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Puget Sound Market stands up with integration in mind

DHA and Madigan leaders unfurl the flag of the Puget Sound Market in a ceremony to recognize the establishment of the Market on Dec. 1 at Madigan. Photo credit: Ryan Graham

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MADIGAN ARMY MEDICAL CENTER - U.S. Army Lt. Gen. Ronald Place, M.D., director of the Defense Health Agency (DHA), and the new Puget Sound Market director, Col. Jonathan C. Taylor, M.D., hosted a ceremony at Madigan Army Medical Center on Joint Base Lewis-McChord, ushering in the new Puget Sound Market within the nationwide Military Health System (MHS).

The Puget Sound Market is on the leading edge of the MHS's historic change, following its certification by the DHA on July 13, 2021 - the point at which it completed the milestones required to stand up as a market. By establishing the Puget Sound Market, the DHA enables greater collaboration across military hospitals and clinics with the goal of strengthening the medical readiness of service members and enabling these facilities to deliver better care and a better patient experience.

"Our mission is to deliver readiness and world-class healthcare to those who serve our country. This mission is a privilege and an enormous responsibility. We owe them the very best," said Taylor, who is also Madigan's commander.

As part of the 2017 National Defense Authorization Act, the MHS is transitioning administration and management of all military and hospitals and clinics to the DHA. To do so e?ectively, the DHA chose a "market approach," based on the six Enhanced Multi-Service Markets already in place. Markets are groups of hospitals and clinics working together in a geographic area operating as a system to support the sharing of patients, sta?, functions, budget and more across all market facilities.

"Our goal throughout this transition remains the same - support our war?ghters and care for our patients," said Place. "In fact, that's why we decided the market approach is most appropriate for our system. It helps create a ?exible, integrated health system that best supports the operational demands of the Department, and it meets the needs of our patients. In my eyes, that's a win-win."

The Puget Sound Market includes Madigan, Naval Hospital Bremerton, Naval Health Clinic Oak Harbor and the Air Force's 62nd Medical Squadron. The market serves a population of about 284,000 eligible MHS bene?ciaries, with over 150,000 enrolled to the military treatment facilities (MTFs) for direct care. Altogether, the Puget Sound Market consists of 20 MTFs, 11 dental treatment facilities and is one of 20 direct reporting markets that DHA has established.

The Puget Sound Market leaders are now responsible for managing all healthcare for its military population within Western Washington. It will operate as a system with an aim to improve readiness and the delivery and coordination of health services. For a typical day in the Puget Sound Market, this includes 4,589 appointments, 104 emergency room visits, 3,939 lab procedures, five births, 558 dental procedures and 4,756 pharmacy prescriptions.

In addition to Taylor, commanders of the other MTFs joined the celebrations. Capt. Patrick J. Fitzpatrick, R.N., of Naval Hospital Bremerton, Capt. Steven A. Kewish, M.D., from Naval Health Clinic Oak Harbor and Col. Reid Orth, M.D., of the 62nd Medical Squadron, were front and center at the ceremony, welcoming the DHA and its director to the Puget Sound Market area to unfurl the Puget Sound Market flag.

In welcoming the Market to the DHA, Place noted his personal experience in the Puget Sound area.

"I first came to Fort Lewis more than 35 years ago for ROTC advanced camp and medical school rotations. I did my training at Madigan as a general surgeon and was fortunate enough to be part of this market operating both at Madigan and Bremerton as a first assignment after my colorectal surgery fellowship, operating and then returning as Madigan's deputy commander some years later. This market is where I've spent one-third of my military career and more time than any other installation across the world. It matters to me what we do here," said Place.

Puget Sound MTFs are no strangers to collaboration. In 2017, along with Fairchild Air Force Base in Spokane, Wash., they were the first to switch to MHS GENESIS, the Department of Defense's electronic health record (EHR) that is now being implemented across the Department. As "Wave Zero", these MTFs worked together for more than a year to optimize the EHR prior to its adoption by the rest of the DoD. That experience forged a strong spirit of partnership and teamwork.

Even prior to MHS GENESIS, various clinical staff within the Market have met regularly as work groups to identify and implement best practices, standardize and integrate care at the Puget Sound MTFs. Most recently, the population health work group, composed of representatives from each MTF, was recognized for developing best practices for patient outreach and education during the COVID-19 pandemic. Both MHS GENESIS and the pandemic have merely reinforced the existing collective connections of the Market MTFs.

"In short, this is a community that understands the value of joint, integrated operations and operates in a community that embraces their affiliation with the Department of Defense mission," Place said. "As our beneficiaries seek care throughout this community, they'll see more and more common processes, the common health record and a simplified means to access care, whether that's in a military facility or a civilian setting."

Taylor attributed the success of the Market's mission to its joint team.

"Thank you to the airmen, the sailors and Marines, to our Space Guardians, to our soldiers, civilians, and to our contractors that all make up this wonderful Puget Sound Market team. Without you we certainly could not carry out the critical mission of caring for each other and for this Puget Sound community. You are without a doubt the greatest asset of our shared success," Taylor concluded.

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