Senate Appropriations Subcommittee on Defense Hearing
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Chairman Durbin, Vice Chairman Cochran, and distinguished members of the Subcommittee, thank you for inviting me to appear before you today.
As the war draws down and the focus shifts to in-garrison care, it is tempting to compare the MHS to civilian health care organizations. But there is a cost associated with being prepared to execute our readiness missions, and no civilian healthcare system in the world can do what we do - and have done -- when called upon to provide deployed and en-route care. That is the one key message I hope to leave with you today. The AFMS remains closely linked with our
The AFMS is committed to supporting the Line of the
As we strive for even greater survival rates, we've evolved our CCATT capability point- of-injury response. This provides more capable care further forward and more sophisticated in- transit support. Our Tactical Critical Care Evacuation Teams (TCCETs) provide damage control resuscitation on rotary-wing, forward-deployed fixed-wing, and tilt-wing aircraft, and have accomplished more than 1,600 critical care patient movements since we began the program in
Our health response teams include rapidly deployable, modular, and scalable field hospitals that provide immediate care within minutes of arrival. The Expeditionary Medical Support Health Response Teams (EMEDS HRT) are successfully deployed as a part of our continuous evolution in medical response capabilities anywhere in the world. They provide immediate emergency care within minutes to hours of arrival -- surgery and intensive critical care units in place within six hours, and full capability established within 12 hours of deployment arrival.
The training course at
The success of TCCET, CCAT, and EMEDS-HRT in expanding our capabilities relies on collaboration with our civilian partners in the areas of research, education and training, and provider currency. We are involved in some amazing state-of-the-art research in our major thrust areas of
One fascinating example is the Airborne Laser Sensor project, a collaborative effort with
We also focus research on better care and health for
Our C-STARS partnerships in
In another exciting new program, we have joined with
In addition to education and training, human performance initiatives are critical to optimizing performance of our personnel, especially as the definition of the "warfighter" has evolved. For example, Remotely Piloted Aircraft (RPA) and Distributed Common Ground System (DCGS) operators execute their core missions in garrison, requiring a shift in how we view and provide medical support. We have customized our medical support to meet the needs of Airmen performing these very stressful missions. Our medics are becoming Human Performance Practitioners - actively seeking opportunities to sustain, enhance, and optimize performance of
Lessons learned in support of Special Operations Forces through the Preservation of Force and Families initiative have improved our support of other "Battlefield Airmen" (for example,
Additionally, we are studying the operational and occupational health effects impacting personnel in
The success of our operational health initiatives relies on a strong foundation of in-garrison care. We continue to embrace the principles of Patient-Centered Medical Home (PCMH) to improve patient care, access and outcomes. We have attained all-time-high levels of provider and team continuity throughout 2013, while reducing emergency room utilization rates. We developed standardized support staff protocols to promote evidence-based practice, reduce variation, and enhance reliability by utilizing PCMH teams to their fullest capabilities. The protocols have also helped improve currency of our medics while creating access opportunities for our patients.
Likewise, we have achieved enhanced access through the continued deployment of secure messaging. This technology has now been launched throughout the AFMS and includes more than 305,000 enrolled users sending over 41,000 messages per month. This leading-edge communication tool provides an additional venue to meet patient needs without face-to-face appointments, and helps our patients partner with providers in the management of their care.
Last year we reported that we launched our telehealth initiative called Project ECHO (Extension for Community Health Outcomes) with one specialty (complicated diabetes management) serving three military treatment facility (MTF) pilot sites. Now in our second year, we have added chronic pain management, traumatic brain injury, behavioral health, dermatology, ENT and acupuncture for a total of seven live ECHO specialty series and are on track to add four more specialties areas (Addictions, Infectious Disease, Neurology and Dental) this coming year. We have expanded participation to include all Services and the
Our patient safety program continues to be the bedrock of our healthcare operations. Patient safety managers collaborate with subject matter experts in risk management, clinical quality, customer service, professional staff management, compliance and accreditation to ensure we provide the highest quality care in the safest environment possible for our beneficiaries. The "
The high quality of our care in our inpatient facilities is monitored and validated by, the Joint Commission (TJC), the leading accreditor of health care organizations in America. This past year three of our hospitals earned top accreditation honors by TJC for exemplary performance and were named among the nation's Top Performers on Key Quality Measures.
World-class healthcare begins with disease prevention: We promote healthy behaviors and lifestyle choices to reduce illness and ensure a high quality of life for our Airmen and their families, resulting in a healthy, fit, resilient and productive force. We are targeting nutritional fitness, physical activity, healthy weight and tobacco-free living. Ten percent of active duty Airmen are obese. While this rate is much lower than the civilian average, we will continue to execute initiatives such as "Go For Green" - a food labeling system in military dining facilities that promotes healthy food choices. The
To increase resilience of deploying Airmen and reduce the likelihood of post traumatic symptoms, our Airman Resilience Training provides standardized pre- and post-exposure training and reintegration education, which we are now redesigning to be better tailored to specific groups of deployers. Even though
We have formally trained the majority of our mental health providers and all new social work and psychology trainees on evidence-based treatments for PTSD, and the
The mental health of our Airmen and their families' remains an important focus area for us. We are continually striving to improve access to mental health care through initiatives such as
Fortunately, the incidence of deployment-associated traumatic brain injury (TBI) has remained low for the
We remain concerned about suicides in the
Airmen and their families are our most important resource and in an effort to improve the care provided to Air Force Families, we have recently completed a comprehensive examination of the relationship between deployments and subsequent rates of family violence. We found that among deployers, the rate of spouse abuse and child maltreatment is about the same before and after deployment. We have also identified a few specific situations that place military families at higher risk for family violence and are targeting family violence prevention efforts to those families at risk.
We are also committed to ensuring quality, compassionate care for victims of sexual assault, through the
Another area of concern is the impact of hearing loss on operational readiness and long-term quality of life. Hearing loss remains an easily overlooked occupational injury in service members and Veterans. As lead agent for the
One of the most successful projects is the Joint Vascular and Endovascular Surgical Services project at
Other successful sites include the 81st
Throughout the Air Force Medical Service,
The FY 15 President's Budget includes a proposal for a TRICARE Consolidated Health Plan along with modest increases in beneficiary out-of-pocket costs for active duty families, retirees and their families, and reserve component members and their families. These proposals reflect the
Finally and importantly, the AFMS is united with our
In conclusion, despite the challenges we all experienced in the past year, the Air Force Medical Service continued to focus hard on providing operational support and high quality care around the globe, in-garrison and deployed, on the ground or in the air - that's what we mean by "Trusted Care Anywhere!" I am honored to lead and serve with
Read this original document at: http://www.appropriations.senate.gov/sites/default/files/hearings/Lt%20Gen%20Travis%27%20Statement.pdf
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