Patient-Centered and Mission-Ready

Created in 2013, the Defense Health Agency (DHA) celebrated its 11th anniversary this year. It started as an agency focused on shared services across the enterprise for such functions as health IT, medical logistics, pharmacy operations, TRICARE, and acquisition. In 2017, Congress expanded the DHA’s responsibilities to include management responsibilities of the military hospitals and clinics worldwide. Such a significant effort took some time with all responsibilities migrated from the military departments to the DHA completed in 2022.

Throughout its evolution, the DHA's mission has stayed consistent: To support the nation by improving health and building readiness.

Today, the DHA delivers health care to almost 10 million Americans—service members, families, and retirees, and manages the TRICARE program, when care is delivered outside of our direct care system. It does all this while managing a $60-billion healthcare budget with a staff of 130,000 across the agency and its medical facilities.

Lt. General Telita Crosland, director of the DHA joined me on The Business of Government Hour to share her vision for the agency and the future of military healthcare.

With a transformative approach that balances operational excellence, innovative technology, and resilient healthcare delivery, Lt. General Crosland is steering DHA to meet both current needs and future challenges. Our conversation illustrates her commitment to adaptability, data-driven decision making, and patient-centered care, positioning DHA as a forward-looking healthcare organization. The following summarizes the key themes and insights from our discussion.

Defining the Role and Responsibilities of the DHA Director

“My job,” explains Lt. General Crosland, “is to make sure the department meets its healthcare mission by ensuring our service members are ready to go; and to ensure our healthcare providers are getting the training and experience in our Military Treatment Facilities (MTFs).” She underscores the importance of being there for the people DHA serves—“Anytime, Anywhere, Always.”

This is no small feat given the size and scope of the agency’s operations and the importance of its mission.

"DHA is a combat support agency, and what that means is as an agency, we provide support to our combatant commands across the globe . . . to focus and make sure our nation is ready across the continuum of crisis,” explains Crosland.

With a global mission, that means DHA needs technology support to ensure it can serve individuals in the most far-flung locations. It also means the agency needs to give its patients and providers the tools they need to better manage their health. “When I arrived, there was some under-investment in those capabilities,” she admits, “but our team has done an amazing job of getting after that.”

Aligning Mission with Innovation and Efficiency

At the core of Lt. General Crosland’s strategy is an alignment of DHA’s mission with the values of innovation, efficiency, and responsiveness. DHA’s primary objective remains ensuring high-quality, accessible healthcare for all who serve, but the agency is now placing increased emphasis on achieving this through systems that are not only efficient but adaptable to future demands. Crosland envisions DHA as a “learning organization,” meaning one that constantly evaluates and improves upon its systems to maintain peak performance across all aspects of healthcare delivery.

One strategic priority is the integration of advanced data and analytics into decision-making processes. By fostering a data-driven culture, DHA can optimize patient care, streamline operations, and anticipate emerging health trends. For Crosland, building a foundation on data analytics is essential not only for tracking health outcomes but also for creating a proactive, rather than reactive, approach to military healthcare. She is keen on implementing tools that provide DHA leadership with real-time insights, enhancing the agency’s ability to allocate resources strategically and optimize patient care outcomes. “Most important is the criticality . . . to have to pivot," notes Crosland.

"I'm not planning for everything. I'm planning for anything."

Navigating Complex Operations and Strengthening Workforce Resilience

One of the primary challenges Lt. General Crosland acknowledges is the sheer scale and complexity of DHA’s operational landscape. Serving a global, highly mobile population means that DHA must maintain continuity of care across diverse environments, including domestic bases, overseas postings, and deployed settings. Managing resources across this vast network requires robust infrastructure but also a streamlined operational framework capable of responding to shifting demands and emergencies. Crosland’s approach includes leveraging scalable systems and adopting flexible staffing solutions to ensure continuity and quality across DHA’s service points.

