Volume 41, No. 5

A worldwide publication telling the Army Medicine Story ARMY MEDICINE MERCURY CONTENTS

DEPARTMENTS

FEATURE

2 | ARMYMEDICINE.MIL ARMY MEDICINE MERCURY US ARMY MEDICAL COMMAND ARMY MEDICINE PRIORITIES

Commander COMBAT CASUALTY CARE Lt. Gen. Patricia D. Horoho Army Medicine personnel, services, and doctrine that save Service members’ and DoD Civilians’ lives and maintain their health in all operational environments. Director of Communications Col. Jerome L. Buller Chief, MEDCOM Public READINESS AND HEALTH OF THE FORCE Affairs Officer Army Medicine personnel and services that maintain, restore, and improve the Jaime Cavazos deployability, resiliency, and performance of Service members. Editor Valecia L. Dunbar, D.M.

Graphic Designers READY & DEPLOYABLE MEDICAL FORCE Jennifer Donnelly AMEDD personnel who are professionally developed and resilient, and with their units, Rebecca Westfall are responsive in providing the highest level of healthcare in all operational environments.

The MERCURY is an HEALTH OF FAMILIES AND RETIREES authorized publication Army Medicine personnel and services that optimize the health and resiliency of Families for members of the U.S. and Retirees. Army Medical Department, published under the authority of AR 360-1. Contents are not necessarily official views of, or endorsed by, the U.S. SOCIAL MEDIA CENTER Government, Department of Defense, Department of the Army, or this command. FOLLOW US ON The MERCURY is published Army Medicine monthly by the Directorate of Communications, U.S. Army LTG Patricia D. Horoho Medical Command, 2748 CSM Donna A. Brock Worth Road Ste 11, Fort Sam Houston, TX 78234-6011. BE CONNECTED ON Questions, comments or submissions for the Army Medicine MERCURY should be directed to the editor at 210-221-6722 (DSN 471-7), SEE WHAT’S PLAYING ON or by email; Army Medicine EXPLORE OUR PHOTOS ON The deadline is 25 days before Army Medicine the month of publication. Unless otherwise indicated, all photos are U.S. Army photos. The MERCURY submission START PINNING TODAY ON and style guide can be accessed Army Medicine JOIN THE CONVERSATION ON Army Medicine

3 | ARMYMEDICINE.MIL JUST IN...

Red Sox Medical Director Meets with Army Surgeon General, MEDCOM Experts Dr. Larry Ronan (left), medical director for the Boston Red Sox, met with Lt. Gen. Patricia Horoho (center) and Brig. Gen. Patrick Sargent to discuss the Performance Triad, TBI, and the Comprehensive Soldier Fitness Program Jan. 14, 2014. (U.S. Army photo by Ron Wolf) Access the full article at: http://goo.gl/zV8NsV

Surgeon General of the Army Lt. Gen. Patricia D. Horoho and Judge Advocate of the Army Lt. Gen. Flora D. Darpino Surgeon General of the Army Lt. Gen. Patricia D. Horoho and Judge Advocate General of the Army Lt. Gen. Flora D. Darpino, spoke Jan. 22, 2014, before the Women Mayors’ Caucus in Washington, D.C. The caucus is part of the larger United States Conference of Mayors, for mayors of cities with 30,000 or more citizens. The group held its 82nd Winter Meeting, Jan 22-24, in the nation’s capital. (U.S. Army photo by C. Todd Lopez). Access the full article at: http://www.army.mil/article/118716/ Women_leaders_serve_as_role_models__whether_they_realize_it_or_not/

