As the Defense Health Agency assumes responsibility for managing all military hospitals and clinics, Army leaders want patients to know that they are listening to concerns.

At a town hall forum Tuesday with soldiers and family members at the Association of the United States Army annual meeting in Washington, Army Chief of Staff Gen. James McConville urged military health system patients to use the tools available to them, including appointment surveys, patient advocates and the military command structure, to keep the brass apprised of problems arising from the sweeping changes currently underway in military health care.

McConville said he shared the apprehension of family members as management of health facilities is transferred to the Defense Department.

“We’ve been told the same type of things — [it will be] better care, less cost, all these wonderful accolades. But like Ronald Reagan [said], ‘Trust, but verify.’ I want to see those types of things, but make sure it is happening,” McConville said to a ballroom backed with military advocates, Army personnel, spouses and retirees.

DHA assumed management and administration of all military health facilities in the continental United States on Oct. 1 with an eye toward streamlining administration and management and standardizing processes.

In what is the largest transformation of the military health system since Tricare was introduced in 1992, Defense Health Agency also is placing all facilities into management regions known as markets and eventually will absorb management functions of overseas military health facilities.

Voicing concerns of military patients, Karen Ruedisueli, deputy director of government relations for the National Military Family Association, asked how patients can express concerns if they encounter issues.

“The problem resolution process is not well understood,” Ruedisueli said during the forum. “There is a fairly low awareness of patient advocates among military families … I am not sure that even after working on health care issues for years I really understand where to direct families if they do experience these problems.”

Each military hospital is supposed to have a patient advocate, also known as a customer service advocate or patient relations expert, who is supposed to represent patients in any dispute.

Also, the command structure will remain in place to hear patient concerns, explained Army Surgeon General Major Gen. Scott Dingle.

“The systems will not change. The thing people should understand is that we have been thinking of this ‘as we and them,’ as in Army and DHA. But we are them. The same commander wearing that Army uniform is still in charge, and he is working for that senior commander on that post, camp or station,” Dingle said.

Army Secretary Ryan McCarthy told reporters after the forum that senior service leaders meet with DHA officials regularly to monitor the changes and coordinate efforts.

McConville said to ensure that the transition occurs smoothly, and to prevent future problems, such as those seen without housing and permanent change of station moves, the leaders

“What we want is to make sure we get the feedback ... if we are looking at the statistics and they are all good, we may not even know we have a problem. if there is a problem we want them to give us the appropriate feedback,” McConville said.

“As we highlighted before, this is a merger. Any time we bring large institutions together as part of a merger, things have got to get steady ... there is always an opportunity for challenge. We have to put the information forward to the chain of command so we can make adjustments,” McCarthy said.

Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.

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