As the director of the Defense Health Agency, Vice Adm. Raquel Bono is tasked with designing and maintaining a health care system to service personnel from the Army, Navy and Air Force, including dependents.
In this role, Bono is overseeing DHA's move to an electronic health record system called the Defense Healthcare Management Systems Modernization, or DHMSM, as well as recent reforms to the military health benefits program, Tricare.
Bono took some time during the HIMSS conference to talk with Senior Reporter Carten Cordell about developments in both DHA programs as well as the future of interoperability in health care.
You've recently introduced reforms to the Tricare system that creates HMO-style and preferred provider programs for military beneficiaries. Can you talk about what result you are hoping to get from the changes?
This is something we really spent a lot of time thinking about — what we can do to give better choice to our patients. So with the new plan Tricare Select, which is our managed care option, and then Tricare Choice, which is our preferred provider option, [we offer] something that the health care industry and the insurance industry have evolved; we are now more contemporary with that format.
I think the other piece of it too that is very helpful for our patients is that it does allow them now to come into the direct care system, the [Military Treatment Facilities]. So that provides even greater choice for some of our retirees, for those who are over 65. I think that's a real benefit that we are looking forward to having more frequently and more readily for our patients.
Now in terms of the DHMSM program, how are interoperability measures developing, especially since the retirement of DHA CIO Dave Bowen?
The great thing about Dave Bowen's work is that he really put us in the right trajectory. Being able to continue his efforts on that have gone unfettered. So as we are continuing the interoperability work, we've really increased and enhanced the interoperability that we've had with the VA and the VA records through our Joint Legacy Viewer. We are also including our partners within the civilian health care network as part of that interoperability, which will be even more enhanced with the DHMSM, the new EHR [system].
There's obviously a lot of innovation going on within health care IT. What are some new developments that you've seen emerge here at the HIMSS conference?
The great thing about this conference is being able to see what the options are out there for interoperability. It's very interesting to see the different vendors and organization participating. The efforts that the DHA and [Military Health System] are making in terms of that interoperability are very contemporary and very relevant, because DHMSM is going to allow us to flex to the future needs. I think that's what's so exciting about it.
DHA is sort of at the forefront of interoperability efforts right now. What do you think about all of the players involved in that effort and what it will take to bring them together?
We rely on our civilian partners to take care of our patients, our military beneficiaries. In order to do that comprehensively and well and longitudinally, we need to have access to that information when they receive their care in the civilian network, outside of the MTFs. This interoperability will allow us to communicate back and forth — that's great for the patients. They can have access to their information, their health data. And it's great for the providers, who are working together collectively and taking care of patients. As technology evolves and advances, interoperability will become something leading edge for everybody to participate in.
So what's next for DHA and what are your goals for 2016?
So we are looking at ourselves now that we are at full operating capability, to make sure we are continuing to add value to the services. We want to become more responsive to their needs and to be able to provide them with products so they can continue to do the things that are very specific to the Army, Air Force, Navy and military services. The other thing we are looking at is how we can mature our capabilities to be more supportive of the combatant commanders as a combat support agency. And underlying that is optimizing our internal operations and taking a look at our personnel, our infrastructure, our processes and making sure everyone has an opportunity to contribute at the top of their game.