Skip to main content

Military Health System

MHS quickly adapted to improve patient experience during pandemic

Image of Military health personnel waiting for the next phone call on the COVID-19 advice line. Regina Andrews, a registered nurse at Fort Carson’s Evans Army Community Hospital Department of Surgery in Colorado, awaits her next phone call Aug. 5, 2020, from the COVID-19 patient advice line (Photo by: Emily Klinkenborg, Fort Carson Evans Army Community Hospital).

Recommended Content:

Coronavirus and the COVID-19 Vaccine | Coronavirus & the MHS Response

Faced with the onslaught of the COVID-19 pandemic, the Military Health System (MHS) responded swiftly to fight the novel coronavirus and deliver necessary medical care, routine health care and services to maintain a medical ready force.

"At the beginning, the goal was to continue providing medically necessary and readiness-related care, which could not be delayed in order to protect patients and staff from unnecessary exposure to COVID," said Regina Julian, chief of the Healthcare Optimization Division at the Defense Health Agency (DHA). Julian cited dialysis services, the delivery of babies, well-infant examinations, emergency surgeries, and cancer-drug infusions as examples.

"We did these services in safe cohort areas" at military medical treatment facilities (MTFs), she said.

"We based our model on what we learned from our own high-performing MTFs and consistent with what civilian hospitals such as Brigham & Women's (in Boston), Columbia-Presbyterian (in New York) and Cedars-Sinai (in Los Angeles) were doing," Julian said.

"This ability to develop standard processes based on best practices and then to codify those practices in DHA guidance to continue care that is medically necessary and necessary to keep the force operating fully is all part of DHA being a high-reliability organization," she said.

"We were able to be nimble by leveraging and modifying our existing DHA Healthcare Optimization Division guidance for primary and specialty care, access, referrals, patient experience and virtual health for all MTFs world-wide" to reflect new COVID-19 processes, Julian said.

Because of this, "the Direct CareDirect care refers to military hospitals and clinics, also known as “military treatment facilities” and “MTFs.”direct care system remained open throughout the pandemic" and delayed elective care, Julian said. "We took advantage of being able to shift additional patient visits to telephone visits, video visits, the Nurse Advice Line and asynchronously using secure messaging and e-visits.

To establish standard processes during the COVID-19 pandemic, DHA released more than 37 new clinical and operational guidance documents. The lessons learned during COVID-19 and the rapid implementation of new guidance enabled continuous process improvement. As a result, DHA will incorporate these new best practices into permanent DHA guidance by October 2021.

"Our focus was on the safety of patients and staff," said Army Col. Timothy Switaj, the Healthcare Optimization Division's Primary Care lead and the chair, Department of Family and Community Medicine, Brooke Army Medical Center (BAMC) at Joint Base-San Antonio in Texas.

"We transitioned a lot of care to virtual primarily via telephone to minimize the number of people who needed to physically come to the medical treatment facilities," Switaj said.

"Our biggest focus was on safety, but a close second was ensuring adequate communication with our patients via any medium informing them of what care we were providing, how we were providing that care, and the safety protocols put in place," Switaj said.

Survey data demonstrated patients appreciated the care MTFs took to ensure their safety and the convenience of virtual care, which demonstrated the MHS' efforts to communicate with patients was successful.

Switaj leads the primary care effort in San Antonio with collaboration from primary care leaders at all MTFs. The ongoing collaboration "ensured everyone spoke with one voice in primary care," he said.

"We would send changes in operations out to patients as soon as possible," Switaj said. "For patients worried about potential COVID-19 symptoms, we established a local nurse information line (for all of San Antonio). They used standard scripts, algorithms, and protocols to triage patients helping to determine who should be tested, and for those who had been tested, how to interpret their results, what precautions they should take, and how to manage their symptoms.

"Additionally, the nurse information line provided general information such as testing site locations, hours, and, later, vaccine information as it became available," he said.

The BAMC market has approximately 250,000 beneficiaries, and primary care services are provided to more than 150,000, Switaj said.