Equally challenging is the issue of workforce resilience. Healthcare workers in DHA face intense pressures that stem from both military operational demands and the high-stakes nature of military healthcare. General Crosland’s vision includes robust support systems designed specifically for DHA’s healthcare providers, such as counseling resources, mental health services, and stress management training. She underscores the importance of building a culture that values the well-being of its workforce as a key component of sustainable healthcare delivery, noting that resilient staff are better positioned to provide compassionate, effective care.

Further, Crosland’s workforce strategy involves equipping healthcare workers with the tools they need to stay agile in an ever-evolving field. Through ongoing training and professional development, DHA’s staff are better prepared to handle new technologies and adjust to protocol changes. “One of my key initiatives is organizational well-being,” notes Crosland. By investing in workforce resilience and training, Crosland seeks to enhance not only morale but also the quality of patient care.

Advancing Health IT and Expanding Telemedicine Access

To drive her strategic vision forward, General Crosland is spearheading several initiatives aimed at strengthening DHA’s foundational capabilities, particularly in health IT and telemedicine. The agency’s efforts to modernize its electronic health records (EHR) are central to this strategy. A unified, interoperable EHR system is expected to drastically improve care continuity, making patient information accessible to authorized providers across military branches and facilities. This interoperability reduces administrative burden and enhances DHA’s capacity to deliver patient-centered care, regardless of where service members are stationed or deployed.

The expansion of telemedicine services represents another key initiative under Crosland’s leadership. It proved essential during the COVID-19 pandemic, and DHA plans to make it a core element of its service model. Crosland emphasizes that telemedicine offers flexibility and access to care, particularly for those in remote locations or deployed environments. By reducing physical constraints on healthcare delivery, telemedicine allows DHA to overcome geographical and logistical barriers, enhancing service accessibility and reducing strain on physical facilities.

This telemedicine expansion is part of a broader shift towards virtual care options that increase accessibility and convenience for military personnel and their families. "Telemedicine is absolutely a key component of how we expand access and improve the patient experience across the DHA," acknowledges Crosland. This vision for telehealth includes not only video consultations but also remote diagnostic capabilities and mobile applications that allow patients to access their health data and communicate with providers easily.

 "It’s about meeting our service members and their families where they are, even if that’s in remote or hard-to-reach locations. Telemedicine allows us to do that effectively," Crosland admits. This integrated approach to virtual care empowers patients and enhances their engagement with DHA services. "Our focus is on integrating telemedicine seamlessly into the care we provide, so patients can get the care they need without unnecessary delays or travel," she says.

Leveraging AI, Wearables, and Predictive Analytics

Innovation is a cornerstone of General Crosland’s leadership at DHA. "Innovation is essential to keeping our military health system agile and effective, especially as we face new challenges in both technology and patient care,” declares Crosland. She is actively advancing DHA’s adoption of artificial intelligence (AI) and machine learning (ML) to improve clinical outcomes and streamline operations. “We’re looking at AI applications in diagnostics, predictive analytics, and even in administrative functions to streamline workflows, but our emphasis is always on safety and efficacy,” describes Crosland. AI-driven diagnostics and patient triage solutions, for instance, have the potential to transform the way DHA approaches preventive care, by identifying risk factors early and enabling timely interventions. Through predictive analytics, DHA can monitor patient trends, anticipate surges in demand, and allocate resources more effectively.

Additionally, wearable health devices and remote monitoring tools play a crucial role in Crosland’s vision for DHA’s future. “Wearable technology offers us a unique opportunity to monitor patient health in real-time, which is especially valuable for our service members in remote or operational environments,” she explains. These devices enable real-time health data collection, making it possible to track vital signs and health metrics for deployed service members. By allowing for continuous monitoring, DHA can intervene proactively if health concerns arise, even in remote or austere settings. Wearables also support DHA’s efforts to prioritize preventive care, as they offer a noninvasive way to keep track of patient health status and alert providers to early signs of potential health issues. “The data from wearables could inform preventative care and allow us to be proactive, addressing potential health issues before they become critical,” notes Crosland.

