Conquering the ‘tyranny of distance’ with the ‘advantage of presence’: military healthcare in the Pacific

How do you integrate a military health network of Army, Navy and Air Force medical providers with a major Army medical readiness command—both with responsibility across the vast Pacific Ocean—while providing world-class healthcare and achieving preparedness to support large-scale combat operations, if called? That is the challenge U.S. Army Brig. Gen. Deydre Teyhen faced in April 2025 when she became the director of Defense Health Network Indo-Pacific and the commanding general of Medical Readiness Command, Pacific. As she prepares to relinquish both roles June 18, she looks back on what her team has accomplished.

“I believe this team has worked tirelessly to support the warfighter, deliver high quality healthcare, sustain our skills, transform, and strengthen our profession while also bringing the joy and soul back to medicine,” said Teyhen.

The collective footprint of DHN-IP and MRC, P supports a region that covers half the earth’s surface, 60% of the world’s population, and spans from Washington state, California, and Alaska to Hawaii, Guam, Japan and the Republic of Korea. Soldiers from MRC, P deploy to all corners of the region, and the vast distance alone is a major challenge.

Across that expansive footprint, Teyhen is responsible for two major medical centers, two community hospitals, six outpatient health centers, 21 dental clinics, 42 public health branches, approximately 400 Military Working Dogs and a team of 15,000 Army, Navy, Air Force and civilian staff members while providing healthcare to 223,000 service members, family members, and military retirees.

The size of the region provides significant challenges for military planners, logisticians and healthcare providers, but Teyhen said the team overcame the ‘tyranny of distance’ through five key factors: the leveraging presence and proximity, dominion over the horizon, the velocity of victory, and the mastery of distance.

Leveraging the ‘advantage of presence’ to overcome the ‘tyranny of distance’

First, DHN-IP and MRC, P overcame the ‘tyranny of distance’ through ‘the advantage of presence’ by implementing a new governance structure. That enabled the two organizations to integrate their efforts so they could operate as one team that brings together the Defense Health Agency’s healthcare delivery mission and the Army’s medical readiness mission through common processes.

“We focused on making the advantage of presence across the theater our strategic advantage,” said Teyhen.

This governance structure included a Board of Directors (BOD) to govern both service requirements and DHA healthcare requirements and help align priorities and resources.

The Network Regional Operations Committee (NROC) is another part of the governance structure, and it seeks to provide easy access to high quality healthcare---anytime, anywhere, always. Since the NROC was established in September 2025, its proactive approach has added the availability of 3,500 new appointments per month for TRICARE beneficiaries, reflecting a deliberate effort to expand access through template optimization, alignment of medical provider schedules, and improved forecasting of appointment needs. It also increased surgical access and efficiency.

The Medical Affairs Committee (MAC) helps to provide quality and safe care. One initiative included mailing fecal immunochemical test (FIT) kits, potentially resulting in 7,450 fewer colonoscopies. The committee also implemented ‘mammogram while you wait’ and walk-in mammogram programs to increase support to women’s health, and it created a Prenatal Vitamin over-the-counter and pregnancy test program. Another initiative increased well-child visits from 76% to 81%, placing the network in the top three for DHA.

The Resource Management Committee (RMC) also made a significant impact. The committee oversees and synchronizes all resources for MRC, P and DHN-IP. Over the past year, the RMC implemented a hiring initiative that onboarded more than 500 new civilian team members, expertly managed 950 open hiring actions, and decreased time to hire by 25%.

“In a landscape that was defined by rapid change, I am so proud of our human resources teams!” said Teyhen.

The RMC also consolidated administrative functions to be both more effective and more efficient and successfully managed the combined DHN-IP and MRC, P budgets.

Finally, DHN-IP is only the second of DHA’s nine networks to create a Senior Enlisted Leader Committee (SELC). This committee focused on strengthening the profession by fostering a culture of excellence, teamwork, and leadership and developing ready combat formations.

“The SELC moved mountains in ensuring our enlisted can work at the top of their credentials across the Pacific – to build readiness,” said Teyhen.

Leveraging the ‘power of proximity’ to offset the ‘tyranny of distance’

The Hawaii Joint Executive Committee (JEC) broke down service barriers to improve care for the joint force and their families across 12 treatment facilities across Hawaii, resulting in a 55% increase in access to care for physical therapy and reducing the amount that would be paid to providers outside the military network by $2.6 million. The JEC also restructured the Air Force, Navy and Army labs across Oahu into an integrated system with a centralized contract, and it standardized and improved workflows to make it easier for patients to get their prescriptions. Other improvements included centralized after-hours emergency dental care at Tripler’s emergency department, centralized core business functions for civilian HR, and creation of a patient guidebook for military healthcare in Hawaii to improve access to care for TRICARE beneficiaries.

“The Power of Proximity also allowed us to build great partnerships,” said Teyen.

For instance, Tripler Army Medical Center in Hawaii and Madigan Army Medical Center in Washington both saw increased collaboration with the Veterans Affairs health system. Tripler increased overall care delivered to VA patients by roughly 10% for 10,500 appointments per month and 48 admissions per month. They also opened a new Post-Traumatic Stress Disorder Residential Recovery Program and received funding to provide 650 operating room cases per year and start a new transcranial magnetic stimulation service.

In addition to caring for people, the Military Health System provides care to animals, and the new Hickam Vet Clinic in Hawaii provides centralized higher acuity care of animal medicine. A new centralized call center supports all four Oahu vet clinics, resulting in improved access to care– animal visits increased from 600 to 1,200 visits per month. These clinics support both military working dogs and animals owned by military families.

