how the military grows a healthcare cio...or, everything you always wanted to know about the army...

How the Military Grows How the Military Grows a Healthcare CIOa Healthcare CIO

Colonel Barclay P. Butler, PhD, CPHIMSColonel Barclay P. Butler, PhD, CPHIMSCIO, US Army Medical DepartmentCIO, US Army Medical Department

Barclay.Butler@us.army.milBarclay.Butler@us.army.mil

Major Peter V. Marks, PhDMajor Peter V. Marks, PhDChief, Information Management Training BranchChief, Information Management Training Branch

U.S. Army Medical Dept. Center and SchoolU.S. Army Medical Dept. Center and SchoolPetePete--Marks@us.army.milMarks@us.army.mil

PurposePurpose•• Present an overview of the Chief Present an overview of the Chief

Information Officer (CIO) training Information Officer (CIO) training program in the US Army Medical program in the US Army Medical Department to share:Department to share:•• Training principlesTraining principles•• Training executionTraining execution•• Lessons learnedLessons learned

•• With the intent of providing With the intent of providing insight for other CIO training insight for other CIO training programsprograms

AgendaAgenda

Overview of the military health systemOverview of the military health systemDepartment of Defense (DoD)Department of Defense (DoD)The Army Medical Department (AMEDD)The Army Medical Department (AMEDD)

Why is a CIO training program important?Why is a CIO training program important?Training objectivesTraining objectivesProgram contentProgram contentLessons learnedLessons learnedConclusionConclusion

Overview of the Military Overview of the Military Health SystemHealth System

Department of DefenseDepartment of Defense

Military Health SystemMilitary Health SystemMissionMission

Two parts:Two parts:

Provide medical services and Provide medical services and

support to our armed forcessupport to our armed forces

during military operationsduring military operations

Maintain health and provide Maintain health and provide

medical services to the armedmedical services to the armed

forces, family members and forces, family members and

other designated other designated

beneficiariesbeneficiaries

Military Health SystemMilitary Health SystemLevels of CareLevels of Care

Theater Theater HospitalizationHospitalization

First ResponderFirst Responder

Enroute CareEnroute Care

Forward Forward Resuscitative SurgeryResuscitative Surgery

Care Outside TheaterCare Outside Theater

Deployed ForcesSustaining Base

MilitaryMilitaryMedicalMedical

ReadinessReadiness

Military Health SystemMilitary Health SystemIM Strategic DirectionIM Strategic Direction

Overview of the Army Overview of the Army Medical Department Medical Department

Size and ScopeSize and Scope

8 Medical Centers20/76 Hospitals / Clinics

174 Dental Clinics304 Veterinary Clinics23 Other

605 Facilities

Fixed FacilitiesFixed Facilities Field UnitsField Units

29 Combat Hospitals8 Field Hospitals6 General Hospitals

35 Forward Surgical 223 Other 301 Units

$8.5 Billion

Yearly BudgetYearly Budget

493K Active Duty723K Family Members664K Retired749K Family Members Retired365K Other

2,994K Beneficiaries

BeneficiariesBeneficiaries AMEDD PersonnelAMEDD Personnel

4,187 Medical Corps1,002 Dental Corps8,495 Other Officers

30,784 Enlisted 29,114 Civilian73,582 People

Size & Size & ScopeScope

Army Medical Army Medical Department Department Average DayAverage Day

41,400 DentalProcedures1,342 Beds Occupied

366 Patients Admitted

53,360 Laboratory Procedures

25,168 X-rays

37,566 Clinic visits

5,421 Immunizations

74,738 PharmacyProcedures

1,724 Vet Outpatient Visits $18M of Food Inspected

600,000 E-mails

Army Medical Department Army Medical Department (AMEDD) (AMEDD)

Information Management Information Management OfficersOfficers

But first, some But first, some Arrrrrrmmmmeeeee training, sir!Arrrrrrmmmmeeeee training, sir!

