"There's a couple of key lessons," he says. "The Army is about the largest healthcare practice in the country. We have a coordinated EMR, so care delivered elsewhere can be viewed anywhere else."
In integration of primary care and mental health, Warner has developed programs in which nurse case managers serve as the bridge to primary care physicians.
"This represents one of the largest benefits we've seen and can be incorporated in any healthcare system," he says.
In short, with a captive audience of service members who will access military healthcare for a number of years, the Army has embraced a population health model, Warner says. The Army's Healthcare Effectiveness Data and Information Set (HEDIS) helps care coordinators make decisions on early intervention based on population health metrics and screening soldiers for exposures, disabilities or problems coming from their deployments, including depression and PTSD.
"This allows us the ability to identify conditions early, which in the long run, decreases the amount of healthcare costs they will require," he says. "We feel we've done a good job on prevention as opposed to treatment."
That's fine for the Army, you might be saying to yourself, but civilian hospitals don't have the assurance of hanging onto a captive population where such early interventions are practically guaranteed to reduce treatment costs through prevention. Or do they?
Most hospitals are the largest employers in their immediate area. All of the people who work there tend to do so for long periods of time. Focusing on that group might possibly provide valuable experience and a stable population for hospitals to begin their population health and care coordination journey, no?