The Navy’s “Integrated Health Community Initiative” (IHCI) launched in 2011 at the Naval Medical Center San Diego (NMCSD) www.med.navy.mil/sites/nmcsd/ Pages/default.aspx and at the Naval Hospital, Camp Pendleton www.med.navy.mil/sites/cpen/newsite/Pages/default was initiated as a pilot program to improve military beneficiaries’ health and to reduce the rising costs of healthcare.
“The San Diego region was chosen due to the high concentration of Military Health System (MHS) beneficiaries, as we have over 400,000 in the area,” said Cmdr. Sunny Ramchandani, Medical Director for the Healthcare Business Directorate and the IHCI Director in San Diego.
“As a pilot, we’ve designed the program to be scalable because we want other hospitals throughout Navy Medicine www.med.navy.mil to be able to implement this program.”
As part of the IHCI’s strategy, patients are segmented into primary, secondary, and tertiary prevention categories based on health conditions so appropriate measures can be implemented to improve health outcomes.
In collaboration with staff from NMCSD, the NHCP’s Patient-Centered Medical Home Ports is Navy Medicine’s team-based approach to primary care and incorporates IHCI. By using integrated health care, the proactive monitoring and managing of the health of almost 400 patients with chronic conditions over the past two years has resulted in a 20 percent reduction in emergency department use and a 28 percent reduction in inpatient admissions among this population.
“In just two years, the IHCI reduced total healthcare costs for targeted tertiary patients by 39 percent which is an annual savings of $8.6 million,” said Lt. Cmdr. Ryan Jarmer, IHCI implementation Director at NMCSD. “We also initiated a business case analysis and found that our cumulative return on investment is approximately $5 million.”
A product developed by the IHCI is a patient score card used by the patient’s primary care team that pulls patient information from different hospital databases into a single, easy-to-read document. The score card provides an overview of chronic conditions, emergency room use, hospital admissions, medical appointments with primary care and specialty providers, and the overall healthcare costs associated with a specific patient.
Another technology piece that IHCI developed is a web portal to connect providers and beneficiaries to a directory of free or low-cost health, wellness, and social services throughout the local community, on and off base,” said Lt. Cmdr. Michael Mercado, IHCI Implementation Director at NHCP and a Family Medicine Physician. The Navy’s Bureau of Medicine and Surgery www.med.navy.mil/bumed/Pages/Default.aspx plans to initiate IHCI throughout the Navy, starting at four other Navy Medicine facilities on the East Coast in 2015.