WASHINGTON, DC—Jonathan Woodson, MD, the president’s nominee for assistant secretary of defense for health affairs, told a Senate committee last month that if he is confirmed he would draw upon his career experience to “engage others, set the vision, and motivate and inspire others to work for a common goal.”

Woodson was nominated by President Obama in April to serve as the top doctor for DoD’s Military Health System (MHS). If Woodson is confirmed by the Senate he would lead the MHS, which provides care to a beneficiary population of 9.6 million servicemembers, veterans, and family members.

Woodson holds the rank of brigadier general in the US Army Reserve and is currently assigned as assistant surgeon general for reserve affairs, force structure, and mobilization in the Office of the Surgeon General and serves as deputy commander of the Army Reserve Medical Command. He has served in medical missions in both Iraq and Afghanistan.

Woodson also serves as an associate professor of surgery and associate dean at Boston University School of Medicine, and as senior attending vascular surgeon at the Boston Medical Center. He chairs The Boston University Medical Center Institutional Review Board for Human Research and he is an adjunct assistant professor of Surgery at Uniformed Services University of the Health Sciences.

Addressing Healthcare Issues

At a hearing on his nomination last month, he was questioned by the Senate Armed Services Committee on how he would handle a range of issues, including reigning in DoD’s rising healthcare costs. The Defense Health Program’s budget has been a concern to DoD as it has increased from $16.6 billion in 2001 to $51.7 billion in 2011. Senate Committee Chairman Carl Levin, D-MI, wanted to know what Woodson would do to address these rising costs.

Woodson acknowledged the concern and said that moving forward it is important to work with different constituents to stem the rise of that cost. “There is a lot of potential waste in the way we deliver care because of the culture of medicine and there is opportunity to decrease the variability in care resulting in cost saving.”

He also cited that coordination among the services should be examined to determine how to streamline and increase the efficiency of administrative processes as a way to stem rising costs.

Levin also asked Woodson how DoD’s EHR system, known as AHLTA, compares with civilian EHRs. Woodson said that in his experience AHLTA is a “little bit ahead of the curve,” but that the challenge of AHLTA is that it was developed to capture a lot of administrative data that does not help the provider. “So from the health provider user end, it is not an efficient tool to take care of patients. It is a little bit cumbersome, the various databases don’t talk to each other, and it does not provide decision-making tools to lead to efficient provider care that might actually reduce the cost of care.”

In his written response to questions posed by the committee Woodson stated that if he is confirmed, improving DoD’s EHR would be a major goal of his and that he would work with DoD and other federal agencies and the private sector to advance EHR initiatives and interoperability.

Addressing Issues of Care

Republicans on the committee pressed Woodson for specifics on his positions. Sen John McCain, R-AZ, repeated Levin’s question about how Woodson planned to address rising costs in the MHS and said he was looking for specific proposals. Woodson responded that decreasing administrative costs, better interservice coordination, and enhancing the EHR are among the ways to address rising costs.

McCain responded that he hoped that Woodson would have ideas that are more specific in the future. “I hope that as you get into your job you will be able to give this committee some very specific ideas. I understand your answer, but we have got to come up with some specific ideas and proposals.”

Sen Roger Wicker, R-MS, questioned Woodson whether a controversial amendment under consideration in the National Defense Authorization Act allowing abortions at military hospitals would further strain military medical personnel. Currently, most abortion services at military hospitals are prohibited even if paid for with private funds.

Under the amendment, women could obtain an abortion with private funds, though doctors who oppose abortion would not be required to participate in related care. Wicker, who opposes the amendment with McCain and other Republicans, said he thought that performing abortions at military facilities would take medical personnel away from treating the wounded servicemembers and their families. He wanted to know whether Woodson agreed with him.

Woodson said he could not answer the question. “I can’t speak to that directly because I would have to do some analysis of personnel and where they are at. Also, we would have to consider the specialty that is involved in that procedure and see the numbers that are available.”

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