deployment health surveillance
DESCRIPTION
Deployment Health Surveillance. Lt Col Dennis Fay Operational Prevention Division AFMOA/SGZP. Life-Cycle Approach to Force Health Protection. Assess health annually, beginning at accession, and ensure ongoing individual medical readiness - PowerPoint PPT PresentationTRANSCRIPT
I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Headquarters U.S. Air Force
Deployment Health Surveillance
Lt Col Dennis Fay
Operational Prevention Division
AFMOA/SGZP
2I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Life-Cycle Approach to Force Health Protection
Assess health annually, beginning at accession, and ensure ongoing individual medical readiness
Conduct pre-deployment threat assessments and medical screening; target preventive measures
During deployment, assess for environmental hazards and employ active health surveillance
Provide state-of-art expeditionary casualty care Integrate deployment-related health records and
any needs into life-long care
3I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Regulatory Requirements
Public Law: S 1074 E/F “SecDEF shall establish system to assess medical condition of members of Armed Forces deployed overseas”
Pre/Post deployment medical exams Record health status and care (mental
health), serum samples, immunizations, etc)
Quality Assurance is required
4I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Continuously maintain Fit and Healthy Force; individual medical readiness (PIMR)
Pre-Deployment Health Risk Assessment Develop site specific preventive medicine
recommendations consulting with PCM teams and other medical professionals
Ensure deployees receive appropriate interventions before deployment
Pre-Deployment
5I n t e g r i t y - S e r v i c e - E x c e l l e n c e
AFMS SG PIMR Metric
6I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Base-level “Drill Down”
7I n t e g r i t y - S e r v i c e - E x c e l l e n c e
AF Commanders Own Force Health Protection—Online Toolkit
Periodic Health Assessment andIndividual Medical Readiness
8I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Threat Assessments
9I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Target Preventive Measures
10I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Pre-Deployment Screening
11I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Conduct in-theater environmental surveillance Conduct on-going assessments and mitigation of
potential environmental and occupational health hazards
Conduct food and water vulnerability assessments
Record medical encounters, environmental and occupational health exposures, known or potential exposure to NBC agents
During Deployment
12I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Environmental Surveillance—Hazard Assessment
Environmental• Environmental Sampling• Risk Assessment• Hazardous Material Management
Public Health• Vector Surveillance• Food and Water
Occupational Health & Safety• Industrial Hygiene• Environmental Health• Injury and illness• Risk Assessment
13I n t e g r i t y - S e r v i c e - E x c e l l e n c e
B/W Detection devices Hand-held assays--individual agents Ruggedized Advanced Pathogen Identification Device (RAPID)–able to reliably identify multiple BW agents
Environmental Surveillance—BW Detection
14I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Disease & Injury Surveillance
Disease surveillance Global Epidemiological Medical
Support (GEMS)—integrates patient evaluation, Environmental Health Data, epidemiologic analysis, Command & Control
Patient Encounter Module (PEM)--paperless data link for front line medic to record and track individual patients
Theater Epidemiological Module (TEM)—far forward use, reports system with Command and Control surveillance
15I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Langley AFB, VALangley AFB, VALangley AFB, VALangley AFB, VA
CollectionCollectionCollectionCollection
PSABPSABCentral Server
In TheaterCentral Server
In Theater
Personal ComputersPersonal
Computers
Encryption
GEMS Real Time Analysis
16I n t e g r i t y - S e r v i c e - E x c e l l e n c e
GEMS Advances Ability To Meet Requirements Of Force Health Protection
Early Warning Possible Now
-Real Time Analysis
-BW Symptoms
-C2 Response
-Mitigation
-Counter Measures
Patient Record
-Vitals
-Exposure
-Immunizations
-Previous Encounters
-Medications
Population Medicine
-Retrospective Analysis
-Endemic Disease Rates
-Baseline Disease Prevalence
Detailed Data For Enhanced DNBI Surveillance
17I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Online Reporting
18I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Post Deployment Health Questionnaire, DD Form 2796 (completed via face-face encounter with a provider) collected, completed and forwarded to AMSA
Collect post deployment serum sample w/in 30 days of return (JCS defined deployment)
Post-Deployment
19I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Post-Deployment Screening
20I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Expert Clinical Care
21I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Quality Assurance
What are we measuring?MAJCOM reports will provide information to generate
the following AF metrics:
- % returning personnel who completed post deployment health assessment (if required)
- % returning personnel who have had serum sample collected (if required)
- % returning personnel who require clinical referral and % of them who completed initial referral visit
- % returning personnel who completed all required post-deployment checklist items
22I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Quality Assurance Program
How are we doing? Our data shows that 93% of returning personnel have completed
post-deployment health assessments (submitted to AMSA) and serum samples collected. Some returning personnel have completed health assessments but forms have not yet been submitted to AMSA. Our QA program will ensure that all personnel complete post deployment requirements within 30 days of return.
We estimate that among personnel returning from OIF through May 03, 30% of post deployment assessments utilized the new, enhanced DD Form 2796 with a face-to-face visit with a provider. Subsequent to 21 May 03, all health assessments must be completed utilizing the new process.
Our reports indicate 6% of personnel returning since 1 Mar have required a referral for clinical evaluation.
23I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Current Status
Name of MAJCOM
# Personnel Redeployed
% Completed Checklist
% Requiring Clincal
Referral
% Completed Intial Referral
Visit
% Redeployed from JCS Defined Deployment
% Completed DD Form
2796
% Serum Samples Collected
ACC 8416 87% 8% 74% 93% 99% 97%
AETC 821 61% 9% 111% 93% 110% 72%
AFMC 3050 82% 3% 69% 96% 83% 88%
AFRC
AFSOC 1487 100% 8% 100% 96% 105% 84%
AFSPC 501 86% 6% 50% 99% 98% 89%
ANG
AMC 5516 79% 2% 79% 92% 82% 74%
PACAF 1382 93% 1% 100% 54% 89% 90%
USAFA 68 100% 10% 57% 99% 101% 100%
USAFE 2388 87% 8% 73% 97% 100% 90%
11th Wing
Totals 23629 84.6% 6% 78% 92% 93% 87%
Overall
24I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Automation: PIMR, AFCITA The Road Ahead
Link individual actions and completion dates in PIMR (not just questionaires)
Link Force Protection Prescription products in AFCITA to feed into PIMR (pTabs, atropine, malaria Rx, etc)
Automate Pre/Post Deployment Questionaires in PIMR
GEMS (or son of GEMS): continue to populate with Environmental Data
25I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Phases of Deployment
Intervention
Public Law (Sec 1074f)
DoDI/JS AF Policies/Processes
Longitudinal health assessment
PHA
IMR X
Continuous
Quality assurance Required Ensure pre & post assessment
Health/MH assessment
Med exam Required
Threat assessment X Immunizations/ countermeasures
X
Serum sample Required
Pre-Deployment
Envt baseline assessment
X
Threat assessment X Environmental assessment
GEMS
DNBI GEMS PPE X
During Deployment
Clinical records GEMS Health assessment X Serum sample Required
Post- Deployment
Clinical care X Clinical Practice Guidelines
Regulatory Requirements