PDHA & 18

Let me lead with the important first. Maus has her 18th birthday today and The Mole had his yesterday (#20). As you can probably guess, in years past it means that we have had a busy couple of days with first one, then the other having a birthday.

PDHAs – Post Deployment Health Assesments.

Along time ago in a war far away, a lot of service members had problems after they returned home. There were millions spent on studies and lots of theories, but the only thing that was conclusively proven was that an unknown subpopulation had problems. The only thing in common was “deployment.” Certainly not length of deployment or location of that deployment- just simply that they had deployed.

Forever after, any and all adjustment problems and medical problems were blamed on the deployment. Fact is, there were people who were exposed, injured or became ill with documentable problems. And then there were the rest who had non-specific symptoms.

The research, studies and arguments are still raging. Congress (US) has, of course, decided that we simply are not doing all we can to document what is going on. A lot of thought, money, effort and way too many eggheads went into survey design and databases. If you are someone who wants to run a study – cool – there are hundreds of thousands of data points to research. If you want real information – well, I will just say that the system documents what someone is willing to put on a form at a certain time and place. It may/may not have anything to do with reality.

The Post Deployment Health “Assessments” are conducted at the end of the deployment. There are two parts: the first is a questionnaire that the service member fills out; the second is the health care provider review.
The assessment is intended to capture the medical events, “exposure concerns”, alcohol abuse potential, mental health status, and health concerns of the redeploying individual. Most, but not all of the questions are clear. The new ones related to head injuries are not….

All individuals are then supposed to have a face-to-face encounter with a provider who reviews the form, identifies high risk individuals (for alcohol and behavioural issues) and notes the various medical/community/counselling etc referrals that will be needed on return to home station.

[If you were reading my scribbles in 2003-2004 – this is the web-based version of that onerous hand held PDA version that I was stuck with fielding for the Kuwait/Iraq theaters in summer 2003. ]

The current system is web-based; we no longer have hard copies, up loads or delays. All the information is on the server and can be easily accessed back at home station.

Even so – active duty has a different attitude on the form than Reserve or Guard. They have lots of time to get follow on care, not so for R/NG. More importantly for my crew, I simply don’t want them to run out of their normal meds prior to return to home station.

Hence, web-based PDHAs, AHLTA-T for the note I have to stick in the electronic medical record and T2 for ordering of meds. Don’t you just love it?

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