AAMA Nov 2011


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AAMA Nov 2011

  1. 1. AAMA (17 Nov 2011) Lt Gen Green (1-Hour including Q&A)Meeting: AAMA, Air Force Breakout, 17 October 2011, 1330Theme: “The Future of Healthcare”Audience: ~ 150 MSC Officers to include many previous MSC Corp ChiefsPurpose: Future of the AFMSDesign: AFMS hot-topic issues: JUMC, mission and strategy, advances, andcurrent situations and how the AFMS mission/strategy tie into Joint healthcareFormat: UnclassifiedSources: SLW Brief, iEHR brief, MHS Capstone Integrity - Service - Excellence 1
  2. 2. Headquarters U.S. Air ForceIntegrity - Service - Excellence Air Force Strategies for Future Healthcare Lt Gen C. Bruce Green Surgeon General 17 November 2011 2
  3. 3. Moving Forward2009: STRATEGIC IMPERATIVES The Future & Communicating the Vision2010 : EXECUTING THE STRATEGY Focus on Alignment2011: BREAKTHROUGH PERFORMANCE Tools, Incentives, and Rewards2012: CULTURE OF ACCESS, INNOVATION & SERVICE Patient-Centered Care Integrity - 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. Global Operations: ~ 1,400 Total Force Medics Deployed Distribution of Current Total Force Deployments by Corps MC 14%Building Partnerships DC Major Conflicts & Partner Capacity Irregular Warfare 0.51% NC Enlisted 16% 60% MSC 4% Humanitarian Natural Disasters & BSC ResponseHomeland Response 5.8% a/o 2010 a/o 2011 0 41% 29% MSC 1 38% 52% Deployment 2 15% 15% Frequency 3 4% 3% (AD Only) 4 1% 0.75% I n t e 5+ i t y - S e r v i c e - E x c0.29% n c e gr 1% elle
  6. 6. CAF/MAF Improvement Immediate < 20 min ER < 2 hrs T+0 hrs T+3 hrs OR & ICU < 3 hrs EMEDS Health Response Team (HRT) a Reality! Self-Aid Combat Medics Forward In Theater Care Definitive Care Buddy Care Navy Corpsmen Resuscitative Rehab/Recovery Home w/Family Care AF Theater Hosp SAMMCEvolving Expeditionary Operations( SavingcLives Globally! Integrity - Service - Excellen e
  7. 7. 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
  8. 8. Recapturing Care Together Where It Makes Sense Delivering Patient Centered Care To Our Beneficiaries Creating Currency Opportunities To Support Readiness Allowing Medics To Practice Full Scope Of Care Tackling Per Capita Cost Through Targeted Investments Travis AFB, CA Wright –Patterson AFB, OH Langley AFB, VA Nellis AFB, NV Keesler AFB, MS Systems-Based Approach Required To Optimize Our Integrated Delivery System Eglin AFB, FLElmendorf AFB, AKBuilding Capability...Expanding Services(Improving Currency Integrity - Service - Excellence 8
  9. 9. Innovation & Insight to Recapture Care Specialty Hospitals Focused on Currency and Recapture9
  10. 10. AF Medical Home MSC and 4A Team’s Role Critical Goal: >1M EnrolledProcess Balance Decision Support Medical HealthPractice RSV Knowledge Mgmt Supply & PlanVariation Training Tools Equipment Mgmt (GPM) (Readiness) (IM/IT) (Logistics) (TOPA)Healthcare Foundation – Every Team Must Improve Their Care Integrity - Service - Excellence
  11. 11. 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% 85% PCMH PCM 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 11
  12. 12. 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
  13. 13. Electronic Health Initiatives Project (eHIP)Integrity - Service - Excellence 13
  14. 14. Transforming Data Into Knowledge Ready Better Health Better Care Patients receiving Diabetic patient massive infusions of > educated on 10 pints experienced “remote mortality of 33% monitoring” glucometer Clinical Study Readings Practice registry MTF calls automaticallyGuideline to identify patient to sent todeveloped trends discuss healthcare management team Conclude infusing whole blood Uncontrolled sugar reduced mortality levels Identified to less than 20%Using Informatics to Accelerate Change in Practice Patterns & Behavior Integrity - Service - Excellence 14
  15. 15. 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
  16. 16. Investing In Education, Training, & Research Open for BusinessJoint Capabilities are Greater Than Any Single Service Capability Integrity - Service - Excellence 16
  17. 17. Enduring Academic Partnerships Physician/Dentist Education (GME/DME) Stand alone programs Masters with civilian universities Integrated/affiliated with Federal partners 84 Advanced Education General Dentistry-1 slots/yr Dental Specialty certificate/Masters program opportunities Nurse Education (Transition Program) Increasing to 241 enrolled students in FY10 New sites include: Cincinnati, OH & Scottsdale Healthcare, AZ Nurse Enlisted Commissioning Program (NECP) 50 per year with school of their choice Research USAF Dental Hygiene Program Diabetes 10 scholarships per year Telepathology Trident Technical College (SC) Teleradiology St. Petersburg College (FL)Education & Research – Critical Step Toward Building & Sustaining Medical Services Integrity - Service - Excellence
