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Military Health System

Maintaining Mission Readiness During a Pandemic

Image of Gen. Place presents at HIMSS in Las Vegas. Defense Health Agency Director Army Lt. Gen. (Dr.) Ronald Place speaks to the audience during a Views from the Top educational session at the Healthcare Information and Management Systems Society 2021 annual conference at the Venetian Resort in Las Vegas, August 11.

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In the spring of last year, the massive coronavirus outbreak aboard a U.S. Navy aircraft carrier, USS Theodore Roosevelt, was a jarring wake-up call for many senior military leaders about the impact that the pandemic could have on military readiness.

The carrier reported hundreds of COVID-19 infections and was forced to make an unscheduled stop in Guam for almost two months. That was among the early “alarm bells” that forced the Pentagon to ask hard questions that had wide-ranging implications.

“This is a United States carrier group operating to keep sea lanes open across the Pacific, now pulled out of that responsibility due to a severe COVID outbreak on board that ship,” said Defense Health Agency Director Army Lt. Gen. (Dr.) Ronald Place, during a recent discussion of the national security implications of the COVID-19 outbreak.

“How can we safely keep ships at sea? How do we deploy submarines? How do we launch aircraft? How do we manage troop movements around the world with this? The answer is information. Specifically, health information,” Place said. “We needed it right, we needed it fast and we needed it to make decisions on how to manage the pandemic and still preserve our ability to project a fighting force.”

Place provided insights into the decision-making process of senior Department of Defense leaders regarding health care early in the pandemic when he spoke to hundreds of health care professionals who gathered recently at the Healthcare Information and Management Systems Society 2021 annual conference in Las Vegas.

Place cited COVID as the number one cause for reduced readiness over the past year. He also said that the pandemic impacts almost all areas of mission readiness.

“It takes aircraft carriers away from the mission. It has the potential to ground airplanes, keep submarines in port. It takes healthcare workers out of their usual work and makes them do other things, perhaps in other areas of the country. It slows down our ability to process and train new recruits…in other words, it essentially effects everything,” he said.

Among the first steps to address the expanding pandemic last year were to develop a task force and a testing strategy, Place said.

Another important element that Place said helped the DOD’s efforts in combatting COVID early in the pandemic was standardization, especially in the language and terminology used to discuss the problem among military officials around the world.

“Initially, local leaders doing what they thought they had to do, fast, were using their own words to describe some of these tests,” Place said. “That’s fine for local decision makers, but it’s not so great when you’re trying to look at trends. We needed to standardize.”

Place said line leaders and health informaticists in the fleet and field quickly reached an agreement on what nomenclature was going to be used and standardized it, “essentially overnight.”

“We need to be smarter, and faster, and more disciplined in getting the right solutions to clinical providers,” said Place. “COVID’s not going away. How much it continues to consume our waking hours is at least partially up to us. It’s up to us to become better listeners.”

Place said at least part of becoming better listeners is a focus on patient-reported outcomes.

“Their outcomes are expressed differently than how clinicians like me typically express them, but they’re just as important – likely they’re even more important,” he said.

Place had three main points that he saw military health care leaders embody in the current crisis and that he hoped those in attendance at the conference would take away:

  • Explain and manage risks
  • Trust is the coin of the realm – know your data, and be confident in its accuracy
  • Embrace transparency

Place also reminded the audience that the DOD’s mission around the world doesn’t stop, even for a global pandemic.

“We in the military don’t really have the luxury to work from home,” he said. “Home is where the mission takes us – from Iraq to Afghanistan to Africa or Asia and exercises with allies, humanitarian responses – it never stops.”

Dr. Terry Adirim, acting assistant secretary of defense for health affairs, also spoke at HIMSS21 as part of the Views from the Top series earlier in the week.

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This Practice Management Guide does not supersede DOD Policy. It is based upon the best information available at the time of publication. It is designed to provide information and assist decision making. It is not intended to define a standard of care and should not be construed as one. Neither should it be interpreted as prescribing an exclusive course of management. It was developed by experts in this field. Variations in practice will inevitably and appropriately occur when clinicians take into account the needs of individual patients, available resources, and limitations unique to an institution or type of practice. Every healthcare professional making use of this guideline is responsible for evaluating the appropriateness of applying it in the setting of any particular clinical situation. The Practice Management Guide is not intended to represent TRICARE policy. Further, inclusion of recommendations for specific testing and/or therapeutic interventions within this guide does not guarantee coverage of civilian sector care. Additional information on current TRICARE benefits may be found at www.tricare.mil or by contacting your regional TRICARE Managed Care Support Contractor.

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Last Updated: March 11, 2022
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