“These improvements helped more of our families with their animal medicine needs – while building readiness,” said Teyhen.

Turning the ‘tyranny of distance’ to ‘dominion over the horizon’

According to Teyhen, DHN-IP and MRC, P have focused on continuous transformation to ensure they are ready when the nation calls.

“Our focus on innovation and continuous transformation allowed our team’s influence and effectiveness to extend far beyond the immediate line of sight,” said Teyhen.

The region contains the most rugged, distributed, and diverse terrain in the world, from hot, humid rainforests and low-lying coral atolls to arctic plateaus and mountain ranges. Servicemembers conduct cold weather Arctic training in Alaska, jungle training in Hawaii and megacity training in Japan and the Republic of Korea. In the past year, the MRC,P and DHN-IP Operations Teams successfully executed a robust schedule of more than 20 service-specific and joint exercises, tabletop exercises, and global health engagements. The dental team participated in Pacific Friendships, which combined humanitarian aid with disaster relief training in Vietnam. Other exercises helped the team increase readiness to support real-world operations.

“Exercises such as Keen Edge, Tabula Rossa, Vital Knight, and Ultimate Caduceus led innovative techniques for our headquarters to pivot from supporting garrison medicine to supporting U.S. Indo-Pacific Command and U.S. Army Pacific priorities across the area of responsibility,” said Teyhen. “Our operations team has had to be on top of their game as we routinely deploy 90-100 medical personnel a month to support exercises and global health engagements.”

Innovation extends from the battlefield to military healthcare facilities. Almost 100 providers in the network are now leveraging a tool called ambient listening to improve patient documentation and decrease the administrative burden.

The network has also embraced new technologies that allow providers to see our patients from the comfort of their home (or work), and there has been a 25% increase in clinic utilization of virtual health and a 10% increase in number of video visits.

“We now have 1,151 providers using virtual visits, and we are averaging 18,893 virtual visits a month – think about that savings in time, driving, gas, and frustration,” said Teyhen.

Military hospitals like Tripler and Madigan Army Medical Centers also provide excellent training programs for future providers, and the Pacific has 27 Graduate Medical Education Programs, 19 Graduate Health Education Programs and four Graduate Dental Education Programs. Over the past year 568 learners received training.

Teyhen commended her team for creating “an environment for our teams to thrive and grow. Aristotle said, ‘We are what we repeatedly do. Excellence, then, is not an act, but a habit.’”

Teyhen also said the GME programs in the Pacific are extremely successful. Accredited by the Accreditation Council on Graduate Medical Education, Madigan had a first-time board pass rate of 97%. Tripler’s was 96%, and both far exceeded the national average of 88%.

From ‘tyranny of distance’ to ‘velocity of victory’

“In the Pacific, our public health troops have prevailed through 651 food audits, 31 commissary inspections, and 1,786 food protection assessments ,ensuring the food our service members and their families eat are safe across the region,” said Teyhen.

The healthcare teams have also prevailed across the region. Madigan and Bassett Army Community Hospital* in Alaska both received a hospital safety “Grade A” from the Leapfrog Group, a national, independent organization focused on health care quality. The organization evaluates hospitals on a wide range of safety measures, including errors, injuries, and infections. Leapfrog's grading system uses up to 22 evidence-based measures of patient safety. Grades are awarded semiannually. Leapfrog also recognized Brian D. Allgood Army Community Hospital (BDAACH) in the Republic of Korea as a 2025 Top Hospital, placing the organization among the top six percent of eligible hospitals nationwide for excellence in patient safety and quality of care.

DHN-IP’s medical facilities also achieved a 100% infection control and prevention competency rate across all MTFs in the region, and the following facilities passed inspection by The Joint Commission with flying colors: 15th Medical Group/Hickam Clinic, Naval Health Clinic-Hawaii, Tripler, BDAACH, Brig. Gen. Crawford Sams, and Bassett. *

“The Joint Commission conducts a rigorous inspection process, and their industry-standard accreditation reflects the exceptional care our team provides to the military community,” said Teyhen.

The team also prevails through trust and compassion, creating an environment for holistic health, healing and wellness. In a recent Organization Trust Index survey developed by the Covey Institute, DHN-IP and MRC, P leaders received a score of 84%, well above the top 10% of all organizations (which average 78%). Medical facilities also received positive feedback from patients. BDAACH received DHA’s ‘Best of the Best’ recognition in March because their top 10 primary care clerks and receptionists obtained 100% positive responses. Patients at Naval Health Clinic-Hawaii reported a 63% improvement in the ability to receive an urgent appointment quickly, and they gave NHCH a score of more than 90% in Joint Outpatient Experience Surveys (JOES) for being seen in a timely manner at the clinic. The Air Force’s 15th Medical Group/Hickam Clinic achieved a 53% improvement in being able to see a provider when needed and scored 100% in the patient’s ability to fully understand their provider’s recommendations to improve their health.

Transitioning from ‘tyranny of distance’ to ‘mastery of distance’

“I believe we have started transitioning from ‘tyranny of distance’ to ‘mastery of distance,’” said Teyhen. “Our team did not allow distance to limit our team’s progress; we did not just deal with the distance, but we conquered it through skill and effort.”

Looking ahead to handing the reins of DHN-IP and MRC, P to U. S. Army Brig. Gen. Andrew Landers, she express confidence that he will be set up for success. “I think he will agree that he is inheriting an amazing team!” said Teyhen.

• Bassett Army Community Hospital is part of MRC, P for medical readiness, but the medical facility is part of Defense Health Network Central.