I n t e g r i t y - S e r v i c e - E x c e l l e n c e

Headquarters U.S. Air Force

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Future Family Care Initiatives

Lt Gen C. Bruce GreenAir Force Surgeon General

21 Nov 2011

I n t e g r i t y - S e r v i c e - E x c e l l e n c e

We’re All In!

AF MissionThe mission of the

United States Air Force isto fly, fight and win#in air,

space and cyberspace

AFMS VisionWorld-Class Healthcare

for Our BeneficiariesAnywhere, Anytime

AFMS MissionSeamless Health Service

Support to USAF andCombatant Commanders

Through Global Vigilance, Reach, and Power!

I n t e g r i t y - S e r v i c e - E x c e l l e n c e

VIDEO

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I n t e g r i t y - S e r v i c e - E x c e l l e n c e

AFMS Framework ProvidesFocus and Alignment,

Transform Deployable CapabilityRapid Response to Any Worldwide Contingency

Build Patient-Centered CareContinuity & Prevention to Optimize Health

Invest in Education, Training & ResearchSustain Our Future Capabilities

FitForce

OverlappingMission Areas

Strategies

Strategy � Common Practice � Culture

I n t e g r i t y - S e r v i c e - E x c e l l e n c e

In Pursuit of Lighter &Leaner Medical Response

Humanitarian AssistanceRapid Response Team (HARRT)

MSC/Technician Role: Plans, Logistics, & Development

EarthquakesIndonesia

EarthquakesChile

EarthquakesHaiti

Airlift Deployment Requirements:

< 24 HRS +

Health Response Team (HRT)

Rapid Response Medical Capabilities:Emergency, Resuscitative, & Surgical Care

C-17’s

� Transition from Alaska Shelters to Utilis� AK Shelter Compatible; Decreased Build Time� Joint Program Testing w/ Collective Protection

� Developing “Portable” Functional SupplySystem (ER/OR/ICU/Peds/GYN/etc)� Improved Storage/Shipping�Secure/Weather Proof Versus Triwalls/Ropak�Standardized Packing Portable Drawer Modules

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Future Based Agile Thinking for 2045Drivers Scope the Trajectory

Drivers are key factors that influence the future. FBAT researchedto fully define and characterize each driver, its polar description, itsconstituent elements, and its current status and indicated trajectory

Identify keydrivers ofchange

BuildScenarios

Determinestrategic

implications

AdjustOrganization

Strategy

MaintainLearning &

Monitor

Primary Drivers- Knowledge: Science & Technology- Geopolitics- Culture- Resources: Economic & Human

Coloring Drivers- Environmental Change- Human Factors 2

035

2027

2015

AFMS Vectoror String

2045

I n t e g r i t y - S e r v i c e - E x c e l l e n c e

AFMS Strategies – Medical Home

� Family Health Clinics Implemented – 61� Enrolled FH Population – 622,224

� Pediatric Clinics Implemented – 11� Enrolled Population – 26,531

� Total Population Enrolled – 648,755� 57% of AFMS Enrollment

� 83% FH Enrollment� 11% Pediatric Enrollment

711/29/2011

DATE MAJCOM MTF Purpose

01 Oct ACC SeymourJohnson PCMH Sr Consultant visit

3-5 Oct PACAF Eielson PCMH visit #2

4-6 Oct AMC Dover PCMH Sr Consultant visit

10-12 Oct AETC Vance PCMH visit #1

12-13 Oct AETC Altus PCMH Sr Consultant visit

13-15 Oct AFMC Tinker PCMH Sr Consultant visit

18-20 Oct AFGSC Whiteman PCMH Sr Consultant visit

24-26 Oct USAFA USAFA PCMH visit #2

26-Oct ACC -ellis PCMH Sr Consultant Visit

1- 5 -ov PACAF Anderson PCMH visit #2

1 -5 -ov PACAF Kadena PCMH visit #2

1-5 -ov PACAF Osan PCMH visit #2

2 -ov AFSPC Peterson PCMH Sr Consultant visit

2 -ov ACC Dyess PCMH visit #1

Data effective 1 Oct 11 from DSSenrollment numbers Sep 2011

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75%

80%

85%

90%

95%

100%

Jan-11 Mar-11 May-11 Jan-11 Mar-11 May-11

PCMH Aggregate Non-PCMH Aggregate

%Sa

tisfie

d

Percent of Patients Satisfied*Family Health Providers at PCMH Sites

UP isGood

Create The SettingFor “Right” Behaviors

8

ED/Urgent Care Rate: Goal < 3/100

0

2

4

6

8

10

Dec-10 Feb-11 Apr-11 Dec-10 Feb-11 Apr-11

PCMH Aggregate Non PCMH Aggregate

Aver

age

Mon

thly

Vis

it Ra

te (p

er 1

00)