Or, everything you always wanted to Or, everything you always wanted to know about the Army but were know about the Army but were

afraid to ask!afraid to ask!

Walter ReedWalter Reed

Ft DetrickFt Detrick

Ft Sam Houston Ft Sam Houston

1818thth Medical CommandMedical Command

U.S. Army Medical U.S. Army Medical Command (MEDCOM)Command (MEDCOM)

Office of the Surgeon Office of the Surgeon General (OTSG)General (OTSG)

Combat Combat CommandsCommands

U.S. Army Medical U.S. Army Medical Department Center & Department Center & School (AMEDD C&S)School (AMEDD C&S)

Center for Health Center for Health Promotion and Preventive Promotion and Preventive

Medicine (CHPPM)Medicine (CHPPM)

U.S. Army Veterinary U.S. Army Veterinary Command (VETCOM)Command (VETCOM)

U.S. Army Dental U.S. Army Dental Command (DENCOM)Command (DENCOM)

U.S. Army Medical U.S. Army Medical Research and Materiel Research and Materiel

Command (MRMC)Command (MRMC)InstallationsInstallationsU.S. Army Regional U.S. Army Regional

Medical CommandsMedical Commands

A short lesson about the structure A short lesson about the structure of the AMEDD…of the AMEDD…

PacificPacific

WesternWesternSoutheastSoutheast

North AtlanticNorth Atlantic

Great PlainsGreat Plains EuropeEurope

4444thth Medical BrigadeMedical Brigade

3030thth Medical BrigadeMedical Brigade

Executive Agencies Executive Agencies for Trifor Tri--Service Service Functions (7)Functions (7)

A short lesson about the Army A short lesson about the Army grade structure…grade structure…

PromotionPromotion

242423232222212120201919181817171616151514141313121211111010998877665544332211Years ofYears ofServiceService

Career MatrixCareer Matrix

2 NDLieutenant

1st Lieutenant

Colonel

Lieutenant Colonel

Captain

Combat Medicine

A short lesson about Army jobs…A short lesson about Army jobs…

Two types of assignments..Two types of assignments..

Combat jobsCombat jobs Garrison jobsGarrison jobs

Health CareFacilities

Career assignments Career assignments AMEDD Officers can AMEDD Officers can

expect…expect…

22ndnd and 1and 1stst Lieutenants Lieutenants

PromotionPromotion

Combat medical jobs Combat medical jobs Platoon LeaderPlatoon Leader

Garrison jobs Garrison jobs Deputy Hospital Deputy Hospital IMO/CTO IMO/CTO

100 – 200Beds

AssignmentsAssignmentsLieutenantsLieutenants

AssignmentsAssignmentsCaptainsCaptains

Captains Captains

PromotionPromotion

Combat medical jobs Combat medical jobs Company CommanderCompany CommanderBattalion Battalion Communications Communications OfficerOfficer

Garrison jobs Garrison jobs Hospital IMOHospital IMOHealth Care Staff Health Care Staff OfficerOfficer

100 – 200Beds

AssignmentsAssignmentsMajorsMajors

MajorsMajors

PromotionPromotion

Combat medical jobs Combat medical jobs Battalion Executive Battalion Executive OfficersOfficersBrigade Brigade Communications Communications OfficersOfficers

Garrison jobs Garrison jobs Deputy Medical Center Deputy Medical Center CIO/CTO CIO/CTO

400 - 600Beds

AssignmentsAssignmentsLieutenant ColonelsLieutenant Colonels

Lieutenant Colonel Lieutenant Colonel

PromotionPromotion

Combat medical jobs Combat medical jobs Battalion CommanderBattalion CommanderBrigade Staff OfficerBrigade Staff Officer

Garrison jobs Garrison jobs Army Medical Center & Army Medical Center & Regional CIORegional CIO

