Within its first 100 days of operation the Defense Health Agency has begun re-engineering support to the military service branches and service members, and the early results are already evident.

Lt. Gen. (Dr.) Douglas Robb, the director of the new agency, told Health.mil on Dec. 30, that the reforms already being implemented will make the entire Military Health System better, stronger and more relevant for the future.

Established on Oct. 1, 2013, the Defense Health Agency will direct the execution of 10 joint shared services, including the TRICARE health program; pharmacy operations; health information technology; medical logistics; facility management; research & development; education & training; public health; budget and resource management; and contracting.

The first five of these shared services started operating through the agency on its Oct. 1 launch, explained Robb. The remaining five will follow suit in 2014. All 10 shared services will be at full operating capability by Oct. 1, 2015.

“Those five shared services right now are operating in the Defense Health Agency and delivering those shared services back to the Military Health System – the Army, Navy and Air Force medical teams.”

The basic premise behind the Defense Health Agency was “to create the organizational foundation where we will drive joint solutions,” he underscored.

The agency aims to reduce duplication and increase standardization to produce better outcomes. The core belief is that better outcomes and better health are the sustainable path to long-term cost control in this challenging era of dwindling budgets.

The Defense Health Agency recently completed a detailed analysis of how it can improve services and as an added benefit, reduce cost, Robb said. The conservative estimate over the next five years, is that the agency can save the Defense Department over $2 billion. That is better service and reduced cost with just those 10 shared services, he said.

Beyond meeting financial targets, Robb also noted how much positive feedback he has already received from other government leaders during the agency’s first 100 days.

For example, leaders from the Defense Logistics Agency “have said it is absolutely an improvement to have a single point of contact for them to come to [in] the military health system,” said Robb.

“Because before you had to come to four different stakeholders – the Air Force, the Army, the Navy, and TRICARE Management Activity to work initiatives. And now they come to a single point of contact,” he said. “And we can act as the integrated representative for all of them. It’s simpler, it’s faster, and it benefits the entire MHS [Military Health System].”

“We’re building similar communication lanes with our senior Veterans Affairs colleagues,” he added.

Robb also underscored that the Defense Health Agency is engaged in an effort to support large military communities that rely on medical support from multiple military service branch medical departments – or multi-service markets. The initial focus is on six major military health care markets: The National Capital Region in the Washington, D.C., area, the Tidewater area in Virginia, Colorado Springs, Colo., San Antonio, Puget Sound in Washington state, and Hawaii.

Those six markets are home to a large beneficiary population and major military medical centers with advanced specialty care capabilities, said Robb, adding that these markets “comprise about 45 percent of our direct care costs, or what we spend on health care delivery inside our medical treatment facilities.”

“A lot of our folks who actually perform our deployed mission, our “ready-to-go-to-war” mission, come from those areas …. If we have to step again to the next conflict, or to a natural disaster, the health experts will be coming primarily from those six markets,” he added.

Beneficiaries, over time, will see a system that is more patient-centered.

“From a patient’s perspective, the TRICARE benefit itself, as it stands today, is not changing,” said Robb.” The TRICARE benefit will remain as comprehensive as it is today.”

“What they’re going to see is a more integrated system between our direct care system -- our military treatment facilities -- working side-by-side and together with … our TRICARE network” of private sector providers, he added.

The recent experiences of Army, Navy and Air Force medical personnel working together on the battlefield provided a major impetus for the new agency.

“What 12 years of conflict have taught us is that we can deliver incredibly efficient and high-quality health care in austere combat environments,” said Robb.

“We have the lowest disease non-battle rate in the history of recorded warfare. We have the lowest lethality rate in the history of recorded warfare. And the way we did that was through a joint effort …. We can save more lives if we work together,” he added.

“And when you take that, and you extrapolate that to the rest of health care, to garrison health-based care, you can see where the potential is. What we’ve never had before in the Military Health System is a joint organization where we can bring all these efforts together.”

“This is a work in progress,” Robb acknowledged, likening the advent of the Defense Health Agency to the inception of the Defense Logistics Agency, which was founded in 1961 and is now located in 48 states and 28 countries.

“What you’re going to see is that the Defense Health Agency, much like the DLA [Defense Logistics Agency] … will be in transition, probably for a long, long time,” he added.

“Just like the DLA of 25 or 30 years ago looks far different today, I envision that the Defense Health Agency, with its modest beginnings today, is going to look a lot different 25 or 30 years from now than it does today.”

“We have an enduring obligation to almost 10 million Americans who have served their country – those in uniform, their families, military retirees and their families,” Robb concluded. “Being ‘ready’ is a very real concept for our people. The service members have to be medically ready for absolutely anything, anywhere, at any time; families need to be ready; our medical forces need to be ready.”

“The Defense Health Agency is an enabler of the readiness mission. We support the combatant commanders, we support the services, and – in the end – we support every person who walks through our doors and wants to be ready for life.”