SEATAC, Wash. (Sept. 15, 2015) -- A group of 35 senior military and civilian health care executives gathered at the Cedarbrook Lodge for the Puget Sound Health Care Executive Roundtable, Sept. 10-11.

The purpose of the roundtable was to bring together executives from the military, Veterans Affairs, and civilian health care organizations to discuss strategies and explore opportunities in collaboration to improve quality outcomes and access to care in the Puget Sound.

Maj. Gen. Thomas R. Tempel Jr., commanding general of Western Regional Medical Command and market manager of Puget Sound Military Health System, or [MHS], helped lead the event.

"In my 25 years of wearing the uniform, I have never been in a community where the collaboration exists like it does here between the military and civilian community," Tempel said. "The trust has already been built. I hope we can grow upon that today through our discussions. The purpose of the day is to build on the trust that has already been established and foster future relationships and work groups."

Topics of discussion included addressing the changing landscape in the military and civilian health sectors, optimizing health care in the Puget Sound through military-civilian partnerships, and prioritizing collaborative opportunities.

Along with the formal topics - and tackling issues in health care that some called "complex" and "constantly changing" - Tempel hoped the event would be a conversation starter about how to improve health and improve Soldier readiness. Participants clearly agreed as evidenced by the discussions.

"We as Americans need to be loyal to each other and to our joint interest in improving health," said James Collins Jr., principal of Jimmy Collins & Associates, and civilian aide to the Army secretary.

Collins is a retired major general and former I Corps deputy commanding general.

"There is true value to us as a nation for sharing information and for working together," he said.

Andrea Inserra, senior vice president of Booz Allen Hamilton, whose organization helped plan the roundtable, said collaboration is part of the future of health care in this nation.

"I truly believe this is the beginning of a conversation," Inserra said. "It's the beginning of how to work together and set the direction for how we work collaboratively across the United States - so, much broader than the Puget Sound but starting here in the Puget Sound."

The Puget Sound Military Health System is comprised of four military treatment facilities in western Washington - Madigan Army Medical Center, Naval Hospital Bremerton, Naval Hospital Oak Harbor, and the 62nd Medical Squadron clinic at McChord Field - that are responsible for the care of some 280,000 eligible beneficiaries.

"The Puget Sound Military Health System spans 135 miles ... And in between all of those are the VA and civilian networks with a tremendous amount of experience," said Navy Captain Jim Thralls, outgoing chief operating officer of Puget Sound Military Health System. "We don't know nearly as much alone compared to what the collective Puget Sound health systems know."

The University of Washington, or UW, School of Medicine was one civilian network provider that was represented at the roundtable event.

For many years, UW Medicine has partnered with Madigan in several areas, to include simulation training. During the roundtable, Dr. Carlos Pellegrini, chair of the Department of Surgery, UW Medicine, expressed interest in developing a more formal simulation training program with Madigan.

Pelligrini said that if the group wants to do more collaboration practically, it has to come from a high leadership level, and perhaps in the form of a memorandum of agreement.

Ultimately, the executives identified a few key areas that warranted further discussion. Those areas included: referral management and beneficiary education; metrics; wellness and health improvement; emergency preparedness and disaster planning; and collaboration opportunities in research, simulation and graduate medical education.

The executives plan to meet in smaller work groups before reconvening after the new year.

Military participants included representatives from the Puget Sound MHS and associated military treatment facilities, Western Regional Medical Command, Navy Medicine West and VA Puget Sound Health Care System.

Civilian participants included representatives from Harrison Medical Center, UnitedHealthcare Military & Veterans, Washington State Hospital Association, Tacoma-Pierce County Health Department, Multicare Good Samaritan Hospital, Virginia Mason, Pacific Business Group on Health, Pacific Medical Centers, University of Washington Medicine, Providence Health & Services Northwest Washington, Seattle Children's Hospital, Washington Health Care Authority and Booz Allen Hamilton.

Tempel said he was very pleased overall with the great progress and openness for collaboration seen at the roundtable.

"We're all in this together with the common goal of taking care of our patients," Tempel said. "We all have successes, and we all have areas for improvement. When we get together like this and learn from each other, it is a very valuable experience."