March 30th, 2017 16:42 EST
Surgeons General Emphasize Readiness as Priority in Military Medicine
Readiness is the priority of the Military Health System, the surgeons general of the Army, Navy and Air Force told the Senate Appropriations Committee defense subcommittee today.
Army Lt. Gen. (Dr.) Nadja Y. West, Navy Vice Adm. (Dr.) C. Forrest Faison III and Air Force Lt. Gen. (Dr.) Mark A. Ediger testified at a hearing on defense health.
"Readiness, without question, remains my No. 1 priority," West said, noting that Army medicine over the past year launched aggressive efforts to expand access and improve quality for all it serves, including adding 836,000 more specialty care appointments in 2016.
"Our most promising initiative to bring care closer to our patients is virtual health, ... with services spanning 30 countries and territories over 30 clinical specialties," the Army surgeon general said.
Potential uses of virtual health capabilities include remotely monitoring patient vitals, providing virtual consultations, and letting medics provide combat casualty care or treat a combat casualty, West said, adding that virtual health also is a way to revolutionize access in garrison faculties, at patients` homes or at points of injury.
Advances also have been made in preventing and treating infectious diseases such as Zika virus and treating physical and mental combat-related wounds, she said.
Army medicine also is preparing for the years ahead, West said, telling the subcommittee that "capabilities required to support the future operating environment are going to look much different than they do today."
In a multidomain battle environment, the Army may not have uninterrupted air superiority, affecting the ability to conduct on-demand patient medical evacuations, she said. In that case, she added, medics and other early responders may be called on to provide more complex, prolonged field care.
Providing an example of scaling and reconfiguring capabilities, West said that last year Army medicine assembled a damage-control surgical capability to support forces operating in widely dispersed environments in the U.S. Africa Command area of responsibility.
"Retaining this agility is key as we continue to work with our colleagues to implement the 2017 National Defense Authorization Act," West said. "Readiness is foremost, and we must maintain the ability to flex with our service to provide the right capability [and to continue] to meet or exceed national quality care standards in our garrison environment."
Readiness also is a priority for Navy medicine, Faison said, because on any given day Navy medical personnel are forward-deployed and supporting high operational tempos with the fleet, fleet marine forces, special warfare units, the joint force and overseas commands.
"In sustaining our readiness capabilities for the next conflict," the admiral said, "new approaches to training, preparation, equipment and support required by our operational and deployed medical personnel will be critical to realizing high combat survivability."
A primary reason for Navy medicine`s high combat survivability rate is the work performed by Navy hospital corpsmen, which Faison called the Navy`s largest enlisted rating.
"Corpsmen are responsible for delivering initial health care on the battlefield or in isolated assignments aboard a ship or submarine far from shore or any military treatment facility, ... [and] we are changing and improving the training of our hospital corpsmen in [their training] in San Antonio," he said.
Curriculum changes focus on training that will prepare corpsmen to manage the continuum of care in the kinds of high-threat or complex environments that sea-based expeditionary Navy and Marine Corps forces encounter, the admiral added.
"We`re also continuing to leverage private and academic partnerships in key areas such as trauma training at Los Angeles County [Department of Health Services and] the trauma and burn program at the Federal Health Center in Chicago," Faison said.
Navy medicine also is committed to global health engagement, he added, and these efforts complement innovative work in Navy research and development labs around the world where scientists address critical military-relevant research priorities such as malaria vaccine development.
Air Force Medicine
"In Air Force medicine we are adapting our capabilities to enhance the health and performance of airmen by taking our support directly to the airmen," Ediger told the panel.
The Air Force medicine readiness challenge today is to build the capacity to support agile military operations across broad expanses of geography while sustaining the ability to deploy field hospitals in support of large-scale combat operations, he said, noting that answering the challenge calls for increasing the flexibility of deployable medical teams.
"Operations in Central Command and Africa Command have expanded requirements for agile teams trained and equipped for forward trauma resuscitation, damage control surgery and critical care, performing near operating forces often without the benefit of a field hospital," Ediger said.
In 2016, an Air Force medical team supported coalition forces under this construct and performed more than 120 trauma resuscitations in a seven-week period, he said.
And "while employing innovative trauma resuscitation techniques in a pre-hospital setting," the general said, "we recently adapted Air Force mobile-field surgical and critical-care teams to this requirement and completed successful operational tests."
As part of a joint effort, Ediger added, "we are training and equipping teams to be dually capable of this kind of austere agile support and at work within the Air Force expeditionary medical support, or EMED, structure."
This year, the Air Force will train and equip teams to deliver in-flight surgical resuscitation capability, he said.
Partnerships enable deployable medical professionals to work in institutions outside the military, including partnered trauma centers and academic medical centers in the United States and the United Kingdom, and these will grow in importance, Ediger noted.
Since 2012, he added, airmen have gained experience from embedded medical support in mission areas that include special operations, remotely piloted aircraft operations, intelligence operation centers and personnel recovery.
"We`re now building plans to apply what we have learned in those areas more broadly across the Air Force," the general said, "with a focus on units and career fields under high stress and demand, such as aircraft maintenance."
The concept for such an adaptation, he said, involves multidisciplinary medical teams working beside airmen in their duty sections to enhance performance, improve fitness, improve health, build stress management skills and prevent injuries.
And implementing the new electronic health record at Fairchild Air Force Base, Washington, "is the first step of what will be a transformational tool for our health care teams, but also for all of those we serve," Ediger said. (Follow Cheryl Pellerin on Twitter: @PellerinDoDNews)
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