North - Keller Army Community Hospital - U.S. Army

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Commands. This past year I dedicated much effort to the Base Realignmentand Closure [BRAC] Commission-directed realignmentof inpatients from Wilford Hall Medical Center to Brooke ArmyMedical Center, creating the San Antonio Military Medical Centerin its place. I enjoyed working with the Air Force on this BRACinitiative. Here at the Northern Regional Medical Command, myinitial focus has been on the closure of Walter Reed Army MedicalCenter and the Walter Reed installation. At this time, the Army officersand Soldiers at both the new Walter Reed National MilitaryMedical Center and the Fort Belvoir Community Hospital are underthe operational control of the Joint Task Force National CapitalRegion Medical, referred to as JTF CapMed. However, I remainthe Army service component commander for the Joint Task ForceNational Capital Region Medical and have administrative controlfor all Army personnel assigned to the Army Service Elements atWalter Reed National Military Medical Center and the Fort BelvoirCommunity Hospital.Outside of the San Antonio and National Capital Region, theSouthern Regional Medical Command and the Northern RegionalMedical Command are quite similar. They both have militarytreatment facilities that range in size and scope. Both regions havea mixture of Army Forces Command, Army Training and DoctrineCommand and Army Installation Management Commandforces to support.Q: What lessons learned from the Southern Regional MedicalCommand are you bringing with you to the Northern RegionalMedical Command?A: I think experiences gained at the Southern Regional MedicalCommand are largely transferrable to the Northern Regional MedicalCommand. Adjusting for variations expected within this partof the country, I should be able to adapt the best of both regionalmedical commands. For one, we had a highly developed readinessdivision at the Southern Regional Medical Command as much ofits staff came from the Southeastern Regional Medical Commandheadquarters. I will be able to incorporate much of these processesto the Northern Regional Medical Command. On the other hand,I believe the Warrior Transition Brigade here is functioning at anextremely high level. I also like that my headquarters building alsohouses my regional counterparts within the Dental and PublicHealth Commands. I expect large synergies to be gained by thiscollocation.We see one of the advantages being improved communication betweenthe patient and care team, including traditional face-to-faceinteraction as well as virtual/ remote interface via telephone, videoand emerging technologies such as a secure email messaging, improvingcare through enhanced, timely two-way communicationbetween care team and patient.Q: What is happening with the electronic health record effort andwhy is it important?A: Army medicine has long been a leader in recognizing and usingour electronic health record to transform the Army MedicalCommand into a knowledge-driven, evidence-based organization.Given the challenges with our current electronic health record,Army led the way in developing an information management/information technology strategy, and securing funding for acquisitionof a modernized electronic health record. The resulting effortwas the ‘Electronic Health Record Way Ahead’ started in December2009.In 2010, the Department of Defense and Veterans Affairs agreedto pursue a joint, common platform enabled through appropriategovernance for the future electronic health record. The goal is toallow a seamless transition of a service member’s medical informationbetween the military health care system into the VA healthcare system.Both departments have already identified many synergies andcommon business processes, including common data standardsand data center consolidation, common clinical applications and acommon user interface.Q: Can you speak to the transformation to the patient-centeredhealth care delivery model?A: The Patient-Centered Medical Home provides a standardized,consistent and continuous relationship between the patient andhis/her primary care manager and support staff. It will delivercare using the whole-person concept, coordinately and integratingevidence-based primary, specialty and wellness/preventative carein a comprehensive care plan process with the goal of customizingcare to the unique needs of each individual patient.Caravalho speaks to medical professionals during Patient-CenteredMedical Home Training at Fort Belvoir’s Barden Education Center.Photo: 1st Lt. Matthew KorthCreating a single electronic health record will make informationsharing between the two departments a better way to securelytransfer patient data, which is very important in supporting ourwarfighters as they make the transition from the DoD system ofcare to the VA.18
