Patient Movement Main Issues

1. Patient Movement Panel DiscussionCAPT James Marron, MC, USN Medical Director, TAO-PacificCDR Carla Thorson, NC, USN Clinical Operations, TAO-PacificCDR David Byman, MSC, USN Health Care Operations, NH OkiMajor Scott Tonko, NC, AF Deputy Director, TPMRCMajor Domingo Bicaldo, MC, AF Flight Surgeon, TPMRCMs. Marsha Graham, RN Chief Managed Care, TAMC

2. Patient Movement Main Issues • Pacific Referral System – Juniper • Commercial Air Evacuation Brief and Checklist • Overflight Programs for NH Okinawa and TAMC • Military Air Evacuation

3. Patient Movement Algorithm Patient Referral for Specialty Appointment NH Oki schedules appt. dates sends through Juniper CM/AE requests appointment using Juniper TAMC schedules appt. send dates through Juniper Pt accepts or declines CM/AE completes Comm Air Brief Pt travels for appt.

4. Patient Referrals - Juniper • New system replaced Persona Feb/Mar 08 • Pacific facilities must have remote access to TAMC’s system to input referrals • Many MTFs have limited access • Firewalls • Local IT connections • Lack of training and system knowledge

5. Patient Referrals - Juniper • Referral workload now moved to TAMC and other MTFs to input • Faxes and emails between MTFs • Connected MTFs input into system • Creating havoc in specialty care clinics • No shows • Cancellations • Patient miscommunications

6. Comm Air Evac Brief & Checklist ISSUES • Commercial AE lacked standardization throughout the Pacific • Inadequate patient preparation for referral appointments • Negative impact on specialty care availability at TAMC • Increased TDY time/costs to parent command

7. Comm Air Evac Brief & Checklist SOLUTION • Process Action Team created to address issues - comprehensive representation of Pacific MTFs • Created a standardized briefing for the Pacific approved by TAMC and JPLO • Improved patient preparation for referral appointments • Increased specialty care availability at TAMC • Decreased TDY time/costs to parent command – SAVE $$$

8. Commercial Air Evacuation Brief

9. Commercial Air Evacuation Checklist

10. Overflight Program NH Okinawa • No expansion of services, better utilization of existing services • Negligible impact on TAMC’s GME program primarily specialty services • Email communication from originating MTF to COMMANDER • If approved follow normal process • NO involvement of TAO-P

11. Overflight Program Tripler Army Medical Center • Benefits TAMC GME program • Email communication from originating MTF to TAMC DCCS – CAPT David Lane • Approval then to TPRMC for commercial ticketing • NO involvement of TAO-P

12. QUESTIONS?