As the Military Health System transforms, members of the Puget Sound Military Health System are leading the way in integrating care across a joint military environment. Improving the way it handles business planning to optimize health care is the most recent example of collaboration across services.

The military treatment facilities within the Puget Sound MHS will transition to Defense Health Agency management beginning on Oct. 1. In preparation for this transition, the Puget Sound MHS, or market, submitted its annual business plan in June, following a new DHA format, called the Quadruple Aim Performance Plan. The DHA will review and approve plans in August for implementation in the new fiscal year.

"The Quadruple Aim Performance Plan is more than a plan. It is the process by which the Defense Health Agency engages the entire Military Health System to achieve breakthrough performance in pursuit of the Quad Aim: Improved readiness, better health, better care and lower cost," said Ron Krogh, chief of staff, Puget Sound MHS. "It is a paradigm shift from a resource-driven process to one that is strategy-driven."

To accomplish a comprehensive plan, each military treatment facility within the Puget Sound MHS - Madigan Army Medical Center, Naval Hospital Bremerton, Naval Health Clinic Oak Harbor and the Air Force's 62nd Medical Squadron - completed individual plans, highlighting key initiatives that were then rolled into a market-wide plan. In it, each MTF provided an executive summary; strengths, weaknesses, opportunities and threats analysis; and readiness brief; which were presented at the market's first QPP Executive Session May 30.

"In contrast to previous years' business performance planning, the QPP is a new way to do business. We have in the past aligned our plans and our operations here in the market very well, integrating with each other as much as possible," Krogh said. "The content wasn't that much different for us, it was just a new process that will continue to help us improve our efforts."

A member of the DHA team, Jane Hourigan, J5 QPP Planning Team, was on site at the executive session to provide insight into the new process. She acknowledged the Puget Sound MHS was a more "mature market" with a good understanding of the way forward.

"You've been hearing the buzzword, QPP," said Hourigan. "The 'Q' is a very important part of this process - Quad Aim. It's about readiness, better health, better care at a lower cost.
"This will be important going forward in the whole evolution of everybody transitioning to DHA management - to keep readiness at the forefront of the Quad Aim. We generate a medically ready force and a ready medical force."

The QPPs help DHA understand what is happening at every level of military health, she said, and helps in understanding top initiatives and where to position resources.

An example of a market-wide initiative included in the Puget Sound MHS's most recent plan is MHS GENESIS implementation sustainment. The Pacific Northwest was the pilot site for the fielding of the Department of Defense's new electronic health record, and the Puget Sound MHS has made the continued success of its rollout a priority.

Additional MTF-level initiatives have included everything from improvement to readiness tracking through the Air Force Readiness Dashboard via CarePoint and facilities improvements at Oak Harbor to active-duty appointment booking improvements at Bremerton and specialty care optimization at Madigan.
"As a market, we have been acting in a multiservice capacity for about five years or so, so I think we have an advantage and just need to continue to build on our plan," Krogh said.

About the Puget Sound MHS
The Puget Sound Military Health System is an integrated health care market that includes Army, Navy and Air Force hospitals and clinics in Western Washington. They provide care to nearly 280,000 local TRICARE beneficiaries.

About the Defense Health Agency
The Defense Health Agency (DHA) is a joint, integrated Combat Support Agency that enables the Army, Navy, and Air Force medical services to provide a medically ready force and ready medical force to Combatant Commands in both peacetime and wartime. The DHA supports the delivery of integrated, affordable, and high quality health services to Military Health System (MHS) beneficiaries and is responsible for driving greater integration of clinical and business processes across the MHS.