Organization for Optimization. Intervention Recommendations for Optimizing the Delivery of Ambulatory Primary Care and Mental Health Care in Navy Military Treatment Facilities

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Abstract : This report reflects our thoughts and recommendations on ways that Navy Medicine can optimize the delivery of ambulatory primary care and mental health care in Navy MTFs, and ways to employ eHealth in doing so. It draws on our work with the Navy Medicine primary care and mental health advisory boards, but goes beyond that work to also incorporate general lessons and principles we have gleaned from the literature, from our site visits to Navy and other MTFs over the past 2 years, from data analyses we conducted in support of those advisory boards, and from some of our discussions with advisory board members. The focus of the report is on various interventions that Navy Medicine can make to better organize, manage, and integrate its primary care and mental health assets to best achieve optimization goals, including clinical eHealth applications for each board's respective area of health care. The purpose of this document is to support the optimization-related efforts of the Navy's Bureau of Medicine and Surgery (BUMED) and these two advisory boards. In this report, we view optimization as a property of a system that refers to how effectively and efficiently the system transforms available resources to achieve its purposes (system goals) given its environmental context and constraints. As such, optimization is making the best (optimized) use of available resources (i.e., optimizing resource use) by combining, organizing, and structuring the use of its resources through an infrastructure that most effectively and efficiently uses them in the performance of system goal attainment processes. The central question this report addresses is: What are some likely interventions that Navy Medicine can take in building the infrastructure of ambulatory primary care and mental health in Navy treatment facilities to optimally allocate, integrate, organize, and use the human, physical, and technical resources directly or indirectly available to it to achieve the capacity, accessibili