  military  operaCons,  including  humanitarian  missions.  Experience  of  Care:    Providing  a  care  experience  that  is  paCent  and  family  centered,  compassionate,  convenient,  equitable,  safe  and  of  the  highest  quality.  Popula$on  Health:    Reducing  the  generators  of  ill  health  by  encouraging  healthy  behaviors  and  decreasing  the  likelihood  of  illness  through  focused  prevenCon  and  the  development  of  increased  resilience.  Per  Capita  Cost:    CreaCng  value  by  focusing  on  quality,  eliminaCng  waste  and  reducing  unwarranted  variaCon;  considering  the  total  cost  of  care  over  Cme,  not  just  the  cost  of  an  individual  health  care  acCvity.  Types  of  Innova$on  Process  Improvement:    Improving  the  efficiency  and/or  effecCveness  of  processes  through  incremental,  localized  changes.    Leading  Prac$ce:    AdopCng  proven  soluCons  from  within  and  outside  of  MHS  that  update  and/or  expand  exisCng  work  streams  or  services.    Transforma$ve  Innova$on:    New  or  fundamentally  redesigned  work  streams  or  services  that  deliver  expanded  value  proposiCons.    Disrup$ve  Innova$on:    Ground-­‐breaking  changes  that  disrupt  current  behavior,  render  exisCng  approaches  and  delivery  mechanisms  obsolete  and  that  change  the  value  proposiCon.    Innova$on  Framework  10  

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