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Access, Cost, Quality, and Safety
Providers and their patients will continue to see improvements in the quality of care in the Military Health System (MHS) during the transition to a new administration. That’s the word from Dr. David Smith, who is now performing the duties of the assistant secretary of Defense for Health Affairs until a nominee is chosen and confirmed.
We sat down with Smith to get his thoughts on the transition and the future of the MHS.
Q: You’re certainly not new to Health Affairs and the operations of the Military Health System. You have been serving as the deputy assistant secretary of Defense for Health Readiness Policy and Oversight, a position you’ve held for the last four years. You came up through the military ranks of military medicine as a doctor and as a civilian policymaker. What accomplishments by your predecessors will you continue?
Smith: In my interim role, I’ll be carrying on all the great things we’ve been working on. In particular, we’ll continue the Partnership for Improvement (P4I) program. The P4I dashboard gives our leadership a good way to see the progress the MHS is making in access to care, quality, safety and transparency—essential elements in promoting excellence in health care. It’s something we want to develop further. Also, we’ll continue our partnerships with civilian health care organizations, such as the American College of Surgeons, working on several aspects of the trauma system and helping sustain the capabilities that have been developed during the last 15 years of conflict. During that decade and half, we developed the Joint Trauma System, a series of combat casualty care principles founded on four simple tenets: right patient, right place, right time and right care. The results have been the lowest mortality rates for those wounded on the battlefield in the history of warfare.
Q: What are biggest issues you think you may face during this interim period? What may be the biggest challenges facing the incoming Assistant Secretary of Health Affairs?
Smith: The 2017 National Defense Authorization Act (NDAA) certainly gives us a lot to work on over the coming months. We are working closely with the Services and Joint Staff on the specific actions we need to take to implement the law. We also have a new electronic health record, MHS GENESIS, coming online in less than a month in the Pacific Northwest. That deployment – which starts at Fairchild Air Force Base, will be a critical point of focus four. And, particularly with my background in readiness and operations, I’m excited about trying to further advance our readiness capabilities. We have some exciting projects underway to better define the knowledge, skills and abilities required in the deployed environment. All of this is important work.
None of these issues are going to be completed in weeks or even months. These are long-term, strategic issues that will also be facing the next assistant secretary of Defense for Health Affairs. As soon as an ASD(HA) is nominated and confirmed, we’ll want to clearly establish our medical responsibilities to support the larger military mission. We will show him or her the quality of the people we have; and how the MHS contributes significantly, not only to the military and its ability to accomplish its missions, but to the health of our nation and the world.
Q: What in your background would give the MHS workforce and its beneficiaries an indication of how you plan to operate in the interim?
Smith: I’ve dedicated my adult life to working within the Military Health System, very much in an operational role. My love of operational medicine, quite frankly, grew out of a love I have for the military and the mission they’re doing and the importance of keeping our soldiers, sailors, airmen, Marines and coast guardsmen safe, fit and protected in their environments.
Q: What is your message to the MHS workforce – both services members and civilians, the health care provider network, and to the beneficiaries they serve?
Smith: For our beneficiaries, they’ll continue to receive the best quality care available. The Department of Defense is exceptional at managing leadership transitions – we do it frequently in uniform. For those working in the MHS, we have an incredible team with enormous talent and we have a lot to be proud of. And, we are a system that constantly seeks to improve our readiness and the quality of the care we provide. I will ensure we keep moving forward, and at the same time, that we are prepared to support our new leaders as soon as they are ready to step in.