Beyond clinical innovations, DHA is also investing in operational improvements through technology. For example, AI-powered supply chain management can help DHA reduce waste and ensure that resources are directed where they are most needed. By optimizing these logistical processes, DHA can increase efficiency and reduce costs, which ultimately contributes to better care delivery and resource availability. “The way we are approaching artificial intelligence is to ensure it amplifies our capability rather than replaces human judgment,” asserts Crosland.

Vision for the Future: A Resilient, Adaptive, and Patient-Centered DHA

Lt. General Crosland envisions DHA as an adaptable, resilient organization capable of meeting current demands and prepared for future healthcare challenges. Her vision emphasizes a shift from a reactive model to one that is proactive, data-informed, and patient-centered. By fostering an integrated healthcare network that is responsive and resilient, she aims to ensure that DHA is always ready to serve its patients effectively, whether in peacetime or during high-stress operational periods.

Patient-centered care is central to this vision. "We’re putting the patient at the center of everything we do,” says Crosland. This prioritizes a healthcare experience that truly meets the needs of service members and their families.

"Our focus on patient-centered care,” she explains, “is about driving quality, safety, and a personalized approach that respects the individual needs of each patient."

This approach includes gathering patient feedback to refine DHA’s services continually and tailoring care to individual needs. It emphasizes that a responsive DHA listens to and learns from the experiences of those it serves, ultimately building a healthcare system that feels personal, accessible, and reliable.

Additionally, Crosland’s vision includes expanding DHA’s focus on mental and behavioral health services. Recognizing that physical health is deeply interconnected with mental well-being, she advocates for increased support for mental health programs, particularly in addressing issues related to PTSD, anxiety, and stress among military personnel. This holistic approach seeks to address the full spectrum of healthcare needs, supporting not just physical wellness but mental resilience and overall quality of life.

Integral to the success of these efforts also includes having a robust TRICARE program available to service members and their families. TRICARE is a cornerstone of the military health system, providing essential healthcare coverage for service members, their families, and retirees. "We’re focused on making TRICARE more accessible, giving beneficiaries more choices and making sure they have the support they need to navigate their options,” details Crosland. Flexibility within TRICARE is key—its beneficiaries have different needs, and the program must be adaptable to meet those needs effectively. Our goal with TRICARE is not only to maintain its quality and reliability but also to continuously improve it to serve our community better."

Collaborative Partnerships and Continuous Learning: A Strategy for Long-Term Success

To achieve these ambitious goals, General Crosland places a high value on partnerships and collaboration across both military and civilian healthcare sectors. She recognizes that many of DHA’s challenges, such as workforce shortages and technological adaptation, are shared by other healthcare organizations. By fostering close ties with civilian healthcare institutions, academic partners, and industry innovators, DHA can accelerate the implementation of best practices and benefit from shared knowledge.

As we closed our conversation, Lt. General Crosland identified three core values that guide and inform the work being done at DHA. “I’m proud to see us living up to these values,” says Crosland. “They are dependability, humility, and agility. Regarding dependability, our patients and colleagues know we will be there for them when they need us. On humility, my goodness, the talent of people in military medicine are amazing; and yet there is very little chest-pounding, or use of the word 'I' . . . everyone gets the team approach. As for agility, I’m so proud of the agility of this team to pivot to a new approach to healthcare, and to be the people who ask 'Why not' rather than 'Why.'”

Conclusion

Lt. General Telita Crosland’s appearance on The Business of Government Hour offered a compelling look into her leadership at the Defense Health Agency, highlighting a balanced approach of strategic foresight and operational practicality. Her initiatives prioritize data-driven decision making, patient-centered care, and an integrated healthcare network that is resilient and responsive.

By focusing on technology, workforce resilience, and collaborative partnerships, she is steering DHA toward a future where it serves as a resilient and responsive healthcare organization, fully equipped to meet the needs of those who serve. This holistic approach demonstrates a profound commitment to both the present and future of DHA, laying the groundwork for a healthcare system that not only supports military readiness but also enhances the overall well-being of its community.

https://youtu.be/gukuqs4G8jI?si=hwoMEV23Iysmqulf