It was announced on October 1, 2014 that U.S. Defense Secretary Chuck Hagel’s 90-day review of the military health system found that it was comparable in access, quality and safety to care offered on average in the private sector. However, Secretary Hagel said “average” was not good enough: “We have the finest military in the world. Our men and women in uniform and their families deserve the finest health care in the world … the military health care system provides health care that is comparable in access, quality and safety to average private-sector health care. But we cannot accept average when it comes to caring for our men and women in uniform and their families. We can do better; we all agree that we can do better.”
In May 2014, Secretary Hagel had ordered a comprehensive review of the Military Health System (“MHS”) to assess whether access to medical care in the MHS met defined standards, whether the quality of health care in the MHS met or exceeded defined benchmarks, and whether the MHS had created a culture of safety with effective processes for ensuring safe and reliable care of its 9.6 million beneficiaries.
As a result of the findings of the review, Secretary Hagel directed all health care facilities identified as “outliers” in categories of access, quality and safety to provide action plans for improvement within 45 days, and further directed the assistant secretary of defense for health affairs and the military services surgeons general to ensure that the department has unified standards for purchased and direct care. Secretary Hagel also ordered that they establish a mechanism by which patients and concerned stakeholders can provide ongoing input.
The review resulted in six recommendations for the MHS, which provides care for 9.6 million service members, families and military retirees and their families:
1. Immediate action to improve underperformance by addressing the cause of outliers found among MHS’ military treatment facilities, by studying and sharing the experiences of positive outliers and, if poor performance is found, quickly introducing corrective action plans to raise performance;
2. Establish clear enterprise performance goals with standardized metrics and hold the system accountable for improvement, by the MHS creating an enterprise-wide performance management system using a “core set of metrics” for health care access, quality and patient safety. Systemwide performance measures should also be established, and regular formal performance reviews of the MHS should be conducted, with the Defense Health Agency charged with monitoring performance and supporting the health system’s governance;
3. Make good decisions by relying on accurate data, by the MHS developing an enterprise-wide quality and patient safety data analytics system, to include health information technology systems, data management tools and appropriately trained personnel;
4. Show information to everyone — patients, providers and policy makers (transparency of information in direct and TRICARE health delivery);
5. Drive the necessary change with joint MHS decision-making — through new governance models that feature close Service, DHA and OSD collaboration, policy guidance can be developed using common goals, which would advance an understanding of the culture of safety and patient-centered care across the system; and,
6. The MHS should continue to create common standards and processes to improve outcomes across the system for access to care, quality and patient safety where it improves quality, or deliver the same level of quality at a better value.
If you or a loved one were injured due to medical negligence in a VA facility or otherwise through the MHS, you should promptly consult with a local medical malpractice attorney in your U.S. state who may investigate your situation for you and represent you in a medical negligence claim, if appropriate.
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