1,000 –2,000 Beds

AssignmentsAssignmentsColonelsColonels

Colonel Colonel

PromotionPromotion

Combat medical jobs Combat medical jobs Brigade CommanderBrigade CommanderDivision Staff OfficerDivision Staff Officer

Garrison jobs Garrison jobs CIO CIO –– Army Medical Army Medical DepartmentDepartment

X 1,600

2M Beneficiaries605 Hospitals/Clinics301 Combat Units

IMO Positions in the AMEDD…IMO Positions in the AMEDD…

8 Medical Centers20/76 Hospitals / Clinics

174 Dental Clinics304 Veterinary Clinics23 Other

605 Facilities

Fixed FacilitiesFixed Facilities

Field UnitsField Units

29 Combat Hospitals8 Field Hospitals6 General Hospitals

35 Forward Surgical 223 Other 301 Units

IMOIMOCombat SystemsCombat Systems

IMOIMOStaff OfficersStaff Officers

CIOCIOMedical RegionMedical Region

Senior Staff Senior Staff OfficersOfficers

Total: 101Total: 101

CIOCIOCombat SystemsCombat Systems

IMOIMOHospital / ClinicHospital / Clinic

CTOCTOMedical CenterMedical Center

CIOCIOMedical CenterMedical Center

RankRankJob TitleJob TitlePositionsPositions

Congratulations, you Congratulations, you have completed your have completed your Arrrrrmmmmmmeeee Arrrrrmmmmmmeeee

training!training!

That’s the fact, Jack!

Why is a Formal CIO Why is a Formal CIO Training Program Training Program

Important?Important?

Why Have a Program?Why Have a Program?

LeadershipLeadershipHealth Care, Business, TechnologyHealth Care, Business, Technology

CommunicationCommunicationBusiness Process Reengineering, Business Process Reengineering, Project Management, IT OperationsProject Management, IT Operations

Business AdministrationBusiness AdministrationReturn on Investment, Value of Return on Investment, Value of InvestmentInvestment

Magazine

What are the Principles of What are the Principles of the Army Medical the Army Medical

Department Training Department Training Program?Program?

Training PrinciplesTraining Principles

Fully qualified officer:Fully qualified officer:Leadership / Management qualificationsLeadership / Management qualifications

CommunicationCommunicationDecision makingDecision makingPlanningPlanningAnd more…And more…

Education qualifications (Education qualifications (the trifectathe trifecta))Health Care AdministrationHealth Care AdministrationBusiness AdministrationBusiness AdministrationManagement Information SystemsManagement Information Systems

Training Principles EvolutionTraining Principles Evolution

Product and technical skills(e.g., languages, code, tools,

network administration)

Business management skills(e.g., risk analysis, benefit delivery, financial analysis,

vendor negotiation)

Technology management skills(e.g., project mgmt, system

integration, marketing, architectural design, strategic planning, standards)

Training MethodologiesTraining Methodologies

MethodsMethodsMilitary EducationMilitary Education

Leadership and IM/ITLeadership and IM/ITCivilian EducationCivilian EducationContinuing EducationContinuing EducationAssignmentsAssignmentsProfessional AffiliationsProfessional Affiliations

Military EducationMilitary Education

LeadershipLeadership

Military EducationMilitary EducationLeadershipLeadership

Army Leadership TrainingArmy Leadership TrainingIntroduce officers to tenets of leadership and military Introduce officers to tenets of leadership and military tasks throughout their careerstasks throughout their careers

Decision makingDecision makingPlanningPlanningTeam buildingTeam buildingCommunicationCommunicationThe Business of the Business!The Business of the Business!

