WRNMMC, BETHESDA, Md.  –   The Tele-Pain and Patient-Centeredness initiative at Walter Reed National Military Medical Center (WRNMMC) earned a High Reliability in Health Care Award, announced during the annual meeting of AMSUS held at the National Harbor in Maryland Feb. 13-16.

The Tele-Pain and Patient-Centeredness team at WRNMMC received the award March 21, and members of WRNMMC’s Board of Directors were on hand to congratulate them for the honor.

AMSUS (Association of Military Surgeons of the United States), includes federal health care professionals from the U.S. Army, U.S. Navy, U.S. Air Force, U.S. Public Health Service, U.S. Department of Veterans Affairs, U.S. Department of Homeland Security, U.S. Department of Health and Human Services, and the Uniformed Services University of the Health Sciences. Awards presented during the association’s annual meeting recognize achievements in leadership, innovation, high reliability, management, and other elements of military medicine. They are part of the effort by the Department of Defense (DOD) to transform the Military Health System (MHS) into a Ready Reliable Care (RRC) High Reliability Organization, or HRO, to ensure safe, reliable care for MHS beneficiaries and their families.

Dr. Christopher Spevak, an anesthesiologist and pain physician at WRNMMC, leads the National Capital Region Pain Initiative (NCRPI), which includes a tele-pain component. The NCRPI, under the Defense Health Agency (DHA), provides pain resources to MHS beneficiaries across the NCR and globally. Spevak also serves as the NCR’s Opioid Safety Program director. His team includes Amy Osik, senior program manager for the NCRPI and Nicole Cornish, PharmD., clinical pharmacist at WRNMMC who provides medication therapy management in the NCRPI’s tele-pain program. They were on hand for the recognition.

“Chronic pain affects over 100 million American adults, and the prevalence is significantly higher among U.S. military personnel,” Spevak explained. “Compared to 26 percent of the general population, approximately 46 percent of the active-duty military return from deployment with chronic pain. For patients at remote military treatment facilities (MTFs) within the DOD, geographic barriers are an obstacle when they need adequate care for chronic pain management. Often, the specialty health services are not offered on base or outside the facility. Pain specialists mostly reside at major military medical centers. This problem results in increased travel costs and time way from their mission to receive care [for many service members],” he added.

To address the challenge of chronic pain among MHS beneficiaries with limited access to chronic pain specialists, the NCRPI team pioneered the tele-pain program. It uses videoconferencing technology for treatment of pain and related conditions, Spevak added. “Patients have individual facility-to-facility video teleconference initial visits, and follow-ups with members of the WRNMMC pain team, [which also includes] a pain physician and physician assistant, pain health psychologist, integrative medicine physician, pharmacist, and nurse.”

“The NCRPI enhances the access and quality of care for pain patients while promoting readiness, restoration of function and relief of pain while at the same time as reducing the misuse of opioids,” Spevak shared.

“Patient-centeredness is the Ready Reliable Care domain of change that the tele-pain program encompasses, and the two RRC principles that they embody are sensitivity to operations and deference to expertise,” he added.

The NCRPI serves five locations with their tele-health services, and “carved the way for the widespread need for telemedicine during the COVID-19 pandemic,” Spevak said. “To establish virtual health visits as a component of the MHS health care paradigm, NCRPI keeps patient-centeredness as their primary goal,” he added.

Spevak explained the need for telemedicine “skyrocketed in response to the COVID-19 pandemic, with as many as 80 to 90 percent of ambulatory medical services switching to virtual and telephonic formats. Key policy changes at the beginning of the pandemic enabled a greater expansion of virtual health services to TRICARE beneficiaries within the private sector network and opened new possibilities for patients,” he continued.

“Now that the feasibility of telemedicine is well known, the NCRPI works with the DOD to analyze how people, processes, and systems impact the outcomes,” he added.

Dr. Felicia Pehrson, director for quality at WRNMMC, explained that nearly 80 submissions were made for the Ready Reliable Care (RRC) High Reliability Organization (HRO) Awards with 20 winners selected across four categories: continuous process improvement; patient centeredness; leadership; and culture of safety. She said the tele-pain initiative focuses on patient centeredness by Spevak and his team and “is an incredible effort that really puts patients at the forefront.”

Navy Capt. (Dr.) Kelly Elmore, WRNMMC’s chief of staff, also praised the tele-pain initiative team for “continuing to commit to the flagship of military medicine – Walter Reed National Military Medical Center and MHS beneficiaries and their families.”

In addition to the tele-pain initiative, there are several other actions in motion to help the MHS advance toward high reliability and ensures that DHA partners with patients every step of the way to provide the care they deserve, according to DOD officials.

The RRC HRO Awards Program recognizes those initiatives that improve the MHS and seeks approaches and enhancements in both clinical and non-clinical areas that result in more reliable processes, better outcomes, and higher quality care. The goal of the awards program is to promote a culture of learning, sharing, and continuous improvement, according to DHA officials, who evaluated submissions for the based on the use of the seven RRC principles of:
1. Preoccupation with Failure
2. Sensitivity to Operations
3. Deference to Expertise
4. Respect for People
5. Commitment to Resilience
6. Constancy of Purpose
7. Reluctance to Simplify

For more information about the tele-pain and patient-centeredness, as well as Patient Safety Awareness Week 2023 and DOD Patient Safety Program, visit

.

For a listing of other award winners, visit

and https://www.health.mil/News/Articles/2023/02/24/Innovations-in-Military-Medicine-Recognized-by-Military-Health-System.