Monthly Emergency Department and Urgent Care Utilization*Per 100 PCMH Patients

DOWNis

Good

HEDIS Aggregate: Goal > 40

0

10

20

30

40

Dec-10 Feb-11 Apr-11 Dec-10 Feb-11 Apr-11

PCMH Aggregate Non-PCMH Aggregate

Scor

e

HEDIS Measures - Patients Enrolled to PCMH Clinics

UP isGood

Inspiring Trust & Confidence by Measuring and Rewarding Outcomes

123681

64954

121580

42400

21471

0%10%20%30%40%50%60%70%80%90%

100%

Non-PCMH Sites (41/322163) PCMH Sites (34/351952)

Dec 2010 - May 2011

Continuity of CareMTF Primary Care Visit Distribution*

Family Health / PCMH PatientsOther Provider

PCMH Team

PCMH PCM

Other Provider(Family HealthClinic)PCM(Non-PCMHSites)

PCMH TEAMContinuity

Continuity: Goal > 90%Satisfaction: Goal > 95%

$

$

$ $

I n t e g r i t y - S e r v i c e - E x c e l l e n c e

EHR

PDTS

TMDS

DEERS

$ / M2

DMHRSi

Leveraging Medical Informatics

Better Care Through

Evidence Based Practice

Registries

CarePoint

User Interfaces

Better Health Enhanced Patient

Safety

Best ValueHealthy Behavior

Clinical Practice

Guidelines

Medication Alerts

Home Sensors

ExpeditedTest Results

Better CareImproved Patient

Experience

DATA INFORMATION WISDOM CHANGEKNOWLEDGE

Accelerating Information Exchange with Patient Activation

HealthServices

DataWarehouse

(HSDW)

I n t e g r i t y - S e r v i c e - E x c e l l e n c e

PatientCentered

HealthTeam

DecisionSupport

PatientDecisionSupport

PCMH Is The Lynchpin To Better Decision Support For Patients & Health Teams

Activating Patients & Care Teams

I n t e g r i t y - S e r v i c e - E x c e l l e n c e

Investing In Education, Training, Research, & Partnerships

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Education, Research, Partnerships – Absolutely Critical to Building & Sustaining Medical Services

Physician/Dentist Education (GME/DME)� Stand alone programs� Masters with civilian universities� Integrated/affiliated with Federal partners� 84 Advanced Education General Dentistry-1 slots/yr� Dental Specialty certificate/Masters program opportunities

Nurse Education (Transition Program)� Increasing to 241 enrolled students in FY10� New sites include: Cincinnati, OH & Scottsdale Healthcare, AZ

Research� Diabetes� Telepathology� Teleradiology

I n t e g r i t y - S e r v i c e - E x c e l l e n c e

Patient-Centered Care

� Ready: Reassure patient that you “know them”� Accessible: Be there when the patient needs you� Prepared: Respect patient and their time � Precise: Clarify all treatment and follow-up� Organized: Don’t ask patient what you should know or have

available in their medical record� Respectful: Always answer phones/resolve patient concerns� Thorough: Tell patient what to do if they feel worse

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Patient-Centered Care Begins with Access to Earn Trust!

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“TRUSTED CARE ANYWHERE”

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Integrating New Technology

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Hand-held, Battery-powered, Laser Cautery & Ablation Tool

Directed Energy Sensors

Automated Information

& Data Collection

(AIDC)Current CCATT Mission

From Force Health Protection To Logistics To Portable Surgical Tools

Future CCATT Mission -Wireless

Reaching Beyond with Evolutionary Advances and Concepts