Eliminating The Gaps In Medical Care

When a servicemember is injured, whether that injury occurs on the battlefield, during a training exercise or just in their everyday work, they always receive the best medical care that is available. The Defense Department is working to ensure that the gaps that often occur, as a patient moves from the DoD system of care, to the Department of Veterans Affairs healthcare system or even to private hospitals and closed and the transition is much smoother. The gaps that have been experienced in moving between the medical systems is one of the focuses of the Dole/Shalala group and their recommendations that followed.

The Defense Department and the Department of Veteran’s Affairs are working closely to ensure that those gaps are breached and that there is more transparency between the two healthcare systems. One way that can be done, is to ensure that the sharing of medical records between the two entities.

“We have been working to ensure we have secure, global reach of electronic health records,” explained Dr. Stephen L. Jones, principal deputy assistant secretary for health affairs. “The DoD and VA records would be integrated so when you saw that health provider in the VA, he would have access to the records from when the patient first entered the system.”

“All of the task forces and commissions said we needed more integration and cooperation between the DoD and VA, and we’ve made tremendous strides,” he said. “Are we where we need to be? No, because health records are a bit more complicated than financial institutions or airlines and such. Many more components have to be included – radiology, nutrition, provider nodes – all of the various aspects that touch you when you are in the health care field.”

Record-sharing is only one avenue that will ensure a more seamless transition between the two medical systems. Exploration is also being done as to whether one in-patient healthcare system would be feasible between the VA and the Defense Department. There is a study currently underway regarding that issue, which should have recommendations in March.

Besides the gaps between the Defense Department and VA medical systems, there are also gaps between the government and private-sector healthcare systems. According to Jones, the private-sector is not as far advanced in the electronic patient records. If they receive services from a private healthcare provider, information about that visit may or may not make it into their military medical file.

“We need to build a system that will allow the folks working with patients and military families access to the records – whether it be DoD, VA, the state or a private institution,” Jones said. Private-sector health care providers and the government are working to set information technology standards for health care records, he added.

As military medicine focuses on the two signature injuries of the wars in Iraq and Afghanistan, PTSD and TBI, the military is focusing more on those and other aspects of pshychological health. They’re working hard to erase the stigma that has been in place in the military for many years, the belief that it was not okay to seek mental health help. While things are moving in the right direction, more work has yet to be done.

The Military now has specialists much closer to the frontline, in places such as combat stress clinics in battlefield settings. This allows Soldiers to receive help much sooner than they would, if they had to be evacuated back to the United States, due to experiencing some type of psychological trauma.

“Let’s erase the stigma associated with psychological wounds,” he said. “Whether it’s a wound to your body or a wound to your mind, it’s the same thing. You need to get assistance.”

After the black-eye received after the scandal at Walter Reed last year, the Defense Department and the Department of Veterans Affairs are hard at work to correct those problems, which weren’t related to the care of the particular injuries, but instead mostly in follow-up care and the administrative process. Tremendous strides have been made, since that time, to ensure that our Wounded Warriors continue to receive the best medical care possible.

At the Military Health Services annual conference here next week, Jones will host a discussion on the future of military health care. This year’s conference theme is “Caring for America’s Heroes.” More than 3,000 attendees are expected.

The conference is an attempt to communicate ideas throughout the force, and also provides an opportunity for DoD leaders to get input from the field, Jones said.

But it all begins with people, Jones said, and the nation’s wounded warriors are in the best possible hands. From the medics and corpsmen on the ground to the doctors at the combat support hospitals to the specialists at Walter Reed and the National Naval Medical Center at Bethesda, Md., all are providing the best trauma care in the world, he said.

I’m looking forward to continuing to follow the military medical care issues as things change and progress. We’re already seeing many changes that have had a positive impact on our Wounded Warriors and I’m sure that there will be many more in the months to come.


3 Responses

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