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

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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

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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

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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

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AFMS SG PIMR Metric

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Base-level “Drill Down”

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AF Commanders Own Force Health Protection—Online Toolkit

Periodic Health Assessment andIndividual Medical Readiness

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Threat Assessments

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Target Preventive Measures

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Pre-Deployment Screening

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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

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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

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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

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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

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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

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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

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Online Reporting

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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

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Post-Deployment Screening

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Expert Clinical Care

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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

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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.

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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

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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

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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