PromotionPromotion

Officer Basic Course (OBC)Officer Basic Course (OBC)Duration Duration -- 3 ½ months3 ½ monthsFort Sam Houston, TexasFort Sam Houston, TexasIndoctrination into the military and the Indoctrination into the military and the AMEDD.AMEDD.Military laws, customs, and how the Military laws, customs, and how the military fights and wins the nations military fights and wins the nations warswars

PromotionPromotion

Officer Advanced Course (OAC)Officer Advanced Course (OAC)Duration Duration -- six months @ Fort Sam Houston, Texassix months @ Fort Sam Houston, TexasPrepare officers for commandPrepare officers for command

Combined Arms and Services Staff School Combined Arms and Services Staff School (CAS3)(CAS3)

Duration six weeks @ Fort Leavenworth, Kansas Duration six weeks @ Fort Leavenworth, Kansas Leadership for primary staff officersLeadership for primary staff officers

Decision makingDecision makingStaff operationsStaff operationsCommunicationsCommunications

PromotionPromotion

OAC CAS3

Command and General Staff College (CGSC)Command and General Staff College (CGSC)Attend between years 12 and 15Attend between years 12 and 15DurationDuration

In residence In residence –– one year @ Fort Leavenworth, one year @ Fort Leavenworth, KansasKansasDistance learning Distance learning –– three yearsthree years

Masters Degree equivalentMasters Degree equivalentPrepares midPrepares mid--grade officers to work as primary staff grade officers to work as primary staff officers for executive staff sectionsofficers for executive staff sections

PromotionPromotion

Senior Service College (SSC)Senior Service College (SSC)Attend between years 18 and 22Attend between years 18 and 22Duration Duration –– one year @one year @

Washington, DC (National Defense University) Washington, DC (National Defense University) Carlisle Barracks, PA (Army)Carlisle Barracks, PA (Army)Newport, RI (Navy)Newport, RI (Navy)Montgomery, AL (Air Force)Montgomery, AL (Air Force)

Prepares senior officers to work at the highest levels of the Prepares senior officers to work at the highest levels of the military military –– Pentagon StaffPentagon Staff

PromotionPromotion

Military EducationMilitary Education

Information Management & Information Management & Information Technology Information Technology

(IM&IT)(IM&IT)

Major Peter V. Marks, Ph.D.Major Peter V. Marks, Ph.D.

•• DoD / Army IM & IT TrainingDoD / Army IM & IT TrainingArmy Medical Department CoursesArmy Medical Department Courses

Medical Information Management CourseMedical Information Management CourseHealth Systems Functional Proponent Course Health Systems Functional Proponent Course

Federal ProgramsFederal ProgramsDefense Acquisition UniversityDefense Acquisition University

Acquisition Certification Acquisition Certification National Defense University National Defense University

Federal CIO CertificateFederal CIO Certificate

Military EducationMilitary EducationIM & ITIM & IT

Army Medical Department’s Army Medical Department’s Medical Information Medical Information Management CourseManagement Course

Medical Information Management CourseMedical Information Management CourseInitial qualifying course for Medical Information Initial qualifying course for Medical Information Management OfficersManagement Officers

IM/IT PolicyIM/IT PolicyTechnical training Technical training –– security, server admin, security, server admin, networking and communicationsnetworking and communications

DurationDuration90 hours of distance learning90 hours of distance learningEight weeks in residence @ Fort Sam Houston, Eight weeks in residence @ Fort Sam Houston, TexasTexas

1st Lieutenant

Captain

PromotionPromotion

Foundation of Medical Information Management Foundation of Medical Information Management Course:Course:

StrategyBPR and Strategic Planning

IM OperationsAcquisition

OrganizationsSecurity

Technology and SystemsTactical IM

Foundation

StrategyStrategyTraining in Skill DomainsTraining in Skill DomainsBPR and Strategic PlanningBPR and Strategic Planning

IM OperationsIM Operations

Information Information ManagerManager

AcquisitionAcquisition

OrganizationsOrganizationsSecuritySecurity

Technology and SystemsTechnology and SystemsTactical IMTactical IM

Health Systems Functional Health Systems Functional Proponent CourseProponent Course

