DoD Works to Improve Deployment Medical Record Keeping

Navy Capt. David H. Trump recently explained the relatively new requirement for standard pre- and post-deployment health assessments to a group of military medical professionals. The group was meeting here Jan. 31-Feb. 3 for the 2000 TRICARE Conference. Trump is the program director for preventive medicine and surveillance in the Office of the Assistant Secretary of Defense for Health Affairs.

The fiscal 1998 Defense Authorization Act mandated the assessments. "The secretary of defense was directed to implement a medical tracking system for military members deployed overseas," Trump said. The system was to include data on immunizations and "health events that occurred in theater, to include healthcare encounters and environmental exposures," he said.

In May 1999, two standard DoD forms grew out of this requirement -- DD Form 2795, pre-deployment health assessment, and DD Form 2796, post-deployment health assessment. Trump explained the two forms must be filled out before and after all deployments of more than 30 days to "a place that doesn't have a fixed medical treatment facility."

Each form is a questionnaire that allows service members to record information about their general health and to share any concerns they may have.

The pre-deployment assessment asks such questions as: Do you have any medical or dental problems? Do you have a 90- day supply of your prescription medication or birth control pills? During the past year, have you sought counseling or care for your mental health?

The post-deployment assessment asks questions relating to deployment experiences. Some examples: Do you have any unresolved medical or dental problems that developed during this deployment? Do you have concerns about possible exposures or events during this deployment that you feel may effect your health?

Both forms provide for follow-up care or specialty referrals if necessary. Once completed and signed by both the service member and the healthcare provider, one copy of the form is filed in the individual's medical record and the other is forwarded to the Defense Medical Surveillance System.

DoD had been taking steps in that direction before receiving direction from Congress, Trump said. He explained that the need for pre- and post-deployment health screenings became apparent following the Gulf War.

"In many cases, the health screenings that were done as part of mobilization processing weren't recorded in the individual's medical record," he said. "And probably more problematic, many times medical assessments were not done on return from deployment."

This was particularly a problem for Guard and Reserve members, many of whom were separated from military service without ever receiving a pre-separation physical. "This caused many problems for them when they went to seek care from [the Department of] Veterans Affairs," Trump said.

He described the assessments as an easy step with the potential to help a lot of people in the long run. "This is not rocket science. This is not a research study," he said. "It really is just a way to document that people had the opportunity to list their concerns and that a clinical assessment has been made.

"It's just a way of making sure we provide the commander in chief with a fit and healthy force," he said.