Military Audiology Short Course

MASC 2001 Abstracts

Joint Services Audiology Support Agreements

Col Ben Sierra, USAF
Wilford Hall Medical Center, Lackland AFB, TX

Personnel cuts continue to impact the Medical Services (Army, Navy and AF) stressing the need for creative solutions. More and more, the Services are resorting to support agreements. A year ago, the Army and AF Audiology Consultants discussed options on how WHMC could support the audiology mission at BAMC. This presentation will outline the process and discuss the challenges setting up that agreement that successfully culminated in establishing a MOA between Brooke Army Medical Center (BAMC) and Wilford Hall Medical Center (WHMC). In addition, specific recommendations will be presented that can be used as a roadmap by the audience. In April of 2001, WHMC and BAMC finalized a MOA allowing both facilities to attain a win-win situation. I hope to have a live interaction where additional ideas for joint support projects can be discussed.

Background On Audiology Support MOA Between WHMC & BAMC

Issue: As of 1 October 2000, Brooke Army Medical Center (BAMC) Audiology ceased to have Military Audiology Services. This event poised the Audiology Service at WHMC to capture this additional patient caseload provided Wilford Hall Medical Center (WHMC) providers could use BAMC Audiology facilities/equipment and get 100% of the workload credit. Since CHCS policy doesn’t allow to record a patient visit at one facility as being done in another a formal agreement between the two facilities was needed to let WHMC get workload credit for Audiology patients seen at BAMC.

Background: In early July 2000 I the Army Audiology Consultant asked the AF Audiology Consultant to evaluate the possibility of providing audiology support at BAMC. If not seen at BAMC, the patients will have been seen at WHMC or referred to the private sector. The role of both Consultants (Army and AF) was critical in justifying the support agreement. Reasons to support this initiative were numerous

MOA allows WHMC to get workload credit for patients seen at BAMC and in fact establishes a WHMC Audiology Satellite Service
Establishes WHMC/BAMC Audiology as the leading DoD Audiology Service hub
Increase of patient visits for WHMC with no administrative support tail or facility fixed costs
Eases space crunch at WHMC Audiology and Speech Clinic
Improves access to care for North San Antonio and Randolph AFB patient population
- Results in increased customer satisfaction
- BAMC patients would be seen at BAMC—retirees service loyalty is high
- Convenient short drive for AF active duty from Randolph AFB
Access to a literally new facility and audiology equipment with no investment or maintenance costs on AF part
A modest investment will garner a larger resource market share and market penetration
Greater Potential to capture/recapture patient care that otherwise will go to the private sector
Positive impact on potential Bid Price Adjustment
Maintain/increase currency and competency of AF providers by exposing them to different population demographics
Facilitates continuity of care for patients enrolled at BAMC where their physician care and administrative support is provided
Supports joint Otolaryngology Resident Training Program between WHMC and BAMC Opened additional avenue of dialogue and cooperation between WHMC and BAMC

Mapping a Winning Strategy

The most critical component is to plan and articulate a “win–win” strategy both for all parties involved and to get “buy–in” from key decision-makers on both sides. In order to achieve this, key information must be gathered beforehand and a lot of groundwork must be accomplished prior to starting the formal coordination process. It is critical that all concerns are addressed along the Chains of Command and validation of benefits must be done as many times as needed. One must be ready to brief at a moment’s notice and above all never assume that your are clearly understood. In addition, one must be prepare to alleviate any inter–service concerns as well as being prepared to defused any potential challenges that might derail your efforts.

Bottomline

do your homework ahead of time
have valid and reliable data
coordinate ahead of time
if you run into any “road blocks” personally address them
“follow–up, follow–up, follow–up”

Outcome: MOA established in April 00 to address above. AF audiologist currently supporting both AF and Army mission at BAMC.