The new MHS governance structure has resulted in significant gains in terms of collaboration and alignment among the Services and the Defense Health Agency (pages 24-31). However, no single set of metrics is used across the enterprise to monitor performance in the areas of access, quality, and safety, nor are there performance reviews of the system as a whole in these areas. Moreover, the purchased care component is not aligned with the direct care component in terms of data collected or metrics used, making it difficult to draw comparisons between the two components.
The review identified a major gap in the ability of the MHS to analyze systemwide health care information. Although the MHS has a wealth of data, the ability to analyze those data and use the results to guide decision making in quality and patient safety is nascent. Differences in interpretation of policy result in data incompatibility, which adds to the challenge. Without a common set of metrics, it is difficult to present systemwide data in a coherent fashion. Transparency goes hand in hand with a culture of safety, with a lack of transparency being the result of multiple factors. Finally, lack of a mechanism to recognize patient input at the enterprise level makes it difficult to act on feedback as to what the patient would find beneficial.