Health Systems Functional Proponent CourseHealth Systems Functional Proponent CourseBusiness value of ITBusiness value of IT

Brings together information managers with senior Brings together information managers with senior functional managers functional managers Systems development & implementation through Systems development & implementation through trained project teamstrained project teamsDurationDuration

22 hours of distance learning22 hours of distance learningTwo weeks in residence @ Fort Sam Houston, Two weeks in residence @ Fort Sam Houston, TexasTexas

Captain Major Lieutenant Colonel

PromotionPromotion

StrategyStrategyBPRBPR

RequirementsRequirementsFunctional Functional ProponentProponent

AcquisitionAcquisition

SystemsSystemsOrganizationsOrganizations

25%10%

20%15%20%

Training in Skill DomainsTraining in Skill Domains

Defense Acquisition UniversityDefense Acquisition University

AcquisitionAcquisitionAuditingAuditingBusiness, Cost Business, Cost Estimating, and Estimating, and Financial ManagementFinancial ManagementContractingContractingFacilities EngineeringFacilities EngineeringContract Project Contract Project ManagementManagementInformation Information TechnologyTechnologyProduction, Quality, Production, Quality, and Manufacturingand Manufacturing

Purchasing and Purchasing and Procurement TechnicianProcurement TechnicianSystems Planning, Systems Planning, Research, Development Research, Development and Engineering and Engineering ––Science and Technology Science and Technology ManagerManagerSystems Planning, Systems Planning, Research, Development Research, Development and Engineering and Engineering ––Systems EngineeringSystems EngineeringTest and EvaluationTest and EvaluationProgram ManagementProgram Management

Defense Acquisition University Mission:

- “Provide functional practitioner training andservices to enable the acquisition, technology,

and logistics workforce to make smartbusiness decisions.”

CertificationsCertifications

Defense Acquisition UniversityDefense Acquisition UniversityThree Certification LevelsThree Certification LevelsInformation TechnologyInformation Technology

Identification of requirementsIdentification of requirementsWrite and review specificationsWrite and review specificationsIdentifying costs Identifying costs –– Total Cost of OwnershipTotal Cost of OwnershipObtain resources (manpower, funding, and training)Obtain resources (manpower, funding, and training)Test, evaluate, plan, and manage life cycle developmentTest, evaluate, plan, and manage life cycle development

PromotionPromotion

Level 1 Level 2 Level 3

National Defense UniversityNational Defense University

Federal CIO certificateFederal CIO certificateClinger Clinger –– CohenCohenFederal government CIO standardFederal government CIO standardDurationDuration

Two years in distance learningTwo years in distance learning<OR><OR>

Eight weeks in residence in Wash, D.C.Eight weeks in residence in Wash, D.C.

PromotionPromotion

Lieutenant Colonel

Chief Information Officer Certificate ProgramChief Information Officer Certificate ProgramCompetenciesCompetencies

Civilian EducationCivilian Education

Long Term Health Education and Long Term Health Education and TrainingTraining

Training With Industry Training With Industry Masters DegreeMasters DegreePh.D.Ph.D.

Captain Major

PromotionPromotion

Civilian EducationCivilian EducationTraining with IndustryTraining with Industry

Bridge the links between civilian and Bridge the links between civilian and military organizationsmilitary organizationsOne officer per yearOne officer per year

MicrosoftMicrosoftKaiserKaiser--PermanentePermanenteAlways recruiting…Always recruiting…

Civilian EducationCivilian Education

Masters DegreeMasters DegreeTwo to four starts per yearTwo to four starts per year

ProgramProgramMasters of Health Care AdministrationMasters of Health Care Administration

Baylor UniversityBaylor UniversityMasters of Business Administration with Masters of Business Administration with a minor in Information Technologya minor in Information Technology

University of Texas at San AntonioUniversity of Texas at San Antonio

Civilian EducationCivilian EducationMastersMasters

44Officers Officers scheduled to scheduled to attend school attend school next yearnext year

44Officers currently Officers currently in schoolin school

3737Officers with Officers with Masters degreesMasters degrees

4646Positions that Positions that need Masters need Masters degreesdegrees

101101OfficersOfficers

Civilian EducationCivilian EducationPh.D. Ph.D.