Army Doctors Receive Surgeon General’s Recognition By Ann Bermudez Four Army Medical Corps officers were recognized by the Army surgeon general for their excellence in military medicine at the Medical Corps Consultants Training Symposium Dec. 3 in Falls Church, Va. • Col. Kevin Abbott received the Surgeon General’s Award for Military Academic Excellence (The Lewis Aspey Mologne Award). Abbott is the Nephrology fellowship Program Director. • The Surgeon General’s Physician Recognition Award was awarded to three physicians (one each to a Lieutenant Colonel, Major and Captain) who have made significant contributions to military medicine. • Lt. Col. Brian Krakover received the Surgeon General’s Physician Recognition Award for the rank of Lieutenant Colonel. Krakover is the program manager for the Flight Paramedic Training Program. • Maj. (P) Guyon Hill received the Surgeon General’s Physician Recognition Award for the rank of Major. Hill works in Brooke Army Medical Center’s Emergency Medicine. • Capt. (P) Robert Barnwell received the Surgeon General’s Physician Recognition Award for the rank of Captain. Barnwell is the Assistant Director of the Emergency Medicine Simulation Curriculum at San Antonio Military Medical Center.

DC Health & Fitness Expo Becomes a Test Marketing Exercise for the Performance Triad By Mike O’Toole, Army Medicine Public Affairs NBC4 in Washington, D.C., hosted its 21st Annual Health and Fitness Expo at the D.C. Convention Center in January. The venue provided Army Medicine an opportunity to share its Performance Triad messages regarding its 3 tenants: sleeping better, moving more throughout the day, and making better nutrition choices. Access the full article at: http://goo.gl/8dSmeO

Army Nurse selected for 2014 Winter Olympics The second leg of the Women’s Bobsled Team Trials and the Men’s 4-Man Bobsled Team Trials were held at Park City, Utah on Oct. 25-26, 2013. Army nurse 1st Lt. Kristi Koplin teamed with driver Berit Tomten and finished in 5th place in the Women’s Team Trials with a combined time of 1:42.16. Based on these and earlier results, Koplin was named to the Women’s National Team to compete in the 2014 Winter Olympics, Sochi, Russia, Feb. 7-23. Koplin is a member of the U.S. Army’s World Class Athlete Program (WCAP) that provides outstanding Soldier-athletes the support and training to compete and succeed in national and international competitions leading to Olympic and Paralympic Games. Follow the WCAP team’s road to Sochi at: facebook.com/ArmyWCAP

4 | ARMYMEDICINE.MIL TSG SPEAKS! Excerpts from TSG Remarks to the Women Mayors’ Caucus Meeting The Strength of Diversity in Any Forum, Jan. 22, 2014 Becoming a senior female leader by providing purpose, direction, and doesn’t happen overnight. It takes motivation, all while accomplishing a determination, confidence, and is shaped mission. by those you surround yourself with. Something great about that definition Role models, leaders, and mentors have of leadership is that it can apply broadly been a tremendous influence in my career to how we could define leaders, role development. models, and mentors in any forum, not I grew up in a military Family, born at just within the military. Fort Bragg in North Carolina. My father Although our military has become very was an Army officer who served in WW2, diverse, that diversity has not percolated Korea, and Vietnam. I grew up seeing to the top leadership yet. Serving in very few females in uniform; however, I uniform is not an easy pathway for did have military role models – my father anybody, but as I moved up in rank, there and my brother. were fewer and fewer female role models I decided to pursue a career in nursing, who had been in a similar position. which was primarily driven by my love of Lt. Gen. Patricia D. Horoho We all face other people’s perceptions medicine, healthcare, and working with of women in uniform, and women as people. But I was also limited in what the tremendous transformation our Army leaders or executives. Sometimes those options were available for females at that has made. perceptions include criticism – simply time. Being a part of an organization that based on the fact that you are a woman. The span of my 30-year career has seen can evolve, become more inclusive, I think what all of us in this room can changes that allowed me to serve in my more diverse – that instills within me an understand and relate to is the fact that role today. When I entered the Army, amazing sense of pride. for some, this criticism discourages. For women could not serve as commanders, Today’s Army is moving towards others, it ignites a passion and sense of let alone become general officers. The managing talents based on the skills, determination. beauty in what has happened during my knowledge, and attributes of a person There are many critics of women career has been watching the changes rather than focusing on their gender or serving in the military, especially given occur. previous jobs they may have held. The the recent changes concerning the role of women in combat. Something that should never be Something great about that definition of overshadowed by that criticism is leadership is that it can apply broadly to how we recognition of the fact that the global impact our military has made during the could define leaders, role models, and mentors in last 12 years of war could not have been any forum, not just within the military. achieved without strong and confident women. From that young female medic on the Female Engagement Team, to the When I was appointed to be the Army emphasis is on expectations and potential civil affairs officers, women in uniform surgeon general, I was the first nurse, and of whomever will fill that leadership have been an irreplaceable asset to our the first female, to serve in that leadership position – not by gender. nation. position. The Army defines leadership as a Serving to Heal…Honored to Serve. Placing a female leader into this process, not as a position. position during a time of war really shows Leadership is about influencing people

