Leaders in today’s complex health care systems need better processes and systems for aligning day-to-day, clinical-care activities with the strategic goals of their organizations. The U.S. Army has accrued valuable experience in this area over the last decade through the design and implementation of its behavioral health system of care, its term for all of the mental health and substance-use clinical care it provides. Accounting systems now uniformly capture administrative data across a huge, geographically dispersed system. Workload standards allow clinicians the time to engage with the key people who affect recovery, such as commanders and family members. And self-reported patient data is combined with other nonclinical measures to produce a more accurate assessment of quality. Understanding how the Army did it can help other health systems achieve the triple aim of improving the patient experience of care, improving population health, and reducing per capita cost.
How the U.S. Army Redesigned Its Mental Health System
Over the last decade, the U.S. Army has developed valuable experience when it comes to building out an effective mental health care system. In this piece, the authors describe several principles that have helped the U.S. Army in its development process, which may also offer useful lessons to other health care service providers: First, build standardized care on a foundation of uniform accounting codes. Second, establish provider-performance standards that reflect both clinical and nonclinical work. Third, combine structure and process measures of system performance with patient self-reported data to gain a holistic understanding of care quality. Finally, adopt a service-line-management process to systematically connect strategic goals to actual clinical care. As health care systems around the world work to support the mental health needs of their patients, these principles can offer a helpful guide.