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Operating at Speed of Relevance, Key to Great Outcomes, DHA’s Maturation

Image of Photo of U.S. Army Lt. Gen. (Dr.) Ronald Place, Christianne Witten, and DHA Senior Enlisted Leader Command Sgt. Maj. Michael Gragg. U.S. Army Lt. Gen. (Dr.) Ronald Place, center, takes questions from Christianne Witten, DHA chief of internal communications, during his last town hall meeting as director of the Defense Health Agency with DHA Senior Enlisted Leader Command Sgt. Maj. Michael Gragg, Nov. 16, 2022. The event focused on the agency’s greatest accomplishments over the last three years and how the COVID-19 pandemic helped transform the agency’s reputation in the DoD and shape its internal culture. Place and Gragg also discussed the future of military medicine. (Photo by Robert Hammer, MHS Communications)

11/21/2022 By: Janet A Aker

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The Defense Health Agency’s reputation as it stands today rests in large part on its successes during COVID-19.

The pandemic defined the agency’s value to the Department of Defense as a “trusted partner,” DHA Director U.S. Army Lt. Gen. (Dr.) Ronald Place said at his last town hall meeting with the workforce, Nov.16.

When DOD called upon the DHA for help in responding to the pandemic in March 2020, “we became an organization that was trusted by the senior leaders of the Office of the Secretary to include the secretary, himself, and the deputy secretary,” Place said.

DHA senior enlisted leader, Command Sgt. Maj. Michael Gragg, echoed that sentiment for all DHA members. “Thank you all for changing our perception and making the exception the expectation, because that’s what you’ve done as an agency. In the past, our successes were looked at as exceptions,” he said. “Now, your success is considered the expectation that when given a mission by the DOD, the DHA will accomplish that mission.”

During the pandemic, the DHA’s most successful actions include:
  • Creating a real-time COVID-19 global registry to track hundreds of thousands of DOD patients and their health outcomes.
  • Collecting more than 12,000 units of convalescent plasma from recovered COVID-19 patients in less than four months, exceeding the original DOD request for 8,000 - 10,000 units.
  • Conducting the COVID-19 and subvariant vaccine delivery system worldwide.
  • Expanding telehealth services to more than half of all health care patient encounters early in the pandemic.

By completing all these projects, the DHA showed its value as an operational combat support agency. “If we didn’t have a Defense Health Agency before COVID-19, COVID-19 would have driven the Department of Defense to create one,” Place commented.

The DHA was awarded the Joint Meritorious Unit Award for Excellence for its work on COVID-19 from January 2020 through October 2020.

‘Speed of Relevance’ as a Combat Support Agency

With items like the registry, the DHA proved that it could provide powerful data and do so at the “speed of relevance,” Place said. Therefore, “the question becomes no longer about whether the DHA can perform, it’s about its long-term ability to sustain and expand its excellence.”

Gragg pointed out that medical organizations have always been more deliberative in their approach to sharing data. With the pandemic, DHA “had to modify our way of thinking so that we can assimilate and provide the data to the people that we are supporting. And then provide as much accurate data as we possibly can so that the data are relevant and trustworthy.”

Command Sgt. Maj. Michael Gragg, Senior Enlisted Leader for the Defense Health Agency Command Sgt. Maj. Michael Gragg, senior enlisted leader forthe Defense Health Agency, answers a question during the DHA town hall with theworkforce, Nov. 16, 2022. (Phot by Robert Hammer, MHS Communications).

Watershed Changes

The pandemic coincided with a once in a generation transformation of the Military Health System, which included the transition of more than 700 brick-and-mortar military medical hospitals and clinics from each service to the DHA. From a contracting, facilities, logistics and medical equipment viewpoint, this transfer equaled $64 billion worth of property the DHA now oversees. This transformation also led to the creation of more than 20 direct reporting markets, two overseas Defense Health Agency Region offices in Europe and the Indo-Pacific, the Small Market and Standalone Military Treatment Facility Organization, and the continuing rollout of the new electronic health records system, MHS GENESIS.

As for the expansion of MHS GENESIS: “We are more than two-thirds rolled out now, and no pause happened in the MHS transition.” MHS GENESIS will be “done ahead of time and under budget,” Place said. “That is a huge accomplishment.”

More Changes

On top of all those changes, more than 45,000 civilian employees transitioned to the DHA from the services over the course of three months. “That is extraordinary. It’s the largest personnel transfer in the DOD since the creation of the Air Force in 1947,” Place pointed out. All told, the current workforce includes nearly 150,000 uniformed and civilian employees.

The DHA also transitioned to MED365, a DHA-managed, cloud-based office and collaborative service for the entire Military Health System, to provide increased cybersecurity to protect patient privacy and medical systems unique to the MHS community. Migrations of this scope usually take 18 to 24 months, but the DHA’s dedicated team of more than 200 information technology professionals successfully migrated more than 180,000 global users, 20 terabytes of data, and 20,000 non-personal entities, such as organizational mailboxes and distribution lists, to this new platform in three months.

The Future and Ready, Reliable Care

“Ultimately it is the outcomes that matter,” Place said.

The ultimate measure “is what happened to the patient,” Place said. “That’s why, to me, great outcomes will always be the number one priority.”

For patients, “do they feel like we’re interested in them? And if they had a choice, would they always choose us? Because they know that nobody cares more about them than us. That is what ‘satisfied patients’ means,” Place said.

From a fulfilled staff standpoint: “Am I glad that this is where I work? And, if I had a choice … would I choose here over somewhere else?”

“I see the agency moving forward in three words: adaptable, resilient, and courageous,” said Gragg. Even if “we fall … we’re going to bounce back.”

Final Thoughts

Place closed the discussion reflecting on his admiration for the workforce. “I’m nearing the end of a military medical career that I’ve loved and I’ll be honest–the closer I get to retirement, the more encouraged I am about the future of military medicine. And that’s entirely because of you–the people who make our health system thrive every day.”

He went on to add, “I'm incredibly proud of your efforts, of your resilience, your dedication in this once-in-a-generation transformation of our system. Thanks for your willingness to take care of people and each other.”

He thanked the headquarters staff for continuing “to mature within the speed of relevance” as they respond to support requests from the field and the combatant commands. “And I'd like you to remember that phrase. It doesn't matter how fast you think you're going. It only matters if you're fast enough for those you support. And that's the speed of relevance,” Place said.

During the town hall Place also announced his successor, U.S. Army Major Gen. promotable (Dr.) Telita Crosland, currently the U.S. Army deputy surgeon general, as well as Gragg’s successor, U.S. Air Force Chief Master Sgt. Tanya Johnson, who is currently the senior enlisted leader for the DHA Director of Staff. The change of directorship ceremony is expected in early January, and Johnson is expected to assume her new duties in March.

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