Measuring the Strategic Value of the Armed

The Military Health System (MHS) provides health care to active duty service members and their families, retirees and their families, and Guard and Reserve members serving on active duty and their families. In January 2004, the MHS began implementation of the Armed Forces Health Longitudinal Technology Application (AHLTA), DoD's global electronic health record system. AHLTA will ultimately be used by all providers in the military's direct care system at the point of care. The authors describe a four-part framework they recommend that DoD adopt in measuring AHLTA's contribution to MHS performance: (1) outcome measures capturing valued domains of system performance plausibly influenced by the presence of AHLTA; (2) "treatments"-ways of using AHLTA that are expected to influence one or more outcome measures, (3) a logic model describing the mechanisms or processes by which uses of AHLTA (i.e., treatments) influence outcome measures, and (4) an evaluation design for estimating AHLTA's effect on outcome measures in quantitative terms. Book jacket.

Preface	p. iii
Figure and Tables	p. ix
Summary	p. xi
Acknowledgments	p. xvii
Abbreviations	p. xix
Introduction	p. 1
Objective and Rationale	p. 1
Background of the Military Health System	p. 2
AHLTA Background	p. 4
Organization of Monograph	p. 7
MHS Senior Leaders' Views on the Value of AHLTA	p. 9
Relevant Dimensions of MHS Performance	p. 10
AHLTA's Potential	p. 10
Present Status of AHLTA	p. 13
Strategic Value of AHLTA	p. 14
Conclusions	p. 16
Analyzing the Effect of AHLTA on the Strategic Performance of the Military Health System	p. 17
Outcome Measures	p. 18
Treatments	p. 19
Logic Models	p. 20
Evaluation Design	p. 21
Computation of AHLTA's Effects	p. 22
Challenges to Measuring AHLTA's Effects on MHS Performance	p. 22
Unstable Implementation Environment	p. 23
Uncertain Technical and Organizational Adherence	p. 23
Lack of Baseline Measures for Intermediate Outcomes	p. 23
Lack of External Benchmarks	p. 24
Partial Reliance on Direct Care	p. 24
Event Chains Based on Logic Models	p. 25
Summary	p. 26
Potential Benefits of EMR Systems	p. 29
Effects on Efficiency	p. 30
Effects on Individual Provider Performance	p. 31
Care Coordination Among Providers	p. 32
Care Coordination Between Provider and Patient	p. 33
Process Improvement	p. 34
Public Health Surveillance	p. 36
Summary	p. 36
Measures for the MHS Strategic Objectives	p. 39
Manage and Deliver the Benefit	p. 41
Measures for Strategic Objective Related to the Delivery of High-Quality Care	p. 43
Measures for Strategic Objective Related to Managing Cost	p. 48
Measures for Strategic Objective Relating to Global Access to Information	p. 51
Create a Deployable Medical Capability	p. 52
Measures for Strategic Objectives Relating to Medical Care During Military Operations	p. 52
Measures for Strategic Objectives Relating to Homeland Defense and Civil Support	p. 54
Provide a Medically Ready and Protected Force	p. 54
Measures for Strategic Objectives Relating to Monitoring Health Status	p. 55
Measures for Strategic Objectives Relating to Individual Medical Readiness	p. 57
The Remaining Strategic Objectives	p. 58
Strategic Management	p. 61
Constructing Strategic Measures from Detailed Measures	p. 62
Measures and Subsets of the Beneficiary Population	p. 63
Composite Measures	p. 63
Composite Measures from Logic Models and Even Chains	p. 65
Selecting Measures to Display to Senior Leaders	p. 66
Uses of Strategic Measurement	p. 67
Recognizing Problems	p. 67
Diagnosing Problems	p. 69
Fixing Problems	p. 70
Concluding Comments	p. 71
Framework	p. 71
Implementing Measures	p. 72
Analysis Capability	p. 74
Catalog of NQMC Measures	p. 77
Bibliography	p. 95
Table of Contents provided by Ingram. All Rights Reserved.

What is included with this book?

The New copy of this book will include any supplemental materials advertised. Please check the title of the book to determine if it should include any access cards, study guides, lab manuals, CDs, etc.

The Used, Rental and eBook copies of this book are not guaranteed to include any supplemental materials. Typically, only the book itself is included. This is true even if the title states it includes any access cards, study guides, lab manuals, CDs, etc.

FREE SHIPPING

Amazon no longer offers textbook rentals. We do!

Measuring the Strategic Value of the Armed Forces Health Longitudinal Technology Application (AHLTA)

Summary

Table of Contents

Supplemental Materials