Defense Health Agency

1. Defense Health Agency 2019 and Beyond Mr. Guy Kiyokawa Deputy Director, Defense HealthAgency November 7, 2018

2. The Military Health System (MHS) A $50B military medical enterprise with medical readiness at the center of the mission • Health Care Delivery System: • 54 hospitals world-wide • 350+ medical clinics, 280+ dental clinics • Health Benefits Plan: • 9.4 million covered lives / 380,000 participating providers • Global Public Health System: providing community health, global health and environmental surveillance • 24-7 Health IT Platform: MHS GENESIS • Medical Education and Training System: including a University with an accredited medical school and graduate programs, a large scale accredited graduate medical education, enlisted and medical officer training platforms • Medical research and development (R&D) system: ~ $1 billion program

3. Secretary Mattis’ Priorities • Restore Readiness and Lethality • Strengthen Alliances • Bring Business Reforms to DoD Approved for Public Release

4. Need for an Enterprise Approach Outcomes & Experience of Care Safety & Quality Improve Improve processing time between appointment referrals and appointment scheduling critical patient safety measures Unintended Retained Foreign Objects, Wrong Site Surgery, Hospital Infections Increase patients satisfied with getting care when they need it Transparency of performance at MHS and MTF levels Readiness Efficiencies Reduce Streamline the proportion of Service members that are non-deployable due to preventable medical reasons overhead staffing through the consolidation of headquarters functions Standardize Strengthen business, clinical and administrative policies and processes the capability of the deployable medical force FY18 Savings Reprogrammed Cybersecurity Bolster Eliminate medical networks and Cyber standards duplicative IT Systems Approved for Public Release

5. DHA Goals and Priorities Build an Integrated System of Readiness and Health Administer and Manage MTFs Deploy and Sustain the Electronic Health Record Standardize Operations and Processes

6. DHA Goals and Priorities Build an Integrated System of Readiness and Health Administer and Manage MTFs Deploy and Sustain the Electronic Health Record Standardize Operations and Processes

7. Military Health System Consolidation 1 OCT 2018 1 OCT 2019 1 OCT 2020 1 OCT 2021 7% Facilities 13% MIL/CIV FTEs 12% Enrollees 17% Dispositions 52% Facilities 54% MIL/CIV FTEs 57% Enrollees 55% Dispositions 81% Facilities 93% MIL/CIV FTEs 89% Enrollees 88% Dispositions 100% MHS Enterprise Previously transferred Transferring within phase Full Authority to Standardize Policies for all MTFs Health Plan, Pharmacy & Quadruple Aim Performance Plan (QPP) Functional Capabilities Facilities, MEDLOG & Acquisition Functional Capabilities All other Functional Capabilities Approved for Public Release

8. DHA Goals and Priorities Build an Integrated System of Readiness and Health Administer and Manage MTFs Deploy and Sustain the Electronic Health Record Standardize Operations and Processes

9. Health IT Reform Optimize IT costs by reducing duplicative IT services and systems, reducing the IT manpower footprint across the MHS enterprise, standardizing IT business processes and workflows to maintain and enhance quality of patient care Six Core Functions Health IT Mission Implement, manage, and sustain an integrated and protected medical information enterprise in order to ensure the right information is accessible to the right customers at the right time and in the right way. Systems:Provide and sustain assigned enterprise systems being used across the MHS Network:Provide and sustain the medical enterprise network upon which all the systems communicate (“Medical Community Of Interest” or Med-COI) Budget & Portfolio Management: Portfolio management of assigned systems Cyber:Defend and secure the network Innovation / Reform: Design and implement solutions leading to efficiencies to enable cost reductions of IT manpower, infrastructure, and applications Customer Support: Provide enterprise help desk in support of the systems and network Projected Health IT Reform Savings: $1.55B; beginning in fiscal year 2019 (FY19) 7

10. Modern. Secure. Connected. • Breakthrough! DoD and VA are implementing the same electronic health record • Good for patients • Good for providers • Good for society • Innovation is built-in: With commercial technology, all users invest in continuous upgrades • Partnership with - vendor and VA - in words and deeds Approved for Public Release

11. DHA Goals and Priorities Build an Integrated System of Readiness and Health Administer and Manage MTFs Deploy and Sustain the Electronic Health Record Standardize Operations and Processes

12. Strengthening Enterprise Activities (EA) 1 6 Pharmacy Programs Facilities 2 7 TRICARE Health Plan Procurement/Contracting 3 8 Health Information Technology Research, Development & Acquisition 4 9 Public Health Budget & Resource Management 5 10 Education & Training Directorate Medical Logistics

13. Modernizing TRICARE • Successful Program …Built on Early 1990s Managed Care Model • Stakeholders Ready for Change • Beneficiaries • Line Leadership • Congress • Other Federal Partners (VA) • DHA Industry Partner Network Helping to Accelerate Innovation Approved for Public Release

14. Stay Connected @DHADirector @TRICARE Approved for Public Release