Transforming Army Medicine to Ensure Quality Care and Optional Readiness

Article excerpt

Despite more than nine years of continuous armed conflict, every day our soldiers and their families are protected from injuries, illness and combat wounds through Army Medicine's health promotion and prevention efforts; are treated in state-of-the-art fashion when prevention fails; and are supported by an extraordinarily talented medical force including those who serve at the side of the warrior on the battlefield. We are focused on delivering the best care at the right time and place.

Army Medicine is a dedicated member of the Military Health System and is equally committed to partnering with our soldiers, their families and our veterans to achieve the highest levels of fitness and health. Historically, Army Medicine has been a leader in developing innovations for trauma care and preventive medicine that save lives and improve the well-being of our uniformed personnel, improvements that have also benefited civilian care. Army Medicine operates using the following five strategic aims: early prevention, enduring care, effective treatment, optimi2ed efficiencies and an enterprise approach to reflect our commitment to selfless service.

Early Prevention

Army Medicine strives to reduce the need for subsequent care through early prevention with an emphasis on health promotion and has initiated multiple programs in support of this aim over the past year. For example, the Army is leading the way in early recognition and treatment of mild traumatic brain injury (TBI) or concussive injuries. TBI training has been integrated into the education and training initiatives of all deploying units to increase awareness and education regarding recognition of symptoms as well as to emphasize commanders' and leaders' responsibilities for ensuring that their soldiers receive prompt medical attention as soon as possible after an injury.

To ensure early detection and appropriate care, any servicemember in a vehicle involved in a blast event, collision or rollover; everyone within close proximity to a blast; and everyone who sustains a direct blow to the head receives mandatory medical evaluation. In addition, the command may direct a medical evaluation for any suspected concussion that occurs under other conditions. Similar to our approach to concussive injuries, Army Medicine is strengthening our soldiers' and families' behavioral and emotional health through a process called the Comprehensive Behavioral Health System of Care. This system of systems is built around the need to support an Army engaged in repeated deployments - often into intense combat - which then returns to home station to restore, reset the formation, and reestablish family and community bonds. The intent is to optimize limited behavioral-health resources to ensure the highest quality of care to soldiers and families. Program goals include protection and restoration of the psychological health of our soldiers and families, and the prevention of adverse psychological and social outcomes such as family violence, driving under the influence violations, drug and alcohol addiction, and suicide.

The patient-centered medical home, embraced by civilian health care, will enhance primary care for our soldiers and their families. The medical home philosophy concentrates on what a patient requires to remain healthy, to restore optimal health and, when needed, to receive tailored healthcare services. It relies upon building enduring relationships between patients and their providers - doctors, nurse practitioners, physician assistants and others - in a comprehensive and coordinated approach to care. Physicians will evaluate their patients for disease - not only to provide treatment but also to identify genetic, behavioral, environmental or occupational risks. This means much greater continuity of care, with patients seeing the same physician or professional partner 95 percent of the time. The result is more effective health care - for both the provider and the patient - that is based on trust and rapport. …