Monday, April 27, 2009

A Lesson from the Continuum of Care

Coming from a background in Military Medicine, I picked up a bias or two about the benefits of a unified Department. I was a Navy Corpsman, a member of the most decorated Corps in the Navy. More medals of honor and purple hearts have been awarded to Navy Corpsman than any other Corps.

A Corpsman helped to raise the flag at Iwo Jima. Corpsman provide medical support to the Marine Corps (the Marines don't have their own) and have been embedded with war fighters all over the world throughout American history. All Corpsmen take an oath and hold the Corpsman's prayer as sacred. We also tend to have a unique perspective on the military universe.

To me, serving in the military was a very close contact human experience. I quite literally had blood, vomit, and just about anything you can imagine from every patient beneficiary category on my hands at some point: active duty, family members, retirees, reserves from the Navy, Army, Air Force, Marine Corps and from what some Navy sailors call CIVLANTFLEET (the civilian world). My specialty was emergency medicine, but I pulled my share of overnight duties in the medical surgical wards, low level jump support duty with Underwater Demolition Teams (UDT's), cardiac care duty, OB/GYN duty, pediatrics... you name it. I even swam 7.5 miles with the SEAL teams in from Vieques Island to Puerto Rico in 1997 (those guys rock, by the way).

Here's a fundamental lesson I learned: it was okay (even desirable) when I was trying to solve a medical problem, to shed any organizational, age, race, religion, uniform or other paradigms and focus on the problem at hand. Sure, things like age and race were factors when considering causality and treatment; and religion gave me clues as to how best to respect the dead; but when people needed help, it didn't matter to them what color uniform I was wearing, how many ribbons I had, what books I read or what policies or politics I followed. As long as I stayed focused on what was most important at the moment, both my patient and I came away from each encounter with the best possible outcome.

In the medical community, we build our entire support structure around the human to human encounter. We commit ourselves and the resources we manage to ensuring that people who turn to us in a time of need get the best care that they can get. We take down artificial boundaries between the Army, the Navy, the Air Force, the VA, and purchased care (networked civilian providers) - so that patients can go without delay to where the care environment is best able to meet their needs. We remove obstacles to data and information sharing so that the care experience is not redundant or lacking - so that we don't revisit discomfort unnecessarily, compromise safety, or miss a vital trend.

We make the time to get it right. We chase inefficiencies, ask the hard questions, combine efforts where it makes sense to combine, shut off redundant expenses, and move every available dollar to where they are needed the most.

The lessons I learned in the medical community translate very well into the realm of Business Transformation. People in the Department are called upon to find ways to work together and stay focused on what matters most. It's not about the paperwork, a particular IT program, a policy, an acquisition methodology, a financial math problem, or any other such superficial and short term convention.

Business Transformation is about our organization's ability to adapt to modern realities. It about the fact that technology evolves faster than the Department of Defense acquisition system can process the paperwork to buy it. It is about the need for America to defend itself while sustaining it's aging population, and honoring the commitments we made to people as they retire. It's about being adaptable enough to stay ahead of national increases in health care costs. It's about eliminating duplication of effort, being open about what we're working on and how we're doing, and moving dollars to where they are needed the most. It's about having financial visibility to the deck plates so that Department management course corrections can be measured, judged, and adjusted as we navigate our organization through turbulent times.

We have to be accountable, transparent, agile, and self aware. Business Transformation tools and methodologies are all means to this end. As long as we stayed focused on what was most important at the moment, and put aside our organizational, uniform, and policy paradigms, we can be successful.

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