Q: How do the regional medical commands work together to fulfillthe Army Medical Command’s mission?Q: What programs do you think play a role in supporting thehealth care needs of warfighters?Caravalho recognizes the outstanding workof Staff Sgt. Glen Cassady in front of the KellerArmy Health Clinic noncommissioned officers.Photo: 1st Lt. Matthew KorthA: There are fiveregional medicalcommandsacross the globe,three of whichcover the continentalUnitedStates. Of thesethree, we arealigned regionallywith ourTRICARE partners.Whetherits health care orreadiness, we arealigned underthe directionof the Army Medical Command commanding general to providestandardized care across the force. As the Installations Commandis accomplishing across its footprint, the Army Medical Commandis building trust among its beneficiaries by providing efficient, appropriate,high-quality and standardized care, regardless of whereit is delivered.A: Taking care of our warriors is the highest calling we have ascaregivers. It is a sacred trust. First, we provide enhanced accessto care for our warriors in transition. Secondly, each wounded, illor injured warrior has a team of supporting staff and cadre to helpthem and their families in their recovery, rehabilitation and reintegrationprocess. Third, we provide options for our warriors toconduct this process either on the installation with us or at home,in proximity to their family support systems.My goal is to provide a consolidated infrastructure of collocatedservices that can address any number of processes that may impactour warriors simultaneously: pain management, physical andoccupational therapy, auditory and visual care, traumatic braininjury care, behavioral health care for the warrior and his/her family,spiritual support, and treatment for drug dependence. I thinkthis will provide the most efficient care for our warriors, many ofwhom have a complex set of simultaneous processes.We are instituting a similar system of collocated DoD and VA servicesto better facilitate the Integrated Disability Evaluation Systemprocess for our soldiers. We owe them an efficient process thatmaintains their dignity and respect, whether they return to duty orreintegrate into society as an Army veteran.The Army Medical Command commanding general uses regularmeetings for the regional medical commands to demonstrate thisalignment, whether in its clinical or business operations, readinessplans or warrior transition programs. We use the balanced scorecardas a measure of progress in keeping with the commandinggeneral’s vision and end state.Q: How have the Base Realignment and Closure Commissionrecommendations impacted the hospitals and clinics under yourcommand?A: The 2005 Base Realignment and Closure Act is more ambitiousthan previous restructuring efforts because it focuses on transformingmilitary operations, not just improving efficiency. Themost significant changes within the Northern Regional MedicalCommand include the August 2011 closing of the Army’s flagshipmedical facility—Walter Reed Army Medical Center. We saidgoodbye to a 102-year-old institution renowned for its health caredelivery, medical training and support, and are watching it transitioninto a state-of-the art joint DoD medical center located on thecampus of the former National Naval Medical center in Bethesda,Md. Another hospital opened at Fort Belvoir to replace the DewittArmy Community Hospital.Of the seven remaining health service areas within the NorthernRegional Medical Command, five of them will have BRAC-relatedchanges requiring relocation of staff and/or restructured facilitiesand services.“Taking care of our Warriors isthe highest calling we have ascaregivers. It is a sacred trust.”-Brig. Gen. Joseph Caravalho, Jr.Q: Are you planning any significant changes in the near future?A: This is an exceptionally fine organization handed to me byMajor General [Dr.] Carla Hawley-Bowland. The men and womenassigned to this command are absolutely wonderful. I couldn’thave asked for a better team to have joined. I don’t see much that Iwould change in the near future.I can tell you we will work feverishly to improve upon our IntegratedDisability Evaluation System and Traumatic Brain Injury/Behavioral Health programs. In both cases, the answer lies in collocationof adequate resources. Our soldiers should be able to haveissues addressed in parallel, rather than sequentially. I am excitedto move forward in this direction.The Army’s pledge to each warrior, retiree and family memberis that they will receive the same high-level care and supportthroughout this transition of Army medical facilities.Check out photos and learn more about Brig. Gen. Caravalho, visitthe NRMC Facebook page at Facebook.com/ArmyNRMC.19
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North - Keller Army Community Hospital - U.S. Army

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