Health Consequences of Service During the Persian Gulf War Recommendations for Research and Information Systems (1996) / Chapter Skim
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Information Systems
Information Systems
Pages 128-140
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From page 128... ...
As an interim measure to obtain information about exposures, health, and medical care among POW veterans, DoD and DVA established four independent programs: the DVA Persian Gulf Health Registry (PGHR) , DoD Comprehensive Clinical Evaluation Program (CCEP)
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From page 129... ...
Whereas no system of medical record keeping can or should be designed to provide the information needed to address every unanticipated issue regarding the health consequences of either military service in general or a specific military conflict, health information systems can be established to facilitate epidemiologic studies of such service. The committee has identified several changes in health information systems for military personnel that will enhance the capability of the military to evaluate the health consequences of future deployments and service.
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From page 130... ...
Therefore, each data item should clearly support the stated objectives of the information system, provide useful insight into health concerns within acceptable time frames, and facilitate decision making for prevention and health care programs. Continual evaluation is essential.
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From page 131... ...
TEAM was presented to the committee as including National Oceanic and Atmospheric Administration (NOAA) models for the entire period of the oil well fires, troop unit locations and movement data, satellite imagery to determine the daily geographic extent of oil fire plumes, U.S.
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From page 132... ...
Unit location data will be linked to models of oil well fire location, oil fire plume location, and air pollution data collected by the Army beginning in May 1991. Plans include the development of individual exposure information matrices.
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From page 133... ...
The UMR system should include a minimal data set for all service personnel, encompassing personal and demographic descriptions; health- and service-related exposures; illnesses, injuries, and medical conditions that occur during military service; hazardous and potentially hazardous exposures, job assignments, and locations throughout military service; and periods on temporary duty assignment for training and during deployment for military action, particularly to overseas locations. It also should include information about medical contacts that occur after military discharge through the DVA or other government medical providers and, wherever possible, private providers.
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From page 134... ...
The committee concludes that the branches of the military service, the reserve and National Guard organizations, and the DVA must work together in the development of standardized and uniformly applied practices regarding the collection, recording, and maintenance of service health records. Medical care of the individual, the efficiency and effectiveness of the medical care system, health surveillance, and epidemiologic evaluation of potential threats to the health of service personnel will be greatly strengthened by the development of a system that provides access to the entire medical history of each member of the armed services.
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From page 135... ...
Data are less likely to be available for infertility, pregnancy loss prior to the third trimester, delayed growth and development of offspring, or any condition dealt with by civilian health care providers. The committee has been told that service members on active duty often choose to obtain reproductive care from civilian sources, thus highlighting the need for linkage of this important area of military medical research with civilian medical records.
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From page 136... ...
, and medical events (hospitalization dates, disposition, up to eight diagnoses and eight procedures, cause of injury, sick days per episode, medical treatment facility, autopsy)
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From page 137... ...
A medical record system for patient care should be constructed with major input from physicians, nurses, and administrators and should be oriented largely toward the care of the individual patient. There is a need for a detailed record of personal, family, and medical history; symptoms at the time the patient is first seen and later; physical findings and how they change; results of each laboratory test and radiological
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From page 138... ...
The committee considers these four steps the development of a uniform medical record, (2) the improvement of data collection on exposures and health status of deployed service personnel, (3)
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From page 139... ...
As a result, it will be extremely important for DoD to ensure that active military health data systems facilitate efforts to address questions that arise months or years after personnel leave active service or that occur among their family members. Such a proposal would require a research capability and supporting health information system that do not exist today in either DoD or DVA.
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From page 140... ...
Information systems developed immediately after the POW are limited in scope and disconnected from each other. Systems under development to ensure future medical readiness and to enhance epidemiologic capabilities have great potential for producing a seamless medical record that can be linked to other information systems, and thus meet the important military medical objectives of prevention, providing effective and appropriate medical care, and facilitating epidemiologic research.
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