1. Western Regional Medical Command
A Collaborative Approach To Changing The Landscape Of Military Medicine In The Puget Sound Area
January 8, 2014
BG John M. Cho
Commanding General, Western Regional Medical Command
Senior Market Executive, Puget Sound Enhanced Multi-Service Market

2. Western Regional Medical Command
BG John Cho
CSM Marshall Huffman
Established Headquarters
In July 2009
11 Medical Treatment Facilities
covering 20 Western States
Over 18,000 employees &
$1.6B Annual Operating Budget
Our MISSION is to provide comprehensive health services in order to optimize Force Readiness and the Health and Well-being of our Military, Family, and Retiree population.
Our VISION is to be an integrated and synchronized "Team of Teams" delivering quality, trusted, and responsive healthcare.

3. Western Regional Medical Command
Ft. Wainwright
WESTERN RMC
JBER
MEDICAL RESEARCH & MATERIEL COMMAND
JBLM
NORTHERN RMC
Ft. Belvoir
Ft. Detrick
APG
PUBLIC HEALTH COMMAND
Ft. Leavenworth
Ft. Carson
Ft. Riley
POM
WARRIOR TRANSITION COMMAND
Ft. Irwin
White Sands Missile Range
Ft Leonard Wood
WAMC
Crystal City
SOUTHERN RMC
Ft. Huachuca
CRDAMC
Ft. Bliss
DDEAMC
EUROPE RMC
FSH
BAMC
PACIFIC RMC
MEDCOM
Japan
Korea
SRMC
FSH
FSH
TAMC
AMEDDC&S
FSH
Power Projection Platforms
DENCOM
FSH

4. Military Health System Governance Structure
eMSM
NCR
Tidewater
San Antonio
Colorado
Springs
Puget Sound
Hawaii
Secretary of Defense/
Dep. Secretary of Defense
Under Secretary of Defense (Personnel and Readiness)
Military Health System Executive Review
Policy Action Council
Assistant Secretary of Defense (Health Affairs)
Senior Military Medical Action Council
= eMSM
= Single Service
Medical Deputies Action Group
The Eight Largest Markets (and Service/Department Leads)
The MHSER (Military Health System Executive Review) is the Service Vice Chief’s forum for DoD leadership input into the strategic transitional and emerging issues facing the MHS, the DHP, and the DoD.
The ASD(HA) has overall responsibility for eMSM Governance. Senior Military Medical Advisory Council (SMMAC) Executive Group would champion the eMSM construct.
The eMSM Governing Council comprised of Service DSGs and the DHA Deputy Director. The Council would: provide oversight, guidance and dispute resolution for the eMSMs; hold eMSM Managers accountable for successful implementation of 5-year Performance Plans; and set eMSM objectives in accordance with guidance from SMMAC to achieve alignment with MHS strategic goals. (Improved Readiness, Better Health, Better Care, and Reduced Cost). Funds flow from the Services would be based upon agreed and Council-approved 5-year Performance Plans
The eMSM Manager would be accountable to the eMSM Governing Council for Performance Plan execution. And as previously stated, the MTFs would be accountable to the eMSM Manager and Services to support eMSM performance plans.
Enhanced Multi-Service Market Leadership Group
Army
Army AF
DHA
Army
Navy
Army AF 4

5. Puget Sound Enhanced Multi-Service Market
Naval Hospital Bremerton
VA Puget Sound
Healthcare System
62d Medical Squadron
JBLM – McChord Field
Naval Hospital Oak Harbor
Madigan Army Medical Center
The TRICARE Puget Sound Executive Council (TEC) is established as the governing body for the delivery and management of health care services in the Puget Sound Market
92d Medical Group
Fairchild AFB
Washington National Guard
Health Safety & Work-Life Support Activity (USCG)

6. Puget Sound Enhanced Multi-Service Market
Services: Army, Air Force, Navy
Population Served: Approx. 290,000
Enrolled Population: 180,000
Military Treatment Facilities
Army
Madigan Army Medical Center
Madigan – Puyallup Medical Home
Madigan – South Sound Medical Home
Okubo Family Practice Clinic
OMAMC - JB Lewis-McChord
Winder Family Medical Clinic
Navy
Navy Hospital Oak Harbor
Navy Hospital Bremerton
NBC Everett
NBHC Bangor
NBHC Puget Sound
Air Force
62nd Medical Squad JB Lewis-McChord 

7. Puget Sound Enhanced Multi-Service Market Strategy Map
Vision Lines of Effort Outcomes Endstate
Army, Navy, USAF Unity of Effort to achieve the Quadruple Aim
1. Increase Inpatient Capability and Utilization
Productivity Policy
Leading Practices
Leverage Technology
Partnerships
Medical Diplomacy
Strategic enabler that fully leverages the Direct Care system
Objective 1-1
Internal Medicine PCMH Model
Objective 1-2
Synchronize efforts with Providers & Specialty Leaders
Objective 1-3
A Rapid and Efficient Referral and Patient Transport System
Objective 1-4
UMV Support to Seamless System Interface
2. Support / Maintain / Grow GME Experience
Production and Business Policy
Organizational Development
Standardization/Centralization
Staff Development
Robust GME programs providing a readiness platform while delivering best value care to beneficiaries
Objective 2-1
Accept all Cases/Maximize Capacity
Objective 2-2
Leverage Market Multiple Sites of Care to Meet Patient Demand
Objective 2-3
Redesign Model to improve training quality & Patient Experience
Deliver the highest quality, cost effective and integrated health services in the Puget Sound Market in support of current and former Service Members and their families.
An eMSM fully optimized, with highest value, highest quality primary care, specialty care and GME programs resulting in the Patient’s Preferred system of choice while transforming from a healthcare system to a System for Health.
A System for Health that Maintains, Restores and Improves the health of the population as their Health System of Choice.
3. Maximize Benefits of the PCMH Model
Health Infrastructure
Talent Management
Productivity Policy
PCMH Models
Leverage Technology/Resources
Full enrollment in PCMH will deliver highest quality, best value care
Objective 3-1
Maximize Enrollment
Objective 3-2
Leverage Wellness Centers as extensions of PCMH
Objective 3-3
Maintain, Restore, Improve Health of the Population
Objective 3-4
Enhance the Patient Experience
4. Strategic Engagement and Alignment
Our Successes will transfer Lessons Learned to best meet future needs
Targeted Communication
Patient and Staff Engagement
Partnerships
Leading Practices
Objective 4-1
Tell Our Story of Success
Objective 4-2
Identify Future Opportunities for Patient Engagement
Objective 4-3
Strengthen Partnerships with VA, UW, Network Facilities
Objective 4-4
360 Strategic Communication
Objective 4-5
Exceed Leadership Expectations
Objective 4-6
Create Spirit of Entrepreneurialism to Grow Successful Practices

8. A collaborative approach to healthcare in the enhanced Multi-Service Puget Sound Market