Jonathan Woodson, MD, Assistant Secretary of Defense for Health Affairs

The MHS enters 2012 and its second decade of combat operations with confidence in our ability to sustain and expand the excellence we have exhibited in military medicine.

The world remains a turbulent place – militarily, economically and environmentally.

Working closely with the Surgeons General, our line commanders, and other medical leaders throughout the civilian and military health systems, Health Affairs and the TRICARE Management Activity are focused on several critical strategies that will allow us to not only continue to meet the needs of our leaders, our patients and the American society, but also strengthen the MHS for the longer term.

We remain a nation at war

Although we cannot disregard the national, international, economic and national-security conditions that are driving long-term resourcing decisions across the federal government, the fact remains that the men and women in the armed forces are engaged in intense combat operations today. They are still deploying to austere environments, and they are becoming ill and injured. Casualties continue to be aeromedically evacuated to Landstuhl and onward to our medical facilities in the United States.

Our obligations to wounded servicemembers and their families remain paramount, and nothing will be allowed to detract from the care we provide to their survival, recovery and rehabilitation.

This includes our continued investments in behavioral health support services, ensuring access to care for servicemembers and their families; continued efforts to destigmatize mental healthcare; and coordinated strategies to improve resilience – for servicemembers and families alike.

Moving from Healthcare to Health

Similar to other healthcare organizations – provider, hospital and clinic operations – we have historically focused on the work that occurs within our walls. We have judged our success on the medical interventions we undertake in our exam rooms and surgical suites.

We will continue to focus on high-quality healthcare delivered by well-trained and equipped providers. Yet, while the quality of medical care is unquestionably a priority, managing our population’s health, rather than only delivering healthcare, necessitates a strategy for addressing health determinants, individual risks and the burden of all illnesses.

The medical care we provide in our system is responsible for only about 10% to 20% of the health outcomes of the people we serve. The real investments that matter occur outside our buildings and in the communities where our people live. Behavioral choices such as diet and physical activity; social circumstances like education and housing; environmental conditions; and genetic predisposition comprise the other 80% to 90% that determine health. Here is where we will concentrate.

In order to make a significant impact on overall health, we will transform the way we interact with individuals, families and the military community at large. Our initiatives to move from healthcare to health are not being developed and implemented in isolation but are aligned with the U.S. Surgeon General’s National Prevention Strategy and the national Partnership for Patients.

Much of this work starts with the continued implementation of our Patient-Centered Medical Home. Our primary-care providers –pediatricians, family-practice physicians, obstetricians and internists – will have the leadership roles in our focus on prevention and promoting healthy behaviors, particularly combating the ill-effects of tobacco use, alcohol abuse and obesity.