| Last updated on 2008-09-09 14:09:09 |
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Military Service Organizations and Veterans Service Organizations
May 22,2003 The May VSO/MSO roundtable meeting focused entirely on Force Health Protection. A number of experts provided information on various aspects of our work. Force Health Protection: Francis O'Donnell, M.D., MPH, and provided information on the three pillars of the strategy:
Pre-Deployment Actions at Fort Benning: Ms. Barbara Goodno, program director public affairs and outreach, provided information on a DHSD site visit at Fort Benning, Georgia, in late March. The purpose of the site visit, she explained, was to focus on the pre-deployment health assessment process. The team wanted to see how DOD (and Army) policies were implemented and wanted to identify ways that DOD could enhance the process if needed. Goodno provided a short overview of the mobilization site and the actions taken at each of the Soldier Readiness Processing Center's 10 stations. Similar site visits are planned for the future at Navy, Air Force, Marine Corps and Coast Guard mobilization sites, she said These visits will focus on the implementation of the new enhanced post-deployment health assessment process. Feedback will be provided to roundtable meeting attendees. Environmental Health Surveillance: Craig Postlewaite, DVM, MPH, opened this portion stating that many improvements have been made in environmental health surveillance building upon lessons learned form the 1991 Gulf War. Aspects of environmental surveillance occur during all phases of deployment: pre, during and post. During the pre-deployment phase, for example, medical intelligence obtained from the Armed Forces Medical Intelligence Center, "AFMIC," is used to identify camp locations where deployment personnel can be safely based. In addition, it can be used to brief all deploying personnel on the anticipated health threats during deployment and the associated countermeasures to be used to mitigate the risks of illness or injury. Once deployed, environmental health personnel perform "baseline," "routine," and "incident-driven" environmental to document any hazardous materials/chemicals present that could adversely affect either long term or short term health of exposed personnel. The resulting data and reports are archived for future analysis. When needed, efforts can be made to link exposure data with health outcome data. This data will be made available to the Department of Veterans Affairs to be used for medical diagnosis, treatment, and claim adjudication for veterans. Medical Surveillance: Tom Sellers presented information on the newly created "Joint Medical Workstation." The system was created at the request of the commander, Central Command. The workstation automates and integrates medical records for all military personnel in an operational combat theater. The workstation provides operational commanders and their command surgeons a quick snapshot of medical readiness, including areas of concerns such as available beds, medical supplies, blood supply, and disease/non-battle injury data. Sellers explained that the information is provided "real time," and commanders can focus from a macro to a micro look very easily. The classified web site has the patient information, symptom information as well as providing information on medical alerts and geographic areas. All patient records remain confidential. Post Deployment Health Assessment: COL. John Gardner, M.D., DHSD program director, population medicine, spoke about the enhancements made to the post-deployment health assessments process. Gardner described the evolution of the post-deployment health assessment process, beginning with the programs established in 1998. He explained the various changes in 2001, 2002, and most recently last month. Gardner explained that the most recent enhancements standardize implementation of the post-deployment health assessment process in four ways:
Clinical Practice Guidelines at the Deployment Health Clinical Center: LTC Charles Engel, M.D., director, Deployment Health Clinical Center, said that when service members return from a conflict, their feelings are on the order of 'we did our job, now it's time for you - the medical community - to do yours.' He noted that based on the lessons learned from Operations Desert Shield/Desert Storm, the VA and DoD have worked jointly to develop post-deployment health clinical practice guidelines to be used by health care personnel at military and VA facilities. The guideline is a major development and serve as a military-unique vital sign. Following deployment, at each health care encounter, the servicemember is asked, "Is your visit today related to a deployment?" A "yes" answer directs the provider to a set of treatment algorithms. The guideline serves as a mechanism to ensure consistency of care within the military health system. Engel also described several activities of his office, including traveling teams to train clinical staff, operation of the deployment health clinical center, consultation with staff from other military treatment facilities, and a broad effort to ensure that clinicians correctly identify the diagnostic code for the patient. The next meeting is scheduled for June 26th.
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