One start every two to four yearsOne start every two to four yearsDegreesDegrees

MISMISOperations ResearchOperations ResearchBio MedBio MedMedical InformaticsMedical InformaticsComputer Science / Artificial Computer Science / Artificial IntelligenceIntelligence

Civilian EducationCivilian EducationPh.D.Ph.D.

00(Next start (Next start –– Fall ’04)Fall ’04)

Officers Officers scheduled to scheduled to attend school attend school next yearnext year

11Officers currently Officers currently in schoolin school

44Officers with Officers with Ph.D. degreesPh.D. degrees

77Positions that Positions that need Ph.D. need Ph.D. degreesdegrees

101101OfficersOfficers

Continuing EducationContinuing Education

Continuing EducationContinuing EducationConferences:Conferences:

HIMSSHIMSSCPHIMSCPHIMS

Army Medical Department CIO ConferenceArmy Medical Department CIO ConferenceOfficer professional development programOfficer professional development programGartner ConferencesGartner ConferencesACHE ACHE

Diplomat ACHE Diplomat ACHE Distance Learning:Distance Learning:

Skillsoft trainingSkillsoft training

Professional Professional OrganizationsOrganizations

Professional OrganizationsProfessional Organizations

College of Hospital Management ExecutivesCollege of Hospital Management ExecutivesAmerican College of Health Care ExecutivesAmerican College of Health Care ExecutivesHealth Care Information and Management Health Care Information and Management Systems SocietySystems SocietyAmerican Medical Informatics AssociationAmerican Medical Informatics AssociationAmerican Health Information Management American Health Information Management AssociationAssociation

Training OutcomesTraining Outcomes

COL Barclay P. Butler, Ph.D., CPHIMSCOL Barclay P. Butler, Ph.D., CPHIMS

What is the Deliverable?What is the Deliverable?

Leadership / management qualificationsLeadership / management qualificationsCommunicationCommunicationDecision makingDecision makingPlanningPlanningAnd more…And more…

Education qualifications (Education qualifications (the trifectathe trifecta))Health Care AdministrationHealth Care AdministrationBusiness AdministrationBusiness AdministrationManagement Information SystemsManagement Information Systems

Lessons LearnedLessons LearnedRisk of officer attritionRisk of officer attrition

Army is cashArmy is cash--poor for salary but trainingpoor for salary but training--richrichCTO to CIOCTO to CIODeployments Deployments -- FamilyFamilyNonNon--CIO jobsCIO jobs

On average, over 25% of the training elements On average, over 25% of the training elements change every yearchange every yearEasier to train officers early in their careers because Easier to train officers early in their careers because of:of:

Training structureTraining structureTimeTime

Utilizing quality distance learning helps with this issueUtilizing quality distance learning helps with this issue

Conclusion…Conclusion…The training of an Army Medical The training of an Army Medical Department CIO is a programmed Department CIO is a programmed event that is intended to produce a event that is intended to produce a leaderleader who possess the following who possess the following core competencies:core competencies:

Health Care AdministrationHealth Care AdministrationBusiness AdministrationBusiness AdministrationInformation Systems ManagementInformation Systems Management

Questions?Questions?

Major Peter V. Marks, PhDMajor Peter V. Marks, PhDPetePete--Marks@us.army.milMarks@us.army.mil

Colonel Barclay Butler, PhDColonel Barclay Butler, PhDBarclay.Butler@us.army.milBarclay.Butler@us.army.mil

how the military grows a healthcare cio...or, everything you always wanted to know about the army...

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