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Top five digital health trends for military medical providers in 2021

Image of Dr. Pincus with text "Top Five Digital Health Trends for Military Medical Providers in 2021" Dr. Simon Pincus, chief of the Defense Health Agency Connected Health Branch, makes five health trend predictions for 2021. (Photo by Savannah Blackstock.)

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Few years have ever tested the endurance, skill, and resolve of the Military Health System like 2020. For 10 seemingly endless months, the COVID-19 pandemic has besieged the United States and military providers continue to defend the medical front lines every day. The fight won’t end with the New Year. We must continue to do all we can to ensure the health and safety of our beneficiaries, providers, and frontline health care workers in 2021 and thereafter.

Looking back on all we as a community have been through and learned, I suggest MHS providers keep an eye on these five digital health trends in 2021:

1. The COVID-19 pandemic will accelerate the need for virtual health, especially for tele-critical care: The COVID-19 pandemic response catapulted virtual health to a prominent role in the delivery of health care to our beneficiaries in the Department of Defense and the U.S. health care system as a whole. Through enterprise-wide processes, technology, and training, the Defense Health Agency has supported a local, regional, and global multi-tiered virtual health response that continues to sustain care while keeping beneficiaries and health care teams safe.

The spike in COVID-19 cases this winter is anticipated to significantly increase requirements for intensive care. A significant subset of those patients lives in areas with limited critical care expertise and capacity. DHA is helping address this shortfall through the Joint Tele-Critical Care Network. The JTCCN leverages virtual health to extend critical-care resources and treatment at a distance, similar in concept to how air traffic control systems track and direct planes to ensure they — and their passengers — safely reach their destinations.

The JTCCN provided almost 1,200 days of coverage to more than 300 unique patients in 61 intensive care unit beds across 11 spoke sites from January 2020 to June 2020. DHA is also exploring a partnership with the Department of Veterans Affairs to establish a single federal tele-critical care network to provide care to any of the 1,700 VA or 400 DHA ICU beds.

2. Virtual health will catalyze conversations about the future of health care delivery: The many lessons learned from the COVID-19 response make it clear that virtual health will become an increasingly important and integral part of MHS care delivery for the foreseeable future. DHA is planning to ensure beneficiaries and care teams get the digital tools and support they need for high-quality care, anytime and anywhere.

Rapid adoption and acceptance of virtual health is already catalyzing significant, permanent change in culture and business processes throughout the MHS. The traditional paradigm has flipped — we have gone from unquestioningly assuming in-person care is the de facto standard to weighing many different options for safe, high-quality care. Should we work in the office or telework, synchronously or asynchronously? What patient care can be delivered virtually, which patients need to be seen in person, and how do we respond to patients’ new expectations?

3. The DHA transition and MHS GENESIS implementation will encourage standardization, optimization, and innovation: At the same time as COVID-19 and virtual health radically reshape the health care landscape, the MHS continues its own major transformation establishing a market-based structure for health care delivery and the continued support of medical readiness.

In this transition, DHA will combine all military medical treatment facilities and ensure they provide care in a unified, standardized way to all 9.6 million beneficiaries worldwide. This standardization of technology, processes, and workflows will improve health care access, delivery, outcomes, and patient experience of care. It will also help to reduce redundancies.

One way the MHS will provide that improved care is through DoD’s new electronic health record MHS GENESIS, which will continue its rollout through 2023. MHS GENESIS is not just an electronic health record — it’s a living, breathing system of care that translates evolving clinical needs into clinical workflows through health information technology.

As DOD and its partners advance each wave of deployment, health informatics experts at DHA leverage user feedback to improve the systems configuration at an enterprise level. These ongoing upgrades are designed to improve system usability for both patients and providers, as well as improve the continuity of care among facilities. Significant MHS GENESIS improvements include secure messaging between patients and their care teams and the ability of providers to dictate directly into the EHR.

4. Integration and interoperability will encourage new insights and partnerships: Patients, providers, and the MHS enterprise can truly benefit from the DHA transition and MHS GENESIS only if we ensure that the technology, strategy, policies, and guidance we put in place make it easy for them to connect with each other through digital and virtual means.

For that to happen, the technology needs to be interoperable. The MHS has a worldwide, highly mobile population that moves between legacy (such as AHLTA and Essentris®) and the new MHS GENESIS EHR. DHA has made progress toward an interoperability among MHS GENESIS, AHLTA, VA and health care networks through its Joint Longitudinal Viewer (formerly Joint Legacy Viewer) / joint Health Information Exchange. When fully deployed, MHS GENESIS will provide a single health record for all service members, eligible veterans, retirees, and their families.

Integration of technology is also essential. More integrated systems improve security and the ability to share information. Over time, integration of EHR and digital data from providers, patients, and remote health monitoring will create a well of data that—by applying artificial intelligence and predictive analytics—can help reduce redundancy and delay of care and improve outcomes. All these efforts are already in progress, it’s exciting.

We need to integrate all these efforts in rapid, agile ways, which requires coordination through partnerships. Multiple stakeholders across the MHS must work together to make that happen.

For the Connected Health Branch, coordinating across the MHS and its other partners is essential to help create a care system—both individuals and technology—that delivers integrated digital health that improves both health and military readiness.

5. Successful providers will keep patients at the center of care: We not only have to partner at the organizational level, we have to individually treat each patient as a partner as well. We have to understand where our patients are coming from, meet them where they are, and put them at the center of everything we do.

Having an open, flexible mindset on how to collaborate with patients, especially by leveraging digital means, to accomplish health care goals is important these days. Patients often do their own research into health care treatments and tools (and providers!) using technology.

As providers, we need to listen. If we’re not engaging patients as the savvy consumers they are, we’ve lost them at hello. That disconnect could determine whether the patient is able to effectively use safe, evidence-based digital health tools, or we learn about valuable new research and technology to help that patient and others.

This year has taught all MHS providers unforgettable lessons and will forever change how we view and accomplish our mission to ensure military readiness. Next year will push us to be more innovative than ever before. The new year also gives us the opportunity to partner with each other, our organizations, and our patients, so we can all expand lifesaving and health-improving capabilities for service members, their families, and the country.

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