The Department of Defense’s Military Health System is one of the nation’s largest health care delivery systems. Our enterprise encompasses more than 144,000 clinical personnel delivering care to our 9.4 million beneficiaries in nearly 700 military treatment facilities – 54 hospitals, 377 clinics, and 250 dental clinics – on military installations around the world. In fact, DoD operates more hospitals than any nonprofit hospital system in the United States and would rank among the top five largest for-profit health systems. Today, the complex set of health information technology networks supporting the delivery of healthcare throughout the MHS is the focus of an intensive network consolidation and modernization effort led by the Defense Health Agency Chief Information Officer.
DHA provides the critical infrastructure and software for the health care delivery system. By establishing and investing in health IT as a shared service, DHA is consolidating and standardizing its health IT infrastructure and management; simplifying information sharing through common enterprise-wide services; and increasing effectiveness and efficiency of health care operations. This consolidation increases transparency and accountability for the modernized delivery of DHA health IT services to its MHS customers.
In my role as Chief of the Infrastructure and Operations Division, I lead the multi-talented team responsible for building and sustaining standards-based computing and communications infrastructure IT capabilities, supporting the full range of healthcare delivery in our military hospitals and clinics. Our coordinated effort to streamline health IT infrastructure service lines across the MHS enterprise is known as the Desktop to Datacenter (D2D) program.
D2D provides a secure IT platform allowing healthcare providers and beneficiaries to access health records, move seamlessly among hospitals and clinics throughout the MHS, and exchange health information. D2D enables consistent healthcare clinical capabilities and workflows by standardizing the clinical desktop. When the transition to D2D is completed, all DoD medical providers, whether they are affiliated with the Army, Navy or Air Force, will be able to insert their Common Access Card into any computer on the DoD healthcare network and access their identical desktop as they travel from one location to another inside or outside the continental United States. Other key benefits of D2D include operational efficiencies that increase service levels and reduce costs for the IT infrastructure; significant improvements in security risk monitoring and management; and robust support for infrastructure requirements of DoD’s new enterprise electronic health record solution known as MHS GENESIS.
Technical components of the multi-faceted D2D program include the servers and storage required for computing and storage management; and network security management services for local area and wireless networks. It also includes the circuits, switches and security stacks required for the medical community of interest; standard desktop systems and servers comprising the “desktop as a service” capability; and the directory services and enterprise management login servers that control what our users are able to do on the network. The program also includes our consolidated 24x7x365 enterprise IT service desk capability known as the DHA Global Service Center, which provides a quick response access point for our customers when they require IT system support.
We are implementing D2D at a time when DoD is taking aggressive steps to achieve standardization in how its entire health system is managed, which in large part involves making the DHA responsible for the facilities within the MHS. For the first time, the responsibility for all of DoD’s health delivery functions will be “under one roof.” This creates a tremendous opportunity for the DHA to better integrate our healthcare delivery system as well as the network and IT resources supporting it. DoD has initiated a phased plan to transition responsibility for the administration and management of its military treatment facilities from service commands – Army, Navy or Air Force – to DHA oversight. When this plan is fully executed, DHA will have the authority over, as well as the ability to direct and control, the purchased care DoD provides through managed care support contractors and the direct care delivered at military hospitals and clinics around the world. To ensure we have the ability to standardize operations while this phased plan is being executed, all military hospitals and clinics within the MHS, whether they are still under service command or have transitioned to DHA administration and management, will be required to adhere to DHA policies, procedures, and standard clinical and business processes.
Ultimately, these standardization efforts will streamline and centralize health IT infrastructure, enable much needed standardization of healthcare clinical capabilities and workflows across the MHS enterprise, and steer the entire MHS toward becoming a “higher” reliability organization. What an exciting time to be a part of the DHA IT workforce!