5 | ARMYMEDICINE.MIL AMEDD GLOBAL WRNMMC Receives Level II Trauma Center Verification By Walter Reed Public Affairs

On Dec. 18, Walter Reed National as a trauma surgeon for nearly 35 medicine, officials said. They added, it is Military Medical Center (WRNMMC) years, based on what I have learned also where the nation heals our heroes, was awarded a certificate verifying it through what you have just gone provides extraordinary experiences as a Level II Trauma Center, one of an through, becoming a certified trauma for patients, Families, and drives elite group of hospitals verified by the center, I think it’s probably the most tomorrow’s healthcare advances through American College of Surgeons. important thing we can do,” said Dr. education, innovation, and research. Only 155 U.S. medical centers across David B. Hoyt, ACS executive director, The American College of Surgeons, the nation have met the comprehensive at the presentation ceremony of the or ACS, Committee on Trauma and rigorous criteria required by ACS to verification plaque. conducted an intensive site visit and achieve this designation of excellence, It’s about commitment, Hoyt review in September 2013, evaluating officials said. said. He explained that it’s about all phases and areas of trauma care to “This verification as a Level II commitment to the standards of care, include the medical center’s emergency Trauma Center is yet another testimony measuring performance on a daily department, blood bank, intensive care to the superb care we here at Walter basis through data systems and other unit, operating rooms and rehabilitation Reed Bethesda provide every day for processes. facilities. Using the high standards those we are privileged to serve,” said Public assurance is developed by outlined in their “Resources for the Walter Reed Bethesda Director Brig. subjecting the hospital to external peer Optimal Care of the Injured Patient” Gen. Jeffrey B. Clark. review and by letting someone from the manual, the committee determined that Since 2001, Walter Reed Bethesda outside come in and take a look, Hoyt Walter Reed more than exceeded its has cared for more than 5,000 of said. He added that the plaque which requirements for verification. the nation’s service members as they will hang on the hospital wall really recovered from wounds of war. The represents that commitment and “is a staff embraced the patients’ Families model for healthcare going forward.” as members of an extended healthcare “This designation represents team and supported each other as the an enduring commitment to tempo surged, officials said. extraordinarily high standards. What Walter Reed’s staff commitment to the you have achieved is nothing short of highest standards of patient care, patient truly amazing,” said Assistant Secretary safety, performance improvement, of Defense for Health Affairs, Dr. medical education, research and Jonathan Woodson. teamwork provides outstanding Walter Reed’s American College trauma care for Wounded Warriors, of Surgeons verification as a Level II officials said. That’s why they sought Trauma Center reflects a one-team, to benchmark their processes against patient-centered approach involving national standards of care set forth by more than 60 departments and services world experts in trauma care. within the medical center, ranging from In researching the ACS criteria for audiology to nutrition to pastoral care trauma center verification and delivery to surgical specialties, officials said. They of care to the injured patient, officials explained the verification is a testament David B. Hoyt (left), executive director for the Amer- said they recognized that Walter Reed’s to a patient-centered, hospital-wide ican College of Surgeons, presents Cmdr. Carlos J. Rodriguez, chief of Trauma Surgery & Surgical well-established, multi-disciplinary, effort. Critical Care Division of Walter Reed National hospital-wide approach not only Walter Reed National Military Military Medical Center in Bethesda, Md., with a plaque, during a verification ceremony Dec. 18 at met, but in many cases exceeded, the Medical Center is the world’s largest the hospital. Walter Reed has now been verified rigorous criteria laid out by the ACS. joint military medical center and by the ACS as a Level II Trauma Center. Photo by “I took this job and have practiced is known as the flagship of military Sharon Renee Taylor