  18. 18. Generating Knowledge( PRIMARY CARE 2025: A Scenario Exploration of Forces, Challenges, and Opportunities Shaping Primary Care in the U.S. GENOMIC MEDICINE: An Active Consortium of Government, Academic, and Industry Leaders in the Field of Genomic Medicine Providing Expert Direction for PC2Z Program DOD/VA iEHR and GOVERNMENT HIE SUMMIT: Establishing a Common Roadmap for Today, Tomorrow, and the Future OPEN SOURCE SOFTWARE of the MILITARY HEALTH SYSTEM: A Product Lifecycle Management Workshop VETERANS AFFAIRS ROUNDTABLE: Future Performance Metrics to Assess Population Health, Patient Experience, and Healthcare Value USU-HJF Military Medicine Symposium: The TBI Spectrum, Challenges, Initiatives, & PreventionInnovative Collaboration to Shape the Future of Healthcare Integrity - Service - Excellence 18
  19. 19. AHLTA on the( Information Highway Peak of Inflated Opportunity! Expectations Plateau of Swamp of Productivity Diminishing Vehicle of Returns Opportunity! Innovation Trigger Slope of Enlightenment Cliff of Obsolescence Trough of Disillusionment Time* Gartner Inc., chart from Mastering the HYPE CYCLE by Jackie Fenn and Mark Raskino Integrity - Service - Excellence
  20. 20. Sec Def/Sec VA DecisionCombined Efforts Provide the Best Future EHR Integrity - Service - Excellence
  21. 21. DoD-VA “To-Be” iEHR Architecture Common DoD-VA Requirements: HL7 EHR-S Functional Model with DoD and VA vetted Extensions (SV-4) Common DoD-VA Integrated Health Business Reference Model (OV-5) Common DoD-VA “To Be” Process Flow Model (OV-6C) Presentation Presentation (Common GUI) Layer Team Applications and Services DoD Unique (16) Common (Joint) Applications & Services (30) VA Unique (6) Systems Battlefield Pediatrics Pharmacy Personal Laboratory Blood Mgmt Nursing Long TermMission Capabilities Care Health Record Home CareRequirements Disability Inpatient Emergency Document Team Military Obstetrics Evaluation Orders Mgmt Dept Care Mgmt Rehabilitative Transient& Performance Readiness Care Outreach Consult & OperatingOutcomes Enroute Veterinary Dental Care Referral Mgmt Immunization Room Mgmt Pharmacy Occupational Care Mail Order Health (VA)Team Common Interface StandardsBusiness Enterprise Common Services BrokerProcess Architecture (includes Enterprise Service Bus (ESB) and Infrastructure Services)Team Team Common Interface Standards Common Data Centers Data Inter- Common Information Interoperability Framework (CIIF) operability Common Information Model, Common Terminology Model, Team Information Exchange Specifications, Translation Service Common Data Standards: SNOMED CT and Extensions, LOINC and RxNorm Common DoD-VA Measures of Effectiveness, Measures of Performance and key Performance Parameters Joint DoD/VA DoD Only VA Only Integrity - Service - Excellence 21
  22. 22. Leading the Way with Open Source HOSPITAL PHARMACY VISIT Electronic Electronic PROVIDERRADIOLOGY Health Record Health Record OFFICE VISIT PUBLIC LAB SYSTEM HEALTH SERVICE Open-Source Provides Integration Without Barriers Integrity - Service - Excellence 22
  23. 23. CLOUD COMPUTING Data Center Akamai Network End Users End Users Web 100,000+ Servers Servers 1900+ Locations Fire 1000+ Networks 700+ Cities EdgeDatabase Wall Servers 80+ Countries WAF Load Edge EDNS Balancer Servers EDNS Edge Transaction Servers Server Akamai EDNS Network Site Shield Storage Edge Servers Directory/ Policy Server Edge Servers Edge Servers Edge ServersLegacy App DNS End UsersSystems Servers Server WAF 4,000+ customers 15+ million hits per second Back-Up Site or Load End Users 4+ Tbps normal traffic Balanced Multi-Data Center Peaks of 7+ Tbps Akamai Architecture Operational View – OV-1 Better Access, iInnovation, eand xCare e n c ePatients I n t e g r t y - S e r v i c - E c e l l For
  24. 24. 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 24
  25. 25. Shaping the Future of Federal Healthcare Synergy- Patient-Centered Joint and Coalition Care Organizational Precision Agility Healthcare Technology IntegrationWorking Together, Achieving Success Through A Common Vision Integrity - Service - Excellence
  26. 26. 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 26