Lieutenant General Thomas Travis, Air Force Surgeon General on April 24, 2013 testified on Defense Health Programs before the House Appropriations Committee’s Subcommittee on Defense. He reported on the highlights of the Air Force’s progress in working closely with Defense, Army, and Navy colleagues to achieve the Military Health System (MHS) Quadruple Aim through the goals of readiness, better health, better care, and best value. He commented on the fact that the Air Force has transported 8,200 high acuity patients utilizing Critical Care Air Transport Teams (CCATT). The teams have been instrumental in expanding the capabilities of the Aeromedical Evacuation (AE) system that has changed military medical force deployment and casualty care practices.
Sometimes the Extracorporeal Life Support (ECLS) system is used during Aeromedical Evacuations. Teams at the San Antonio Military Medical Center at Lackland AFB, and at the David Grant Medical Center at Travis AFB are researching whether a miniaturized ECLS system weighing around 28 pounds would be able to transport the injured in high altitudes. Airworthiness testing is pending.
The Air Force Medical Service (AFMS) is also studying how to miniaturize medical devices such as field-deployable lightweight vital sign monitors that would fit inside a cargo pocket and would use sensors to collect patient data. The Air Force is currently working to develop autonomous control of patient oxygen and ventilation via a closed-loop ventilation system to help reduce ventilator-induced lung injury to provide more efficient and precise oxygen therapy.
Also under development is a video-assisted intubation device that will provide caregivers visualization of the vocal cords and the endotracheal tube to help caregivers place the tube when in a constrained and austere AE environment during transport.
The Air Force has fully executed their patient safety programs across 75 Medical Treatment Facilities. So far, there has been a 2.5 percent increase in near miss reporting and a 0.4 percent decrease in harm events over the previous year. The Air Force in collaboration with the other services was able to lead the first patient safety event analysis and now all sentinel event occurrences now being shared among the services.
The Air Force Patient-Centered Medical Home (PCMH) program has made significant progress towards greater continuity of care. For example, the clinic at Davis-Monthan AFB in Arizona is one of the top facilities for continuity of care. Their patient health indicators show a 21.6 percent increase in well child visits, a 4.9 percent increase in diabetes screening, a 9 percent increase in diabetes control, and 48 percent decrease in urgent care referrals. To support PCMH, the Air Force is implementing secure messaging which has now been deployed to a third of the MTFs with the remainder coming on board in 2013.
Currently 26 tri-service MTFs are participating in ECHO, a program that enables family healthcare teams to care for more complex patients in MTFs. The service helps provide complicated diabetes management, chronic pain management, and TBI care. This year the Air Force plans to add behavioral health, dermatology, and international medical readiness into the program with plans to further expand in 2014.