"Initially we transitioned about 90% of care to virtual means so that we could minimize the number of patients and staff in the clinics," he said. "By June 2020, we started gradually transitioning back to more face-to-face appointments, ultimately looking for the right balance for more long-term operations."

Switaj said in the first four to six months of the pandemic there was hesitancy from patients to return to in-person visits, "but, at this point, we are not seeing any issues."

As the world returns to a new normal with the advent of vaccines and better treatments for COVID-19, DHA is developing a patient-facing application for use on any device to enhance patient access, improve patient outcomes, experience, and engagement, said Beth Adoue-Polk, a member of the patient experience branch under Julian.

"We are working to leverage this patient-facing application to improve access and convenience for patients to manage their appointments, access pharmacy services, receive reminders/notifications and also to send secure messages to their health care teams," Adoue-Polk said. "We will have subject matter experts as well as patient feedback to develop the features and requirements for this app."

The TRICARE Online Patient Portal (TOLPP) was very responsive and receptive to the changing needs of DHA during the COVID-19 pandemic, she noted. TOLPP very quickly added virtual appointments, new prescriptions activation, laboratory appointments, and COVID-19 vaccination appointments, Adoue-Polk added. Since starting in March 2020, more than 260,000 virtual visit appointments have been booked via TOLPP across the MHS, according to DHA.

Enrollment and utilization also increased for TOLPP Secure Messaging, which continued to provide patient access to their health care team during the COVID-19 crisis. Using broadcast/blast messaging, MTFs were able to communicate quickly and effectively to inform patients about any changes in operations. More than 2.6 million broadcast messages went out in March 2020. These broadcast messages are now being used as part of the COVID-19 vaccination campaign.

While being nimble helped the MHS to adapt quickly to the COVID-19 crisis, it also helped the system identify new ways of caring for patients, according to Julian.

"If there is a bright silver lining to COVID-19 and to honor those who suffered, it required us to stop looking at the past, and to look to even better ways to establish a new normal," she said.

You also may be interested in...

Genome Sequencing Assists Research at Naval Health Research Center

Article
1/24/2023
Lab technicians doing genome research

Learn how unique samples from naval vessels, US-Mexico border populations, and DOD beneficiaries aided in the Naval Health Research Center’s sequencing efforts.

Recommended Content:

Research & Innovation | Coronavirus & the MHS Response | Coronavirus

U.S. Military HIV Research Lends Lessons Learned to COVID-19

Article
1/19/2023
Gloved hands working in laboratory

The U.S. military has engaged in HIV research for three decades, contributing critical lessons learned, knowledge, and expertise during the COVID-19 research and vaccine development effort.

Recommended Content:

Coronavirus & the MHS Response | DOD HIV/AIDS Prevention Program | Research & Innovation | Coronavirus

Naval Medical Research Center Uses Genome Sequencing for Variants

Article
1/12/2023
Military personnel pose for a group photo

NMRC’s efforts provided important support for sequencing and viral isolation to the Department of Defense and Military Health System.

Recommended Content:

Research & Innovation | Coronavirus & the MHS Response | Coronavirus

USAMRIID Focuses on Genome Sequencing to Detect Variants

Article
1/5/2023
Military medical personnel in laboratory

A connected family of laboratories across the MHS allows a more rapid response to the outbreak.

Recommended Content:

Research & Innovation | Coronavirus & the MHS Response | Coronavirus

Whole Genome Sequencing at Tripler Army Medical Center

Article
12/29/2022
Dr. Keith Fong reviews data with other lab technicians

The third installment in a 6-part series highlighting the efforts of the Military Health System laboratories and the technicians who worked to identify COVID-19 variants using special sequencing technology.

Recommended Content:

Coronavirus & the MHS Response | Research & Innovation | Coronavirus

Walter Reed Army Institute of Research Implements SARS-CoV-2 Genome Sequencing

Article
12/23/2022
Military medical personnel in laboratory

This is the second article in a 6-part series that highlights the work of technicians and scientists in Military Health System laboratories who worked to identify COVID-19 variants using special sequencing technology.