6 | ARMYMEDICINE.MIL AMEDD GLOBAL Army Restructures Warrior Transition Units By Warrior Transition Command Public Affairs

The United States Army announced currently provide outpatient care and Massachusetts, Puerto Rico, Utah and on Jan. 9 a restructuring of its warrior services for Army Reserve and National Virginia. The Puerto Rico CBWTU will transition units (WTUs) as the service Guard Soldiers who do not require become a community care detachment prepares for a scheduled withdrawal day-to-day care, allowing Soldiers to under the mission command of the Fort of troops from Afghanistan and a continue their recovery closer to home. Gordon Warrior Transition Battalion. continued decline in the number of Warrior transition units are located at WTUs slated for inactivation include: combat wounded. major military treatment facilities and Fort Irwin, Calif.; Fort Huachuca, Ariz.; According to Brig. Gen. David provide support to wounded, ill and Fort Jackson, S.C.; Joint Base McGuire- Bishop, commander, Warrior injured Soldiers who require at least Dix-Lakehurst, N.J.; and the United Transition Command and Assistant six months of rehabilitative care and States Military Academy, West Point, Surgeon General for Warrior Care and complex medical management. Under N.Y. Each location has fewer than 38 Transition, “These changes will improve community care, CBWTU Soldiers - Soldiers assigned to the WTU (as of the care and transition of Soldiers those healing at home - will be assigned Dec. 20, 2013). through increased standardization, to CCUs at WTUs located on Army Every attempt will be made to allow increased cadre to Soldier ratios, installations. Soldiers will not have to reserve component (RC) cadre to serve improved access to resources on move or change their care plans. out their tours. Active duty personnel installations, and reduced delays in care. Thirteen CCUs will stand up at assigned to units set for inactivation They are not related to budget cuts, the following Army installations: or force structure reductions will be sequestration or furloughs.” Fort Carson, Colo.; Joint Base Lewis- reassigned in accordance with current As part of the restructuring, the Army McChord, Wash.; Forts Hood and Bliss, Army Human Resources Command will inactivate five WTUs and establish Texas; Fort Riley, Kan.; Fort Knox, Ky.; policies. Civilian employees impacted more than a dozen community care Forts Benning, Stewart, and Gordon, by the force structure changes will be units (CCUs) across 11 installations Ga.; Fort Bragg, N.C.; and Fort Belvoir, reassigned based on their skill sets, by September 30, 2014. The transition Va. Forts Belvoir and Knox will each the needs of the Army, and available to CCUs will result in the inactivation have two CCUs. All nine CBWTUs are employment opportunities. of nine community-based warrior identified for inactivation: Alabama, transition units (CBWTUs), which Arkansas, California, Florida, Illinois,

Retired Army Spc. Luis Puertas, from Orlando, Fla., celebrates as he crosses the finish line first after completing the men’s 1500-meter race for above-the-knee single and double amputees during the 2013 Warrior Games at the U.S. Air Force Academy in Colorado Springs, Colo., May 14, 2013. (U.S. Army photo by Brent Powell)

