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What Can We Learn From The Military Health System?

jeffgruenheadshot2Together the Department of Defense and the Department of Veterans Affairs have the largest and most advanced IT infrastructures in US healthcare. As the Obama administration ramps up funding for electronic medical records and other IT initiatives, one might ask what the public and private sectors can learn from the military IT systems (aka AHLTA and VISTA).

I interviewed Dr. Jeff Gruen about the upcoming Military Health Summit at the World Health Care Congress, April 14-16 in Washington, DC.  Jeff is Head of the Global Healthcare Practice at PRTM, a management consulting firm and a Chairman of the Military Health Summit.

You may listen to our conversation by clicking the arrow button, or read a summary of our conversation below.

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Dr. Val: To set the stage, tell me a little bit about the World Health Care Congress, and what the Military Health Summit hopes to achieve.

Dr. Gruen: This is the 6th annual World Healthcare Congress (WHC), and the first year for the Military Health Summit. We expect 1500 to 2000 participants – the WHC is the premiere event for healthcare services and the healthcare system at large. It brings together people from across all sectors of healthcare and in addition to the general summit events we have this exciting Military Health Summit track.

Dr. Val: What does the healthcare system at large have to learn from the military health system?

Dr. Gruen: Three things: first, we can use the military health system as a case study for IT initiatives, since they’ve already achieved broad adoption of an EMR. It’s not perfect, but it’s used widely and is getting better. The DOD and the VA are working hard to make their systems interoperable.  Second, because the military health system is both a payer and a provider, it serves as a wonderful laboratory for inventing new ways of delivering care. Realigning incentives between inpatient and outpatient care or primary and specialty care can be achieved nicely in the military system, which is like a giant, international Kaiser Permanente. Third, the military has developed very advanced battlefield techniques and devices for saving lives – including telemedicine. So it’s fun to hear about these advances.

Dr. Val: How will healthcare reform impact the Military Health System – do you have any predictions based on what you’ve heard on Capitol Hill?

Dr. Gruen: It’s impossible to know exactly, but let me offer a couple of observations. First, there’s a sense of national patriotic commitment to make sure that our service men and women (and their dependents) get the very best care possible. There’s a real desire to apply the best practices from the commercial sector to the military. PRTM feels very passionate about this, especially since one of our own is currently serving in Iraq right now.

There are a few core problems in healthcare, and they all fall under the rubric of “the right care delivered in the right environment by the right provider at the right time.” These problems may be addressed with interventions including providing point of care decision support, tools that would decrease provider practice variation, and connected convergent care – the idea that we have to move from a system that is designed for acute care to one that is very good at managing chronic care. We also need to move to a system where all the data is present in a very transparent way across environments to allow us to apply the same protocols regardless of whether someone’s in the hospital, or at home, or in a nursing home.  The military health system could get these systems in place in a faster and broader way than the general healthcare system.

Dr. Val: Who should attend the Military Health Summit? How do they register?

Dr. Gruen: Those who should attend include: 1) People actively involved in the Military Health system because it offers an opportunity to interact with their luminaries. 2) Anyone on the commercial side of healthcare who’d like to do work with the military 3) Anyone who is interested in health reform 4) People with a particular interest in health IT (disease management and telemedicine in particular) 5) Anyone who wants to hear about the coolest new things coming out of battlefield medicine.

To register, one need only go to the World Health Care Congress website and follow the prompts for the Military Health Summit.

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