Integrity - Service - Excellence CSPAR (3 Dec 2011) Lt Gen Green/CMSgt Cole (60-Minute) Meeting: CSPAR, 3 December 2011, 0800 (60 minutes includes Q&A) Theme: “Transformational Pathways to Global Healthcare” Audience: ~ 100 Airmen including Consultants and Enlisted Functionals Purpose: Future of the AFMS Design: AFMS future updates, AFMS mission/strategy Format: Unclassified Sources: AMSUS brief, SLW brief, iEHR brief 1
Transcript
1. CSPAR (3 Dec 2011) Lt Gen Green/CMSgt Cole
(60-Minute)Meeting: CSPAR, 3 December 2011, 0800 (60 minutes
includes Q&A)Theme: Transformational Pathways to Global
HealthcareAudience: ~ 100 Airmen including Consultants and Enlisted
FunctionalsPurpose: Future of the AFMSDesign: AFMS future updates,
AFMS mission/strategyFormat: UnclassifiedSources: AMSUS brief, SLW
brief, iEHR brief Integrity - Service - Excellence 1
2. Headquarters U.S. Air ForceIntegrity - Service - Excellence
CSPAR: The Future is Now Lt Gen C. Bruce Green CMSgt Charlie Cole
Surgeon General CMEF 3 Dec 2011 2
3. Were 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
4. Moving Forward- 2009: STRATEGIC IMPERATIVES -The Future
& Communicating the Vision - 2010 : EXECUTING THE STRATEGY -
Focus on Alignment- 2011: BREAKTHROUGH PERFORMANCE -Tools,
Incentives, and Rewards - 2012: CULTURE OF
ACCESS/INNOVATION/SERVICE - Patient-Centered Care Integrity -
Service - Excellence 4
5. Focus and Alignment6 Through the AFMS Framework 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
6. In Pursuit of Lighter & Leaner Medical Response
Humanitarian Assistance EMEDS Health Response Team (HRT) Rapid
Response Team (HARRT) Airlift Deployment
Requirements:EarthquakesIndonesia < 24 HRS + C-17s Rapid
Response Medical Capabilities: Emergency, Resuscitative, &
Surgical CareEarthquakes Chile T+0 hrs Operational Results:
Immediate Care < 20 min EREarthquakes < 2 hrs Haiti OR &
ICU < 3 hrs T+3 hrsPursuing Perfection in Medical Response
Capability Integrity - Service - Excellence
7. Continuous Advances in Casualty Care WWII 30% Learning From
Coalition Partners, We Leveraged Trauma Registry Data To Build
Innovative Solutions > 80 Patients Moved as of Nov 11Combat
Mortality Rate Korea 25% Tactical Critical Care Evacuation Team
(TCCET) Vietnam 24% INTERFLY AGREEMENT Applying Lessons Learned
From the C-17 *AeroSpace Interoperability Council Persian Gulf 24%
Creating a patient staging continuum Modular Aeromedical Staging
Capability (MASC) OIF/OEF New CASF Activated at SAMMC 65
y/oExpanding Services to Recapture More DoD Beneficiaries Integrity
- Service - Excellence 10
11. Transforming Focus from Healthcare To Health Healthcare Is
A FH Clinics Started- 69 Team Sport Ped Clinics Started- 35 Clinic
Health Management Management HEALTHCARE HEALTH Right Patient9 Right
Prevention9 Right Time9 Right Outcome9Maximize Teamwork/Skill Set s
to Deliver Better Health & Better Care Integrity - Service -
Excellence 11
12. 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 12
13. Leveraging Medical InformaticsDATA INFORMATION KNOWLEDGE
WISDOM CHANGE Better CareTMDS Clinical Through Practice Evidence
Based GuidelinesDEERS Practice CarePoint Medication Better
HealthPDTS Alerts Enhanced Patient Registries Safety$ / M2 User
Home Best Value Interfaces Sensors Healthy BehaviorDMHRSi Expedited
Better CareEHR Test Results Improved Patient Experience Decision
Support Is No Longer Just For Our Providers Integrity - Service -
Excellence
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. Generating Skills/Knowledge Through Medical Simulation
Maximizing the skills of our entire healthcare team New DoD Center
of Excellence Phase 1 Under Development METC Training Gaming
Simulations Synthetic tissue to augment/replace live tissue Mobile
Lightweight SimulatorImproving Healthcare Capabilities Through
Realistic Scenarios Integrity - Service - Excellence 15
16. Activating Patients & Care Teams Health Team
PatientDecision Patient DecisionSupport Support CenteredPCMH
Provides Improved Decision Support- For Patients c eHealthcare
Teams Integrity - Service Excellen &
17. Electronic Health Initiatives Project (eHIP)Integrity -
Service - Excellence 17
18. Investing In Education, Training, & Research *METC
Awarded Institute for Credentialing Excellences Presidential
Citation 2011!Keeping Medics Ready Through Joint & Civilian
Partnerships Integrity - Service - Excellence 18
19. Establishing Partnerships to Enhance Capabilities
Physician/Dentist Education (GME/DME) Stand alone programs Masters
with civilian universities Integrated/affiliated with Federal
partners Nurse Education (Transition Program) New sites include:
Cincinnati, OH & Scottsdale, AZNurse Enlisted Commissioning
Program (NECP) USAF Dental Hygiene Program Research Partnerships
are Vital Tools to Build & Sustain Medical Services Integrity -
Service - Excellence 19
20. DoD-VA Sec Def/Sec VA Decision 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
Term Health Record Capabilities Care Home CareMission Military
Disability Inpatient Emergency DocumentRequirements Team Readines
Obstetrics Evaluation Orders Mgmt Dept Care Mgmt Rehabilitative
Care Transient Outreach s& Performance Enroute Veterinar Dental
Care Consult & Immunization Operating Pharmacy Occupational
Referral Mgmt Room MgmtOutcomes Team Care y Mail Order Health (VA)
Common Interface StandardsBusinessProcess Team Enterprise Common
Services Broker Architecture (includes Enterprise Service Bus (ESB)
and Infrastructure Services) 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 Combined Efforts Provide theOnly Joint DoD/VA DoD Best
Future EHR VA Only Integrity - Service - Excellence 20
21. 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
21
22. 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
23. Generating Knowledge6 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 23
24. Patient-Centered CareReady: Reassure patient that you know
themAccessible: Be there when the patient needs youPrepared:
Respect patient and their timePrecise: Clarify all treatment and
follow-upOrganized: Dont 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 24
25. TRUSTED CARE ANYWHERE Integrity - Service - Excellence