Recommended Content:

Global Health Engagement | Coronavirus & the MHS Response | Research & Innovation

Protect Yourself With Respiratory Illnesses on the Rise

Article Around MHS
12/19/2022
Military medical personnel administering vaccine

"Tis the season, and respiratory illnesses are on the rise. Learn critical health guidance about the viral triple threat of COVID-19, influenza, and the common cold, and the commonsense steps you can take to protect yourself and your family.

Recommended Content:

Coronavirus & the MHS Response | Children's Health | Medical and Dental Preventive Care Fitness | Immunization Tool Kit | Influenza, Northern Hemisphere | Immunization Healthcare Division

Military Labs Use Whole Genome Sequencing of COVID-19 Variants

Article
12/16/2022
Lab technician at work

The first in a 6-part series highlighting the work of technicians and scientists working in support of the MHS who identified COVID-19 variants using special sequencing technology.

Recommended Content:

Research & Innovation | Coronavirus & the MHS Response | Coronavirus

DOD Reduces Health Care Waste by Reusing Crutches

Article
12/15/2022
Military personnel using crutches

When military facilities faced a national shortage of an essential mobility aid, they launched a grassroots initiative that not only ensured patient care, but also created a new waste reduction model within the DHA.

Recommended Content:

Warrior Care | Coronavirus & the MHS Response

MHS Minute | Nov 2022

Video
12/12/2022
MHS Minute | Nov 2022

The latest MHS Minute focuses on highlights from DHA Director Lt. Gen. Ronald J. Place’s final virtual town hall with the workforce, Nov. 16, 2022. The discussion included the agency’s biggest accomplishments over the past three years and the impact of COVID-19 on DHA’s reputation and approach to health care delivery.

Recommended Content:

Coronavirus and the COVID-19 Vaccine | Coronavirus

Naval Medical Research Center Joint Study with Mount Sinai Uncovers Differences in COVID-19 Immune Response between the Sexes

Article Around MHS
12/5/2022
Amanda Cherry, research assistant, performing diagnostic testing at NMRC

A collaborative study between researchers at Naval Medical Research Center and the Icahn School of Medicine at Mount Sinai, and Princeton University has highlighted immune response differences in the coronavirus infection responses between male and female patients.

Recommended Content:

Medical Research and Development | Coronavirus & the MHS Response | Coronavirus

Get Protected With New COVID-19 Booster and Flu Vaccine

Article Around MHS
10/24/2022
Military medical personnel administering vaccine

There are two vaccines you should consider getting this Fall, and now you can get them both at the same time.

Recommended Content:

Immunizations | COVID-19 Vaccine Efforts | Seasonal Influenza Vaccine Toolkit | Coronavirus and the COVID-19 Vaccine

Collaborating In the ER: Reservists Assist, Learn in Community Hospitals

Article Around MHS
10/20/2022
Military medical personnel in medical training session

In the early days of the COVID-19 pandemic–when there were no vaccines, a shortage of health care workers, and hospitals were beyond capacity– the U.S. health care system needed help. Here's one of many ways the Department of Defense answered the call.

Recommended Content:

Coronavirus & the MHS Response

Time to Get Your Flu Shot and Your COVID-19 Booster, Too

Article
10/14/2022
Senior MHS officials and medics from the Pentagon stand together Oct. 13 after receiving their flu shots and bivalent COVID-19 boosters.."

It's flu shot time. Get your COVID-19 booster at the same time.

Recommended Content:

Coronavirus & the MHS Response | COVID-19 Vaccine Efforts | Coronavirus and the COVID-19 Vaccine | Seasonal Influenza Vaccine Toolkit | Immunizations | Coronavirus

Prevent the Spread of Influenza and COVID-19 Viruses Within Your Community

Article
10/11/2022
A person getting an injection on their arm.

As families return from summer vacation and students return to school, the influenza (flu) season is approaching while the COVID-19 pandemic is still on-going.

Recommended Content:

Coronavirus & the MHS Response | COVID-19 Vaccine Efforts | Immunizations | Coronavirus and the COVID-19 Vaccine | Seasonal Influenza Vaccine Toolkit
<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 31
Refine your search
Last Updated: January 17, 2023
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on Twitter Follow us on YouTube Sign up on GovDelivery