Army Occupational Medicine Strategic Plan

1
Army Occupational Medicine Strategic Plan

• LTC Timothy M. Mallon, MD, MPH
• August 2002

2
Goals

• Provide Occupational Environmental Medical
  Surveillance for Army personnel
• Garrison
• Deployed Settings
• Develop Occupational Injury Illness Prevention
  Control Programs
• Optimize Management of the Occupational Health
  Program
• Improve the Chemical, Nuclear Biological Surety
  Programs

3
Goal 1 Objectives (Provide O/E Med. Surveillance)

• Assess OEH exposure data determine the high
  risk populations
• Determine MOSs most at risk
• Consider control measures used for adequacy
• Document unsafe exposures above TLV/STEL
• Collect Analyze Population based medical
  surveillance data where available
• Review illness trends to identify breakdowns in
  controls
• Identify high cost high frequency occurrences
  target interventions
• Document success / ROI communicate lessons
  learned to CDRs to promote change

4
Goal 1 Objectives (cont.)(Provide O/E Med.
Surveillance)

• Develop algorithms for HCPs who see patients with
  TICs/TIMs NBC warfare agent exposure
• Train other HCPs regarding OEH threats
• OH Consultations
• Distance learning OH Basic Course
• Develop supplement to pre post deployment
  medical surveillance questionnaire for OEH
  threats
• Document medical evaluation potential for
  health outcomes in the electronic medical record
• Develop partnerships with other DOD Agencies, VA,
  Reserve NG to review medical surveillance data

5
Goal 2 ObjectivesSupport Occupational Injury
Prevention Pgm

• Establish injury prevention control program
• Conduct occupational injury surveillance
• Standardize metrics for tracking occupational
  injuries
• Integrate CPMS, COP, CHCS, TMIP DMSS data
• Use occ. epidemiologist to coordinate
  surveillance
• Target high risk MOS/injuries for intervention
• Demonstrate ROI of targeted interventions
• Market success, integrate best products into
  policy doctrine

6
Goal 3 Objectives(Optimize Management of OH)

• Develop resource model for staff needs
• Develop Std OH Program
• Id core competencies credentialing standards
  for providers at all levels
• Define command oversight role at MACOM, RMC MTF
  and clinic level
• Standardize OH Program metrics
• Incorporate into OH Program document
• Standardize training requirements
• Maximize IM/IT solutions to advance OM

7
Goal 4 Objectives (Improve Chem., Nuc. Bio.
Surety)

• AMC/MEDCOM Actions
• Applied PM Resourcing Model
• MEDCOM allocated funding to fill priority
  positions
• Chemical Surety UFR to staff POPM to conduct
  annual assistance visits
• Oversight training by RMC OM consultants
• Add Chem/Nuc Surety Component to MRMC Tox-Chem.
  Training

8
OH Improvement Plan Status

• LTC Tim Mallon, MD, MPH

9
PM Resourcing ASAMs III

• Defined roles and missions at all levels
• Establishes metrics, benchmarks permits trend
  analysis
• Establishes resource requirements (Fiscal
  Human)
• POM for shortfalls in resources
• Unfinanced Requirements (UFRs)
• Current year
• Mini-POM submissions PM resourcing model
  developed
• Tina Allen, CHPPM Pete Martinez, MEDCOM are
  the POCs

10
Oversight Accountability

• Define role of RMC OM physician
• Ensure OH clinics utilize QA/QI program
  standardize program measures.
• Ensure providers credentialed
• Develop standard job descriptions
• Develop/distribute job descriptions
• Ensure ACOEM, AAOHN ABIH competencies met

11
Oversight Accountability (Cont)

• Field Self Assessment Tools for OH Program on
  process and outcome measurements.
• Develop, staff, and distribute comprehensive OH
  Program document
• delineating responsibilities and reporting
  requirements
• Include all governing references, ARs, DA PAMs.

12
Information Management

• Utilize PC Matrix until CHCSII deployed
• Consider policy requiring PC Matrix interim
  solution
• Train providers on the interim solution
• Provider requested IM changes to PC Matrix
• Examine utility of GEMS TMIP for deployed
  settings
• Emphasize priority of OH solutions within DOD HA
  the CITPO Office
• Feed into Army IM Requirements process for future
  IM/IT products services pre-actively

13
Training

• Ensure OM providers trained on OEH threat
  assessment casualty care for CBRNE
• ID minimum required training for OH staff (MD,
  PA, OHN, Tech) at all levels
• Define refresher and periodic training
  requirements
• Refine OH educational products
• Put Distance learning" products on web
• Update OH Basic Course
• Pre-course materials to be completed in advance
• Update of didactic sessions with HCP focus

14
Credentialing

• Define core competencies for credentialing OM
  providers for all echelons of care
• Define minimum experience in lieu of training
  needed for providers at all echelons of care
• Define refresher and periodic training
  requirements
• Establish oversight requirements when training or
  experience requirements not met

15
Occupational Medicine Metrics

• Process Metrics
• Medical Surveillance
• Worksite Surveys
• Occupational Health outcomes
• Administrative Medicine Functions
• QA/TQI meet local Army standards
• FFD, FMLA, ADA, OSHA standards met
• Workers Comp Case Management
• COP Lost workday rates per 100 employees
• COP Cost rate per 100 employees
• Disability medical cost rates per 100 employees
  from Department of Labor data.