Interview with Jonathan Woodson, MDm Ass't Secretary of Defense for Health Affairs

Dr. Jonathan Woodson is the Assistant Secretary of Defense for Health Affairs and Director, TRICARE Management Activity. In this role, he administers the more than $50 billion Military Health System budget and serves as principal advisor to the Secretary of Defense for health issues.

In response to questions from Group Editor Marty Kauchak, Dr. Woodson addresses a number of policy-level insights on simulation and other learning technologies in his expansive portfolio.

MEdSim: Please share with us your perspectives, as a health care provider and a senior defense official, on the benefits of simulation and other learning technologies for US DoD health care providers and, as important, their patients.

Dr. Jonathan Woodson: The Military Health System is working to develop and sustain healthcare teams that provide compassionate patient-centered care at the highest level of clinical proficiency. To achieve this goal we employ a broad range of learning technologies. One of these technologies, and one that has garnered a great deal of interest, is medical simulation. We are engaged across the Military Health System (MHS) in the development and use of this promising training adjunct and believe that the use of medical simulation in the MHS has the potential to serve as a model for the nation.

MEdSim: As one follow up, what are some of the returns on investment the Pentagon expects from its procurement of medical simulation and other learning technologies?

Dr. JW: We invest in training our people, and the return we hope to see from that investment is better health, and a force that is fit and ready to respond when called upon to do its duty in the defense of our nation. The training tools that we develop and provide to our medical personnel are used to bolster their clinical proficiency, enhance their abilities to work together as members of a skilled and effective healthcare team, and bring proper focus to their efforts to provide patient-centered care.

MEdSim: Tell us about some of the DoD healthcare community's collaborative efforts with its public and private sector counterparts in using medical simulation centers and other technology resources.

Dr. JW: Collaboration is the lifeblood of innovation, and we strive to leverage the expertise of our public and private sector counterparts as we work to advance the state of the art in medical simulation. Our Federal Medical Simulation and Training Consortium represents a broad range of training interests, with membership that includes our military services, the Veterans Health Administration, the Uniformed Services University of the Health Sciences, the Department of Defense Patient Safety Program, our Military Education and Training Campus, and other specialty interests. This group routinely engages with academic learning centers and private sector agencies to share knowledge.

MEdSim: Looking five years downstream, how might the Pentagon's healthcare community's use of simulation expand, in terms of using technology to rehearse for procedures and achieve other outcomes?

Dr. JW: One of the many advantages related to the use of medical simulation is the ability to break a task down into its component parts, then start, stop, rewind, and re-do those component parts, building an effective and capable team. It allows us to practice high-risk interventions and approach infrequently encountered clinical scenarios without putting patients at risk. The opportunity to rehearse and practice to perfection is greatly enhanced by the availability of highly effective medical simulation tools, and we anticipate ongoing development in both technology and curriculum related to the use of these tools. We aim to remain at the forefront of that development, utilizing the most up-to-date technology paired with the most effective teaching strategies to improve health outcomes for our service members, retirees, and their families.

MEdSim: Your help wanted list: what are some learning technology and DoD healthcare training gaps you need the simulation and training industry's support to help close?

Dr. JW: The realism of our training models must improve if we hope to leverage medical simulation’s full potential. The more closely a training model can approximate the look, feel, anatomy, and responsiveness of a human patient, the more effective it will be as a training tool. In addition to improving fidelity, we prize durability and utility in austere training environments. We provide medical care to patients anywhere, anytime, and our training models must be capable of enduring the rigors of the environments in which they are used.

MEdSim: What is the approximate investment the department will make in simulation and other learning technologies for its health care communities through the budget out-years?

Dr. JW: We are dedicated to being good stewards of the resources entrusted to us, balancing current needs with investments in our future. Those future-looking investments include research into the utility of simulation-based training, development of next-generation training tools, and development of a training curriculum that uses those next-generation tools to their best advantage. We must remain flexible and responsive in the face of an unpredictable economic climate, while returning the greatest possible yield to those counting on us to provide high-quality patient-centered care. More than just a static fiscal commitment, our investment will include the human capital dedicated to creating an out-years reality that will integrate highly realistic simulation into a comprehensive education and training strategy. That strategy will provide highly competent, compassionate, and patient-centered teams dedicated to improving the health of those we serve.

MEdSim: As a follow up, what message do you have for any simulation and technology company that wants to do business with the DoD healthcare community under the department's Better Buying Power 2.0 initiative?

Dr. JW: BBP 2.0 initiatives are organized into seven focus areas:

1. Achieve Affordable Programs

2. Control Costs Throughout the Product Lifecycle

3. Incentivize Productivity and Innovation in Industry and Government

4. Eliminate Unproductive Processes and Bureaucracy

5. Promote Effective Competition

6. Improve Tradecraft in Acquisition of Services

7. Improve the Professionalism of the Total Acquisition Workforce

These focus areas align perfectly with our efforts to use and develop cutting-edge simulation technology to improve the quality of our medical education and training. I would encourage simulation and technology companies to embrace these focus areas as they pursue business opportunities with the DoD, or with any other entity.

Published in  MEdSim magazine issue 2/2013