September Message from the Assistant Secretary of Defense for Health Affairs

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from the Assistant Secretary of Defense for Health Affairs, HON Thomas McCaffery

MHS Team:

It’s a momentous time for the Military Health System. Earlier this month, the Defense Health Agency held its Change of Responsibility ceremony to bid farewell to VADM Rocky Bono and welcome LTG Ron Place as the DHA’s new leader. VADM Bono’s leadership during her four years with the DHA prepared the Agency for significant organizational reform that will enhance our integrated system of readiness and health and deliver on our mission to support the warfighter and care for the patient.

LTG Place brings 29 years of outstanding leadership and expertise including extensive surgical training, combat surgical experiences in Afghanistan, deployments during Operation Iraqi Freedom and Kosovo, commanding Army hospitals at all levels, and most recently as the National Capital Region medical director. His experience leading the transitional Intermediate Management Organization to oversee MTFs that transitioned to the DHA last year will be invaluable in helping foster the critical relationships between the DHA and Military Treatment Facilities.

I also would like to welcome Brig Gen Paul Friedrichs as the new Joint Staff Surgeon. Brig Gen Friedrichs has a wealth of experience as well. In his last assignment as Command Surgeon, Headquarters, Air Combat Command at Joint Base Langley-Eustis, he was responsible for organizing, training, equipping and sustaining combat-ready medical forces for rapid deployment. He was also responsible for the health care of 81,000 active duty and civilian personnel located at 12 bases and more than 300 operating locations worldwide.

And congratulations to MG R. Scott Dingle for his nomination for promotion to lieutenant general and assignment as the U.S. Army Surgeon General.

On the subject of change, years of planning are coming to fruition as we reach historic MHS milestones this month and next. These achievements are a direct result of your diligent work and commitment to delivering on key initiatives to support readiness and quality health care delivery. On September 7, the MHS’s new electronic health record, MHS GENESIS, went live at four new sites: Travis AFB, Presidio of Monterey, and Naval Air Station Lemoore in California, and Mountain Home AFB, Idaho. Together, these four sites make up “Wave Travis” – the first wave of post-Initial Operating Capability (IOC) full-scale deployment as we roll out this state-of-the- art integrated electronic health record system-wide.

MHS GENESIS is transformative for our enterprise, for our providers, and for our patients – enabling access to robust information about patients and better management of chronic, complex, and time-sensitive conditions. It also provides real-time clinical decision support, increases patients’ direct communication with providers, and helps the Military Health System better target and tailor resources to meet readiness requirements both for the medical force and the warfighter.

The Wave Travis deployment reflects a strategic and deliberate application of lessons learned during IOC testing in the Pacific Northwest, including improvements to our training strategy, change management process, and infrastructure support. With plans underway to complete worldwide MHS GENESIS deployment by 2024, we are already seeing this complex effort contribute to the broader MHS reform vision – including enhanced cybersecurity, standardized workflows, and improved patient engagement through the MHS GENESIS Patient Portal. A big shout-out to the teams at Travis, Presidio of Monterey, Lemoore, and Mountain Home, for your agility, preparation, and commitment to a successful deployment of MHS GENESIS!

A quickly approaching milestone for MHS transformation is the transfer of authority, direction and control of U.S. Military Treatment Facilities to the DHA on October 1. This pivotal change consolidates the management of MTFs under the DHA, thus advancing standardization, improving readiness, enhancing consistency in patient access and experience, reducing operating costs, and strengthening performance management systems. The end result will be a better system of military medicine – a truly integrated enterprise that optimizes medical readiness and patient care. While this is a big change, there should be no disruption to the daily routine at MTFs both for patients and staff. The conditions-based, direct-support framework that the DHA and the services will use to support MTFs as DHA stands up its headquarters capabilities will ease the transition.

Switching gears, on the topic of support to our warfighters, earlier this month I had the pleasure of meeting with VADM Tim Szymanski, Deputy Commander, U.S. Special Operations Command. We discussed DoD’s Comprehensive Strategy for Warfighter Brain Health, which aims to promote and protect the health and well-being of our forces, including optimizing cognitive performance and enhancing the Department’s capabilities to prevent, diagnose, and treat Traumatic Brain Injury. I’m so impressed with the initiative SOCOM has taken to be more preemptive in their approach, specifically, their Cognitive Surveillance Program, which is designed not only to identify injuries earlier, but also to track individual trends and assist in developing comprehensive treatment plans for a warrior’s recovery. In addition to taking a more deliberate approach to increasing awareness of potential cognitive issues, SOCOM provides initial baseline screening to its special operators, and retests them every two years to determine if there are significant changes. It’s the cognitive equivalent of a routine dental exam or audiogram. Cognitive Surveillance is actively driving the science through blast-exposure research efforts. By determining heavy weapons/breaching exposure levels, they can determine mitigation requirements. SOCOM’s approach is similar to what the Navy did when it created dive tables, which regulate scuba divers’ time underwater to prevent them from absorbing too much nitrogen and getting decompression sickness. With our operational commanders focused on brain health, I know that together, we can leverage innovation, research and development, and enhanced clinical programs to ensure our forces remain both lethal and resilient.

Lastly, I want to take a moment to recognize National Suicide Prevention Month and encourage you to come together to prevent and respond to the devastating trend of suicide. We all have a role to play in creating environments that empower each other to seek support early. Learn about the resources available if you or a friend needs help, and together, commit to build a culture of connectedness. I was heartened to read an inspiring story just last week about Airmen 1st Class Brittany Wright and Tiffany Duffus, two dental lab technicians at Peterson Air Force Base, Colorado. They stepped in to support a friend in need, embodying the team approach to resiliency and suicide prevention necessary to combat this tragedy in our ranks. Senior leadership across the MHS and the Department are committed to fostering a community and culture of support and access to the right help at the right time. For suicide prevention resources, visit Prevention.


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