7 | ARMYMEDICINE.MIL AMEDD GLOBAL Army Nurse Corps Celebrates 113th Anniversary By Col. Betsy Vane, Army Nurse Corps Historian February 2nd marks the 113th pride today. Army Medicine is, Serving their tradition of advancing nursing anniversary of the Army Nurse Corps. To Heal….Honored To Serve!” practice worldwide. They were involved Army nurses have stood shoulder Both men and women have served as in developing the concept of post- to shoulder with Soldiers, providing Army nurses since 1775; however, the operative recovery wards in Europe and care not only to them, but to Nurse Corps did not become part of the in providing airborne en route care from Sailors, Airmen, Marines and Coast Army Medical Department until 1901 combat zones in fixed-wing aircraft. Guardsmen, active duty and retired, and when the Army Reorganization Act was During America’s wars in Korea also to their Families. passed and became law. and Vietnam, Army nurses advanced The Corps was established February 2, The ANC has seen many changes their practice through trauma care 1901, and is the oldest military nursing in its first 113 years. The 1906 San specialization, including triage and corps in the United States and the Francisco earthquake sent Army resuscitative services. They also first women’s component in the armed nurses on their first of many civil relief supported helicopter ambulance forces. missions. When the U.S. entered World transportation from battle locations. Lt. Gen. Patricia D. Horoho, Army War I in 1917, the Army had 403 Today, nearly 40,000 individuals surgeon general and commanding nurses. represent the Triad of Army Nursing: general of the U.S. Army Medical By 1918, 21,460 Army nurses were Active Component, Reserve Command, in a recent message said, serving in base, evacuation, and mobile Component, and National Guard “Since 1901, Army nurses have surgical hospitals around the globe as officers, noncommissioned officers, provided responsive, innovative, and well as on hospital trains in France and enlisted and Civilians. evidenced-based nursing care to our transport ships carrying the wounded The ANC continues to be part of Soldiers, Families and Retirees. We across the Atlantic Ocean. every major conflict that the United extend our sincere gratitude to all This began nurses’ involvement in en States has taken part in and serves as members of the Army Nurse Corps route care of wounded Soldiers. a critical factor in the outcome of the (ANC) as they continue to promote By 1945, 57,000 Army nurses health of our service members and their health and wellness and to serve with were on active duty and continuing Families. February is American Heart Month Every journey begins with one step, is coronary heart disease (also called heart disease and stroke, costs the whether it’s climbing a mountain or coronary artery disease), which occurs United States $312.6 billion each year. preventing heart disease. This American when a substance called plaque builds This total includes the cost of healthcare Heart Month, the Centers for Disease up in the arteries that supply blood to services, medications, and lost Control (CDC) is offering weekly tips the heart. Coronary heart disease can productivity. These conditions are also for better heart health. Take your first cause heart attack, angina, heart failure, leading causes of disability, preventing step on the road to a healthy heart with and arrhythmias. Americans from working and enjoying us. Cardiovascular disease, including family activities. Heart disease is a major problem. The situation is alarming, but there is Every year, about 715,000 Americans good news—heart disease is preventable have a heart attack. About 600,000 and controllable. We can start by taking people die from heart disease in the small steps every day to bring our United States each year—that’s 1 out loved ones and ourselves closer to heart of every 4 deaths. Heart disease is the health. CDC is providing a tip a day leading cause of death for both men and throughout February, but you can take women. these small steps all year long. The term “heart disease” refers to For more information visit, http:// several types of heart conditions. The www.cdc.gov/Features/HeartMonth/ most common type in the United States

8 | ARMYMEDICINE.MIL AMEDD GLOBAL FEATURE Army Medicine’s Workforce 2020 Project: Caring for People While Managing Change By Valecia L. Dunbar, D.M., Army Medicine Public Affairs

The Workforce 2020 Project is an project team, led by project lead Debra recommend processes needed to enterprise-wide initiative chartered Caraway, is comprised of representatives support future workforce decisions. The Nov. 20 by the MEDCOM Chief of from MEDCOM Human Resources, impending financial constraints will Staff to identify and develop process Resource Management, Manpower, require force reductions throughout improvements to inform workforce Civilian Corps, and other key staff. the Armed Forces, and will generate restructuring decisions. WF 2020 key “In our current fiscal environment, reductions to MEDCOM. Additionally, outcomes include realigning workforce building more facilities and hiring multiple MHS studies, including with enduring missions, implementing more people is not tenable,” says Lt. the Modernization Study, Median business rules to assess change, and Gen. Patricia Horoho, Army surgeon Analysis of Mid-Sized Hospitals establishing processes and plans to general and commanding general U.S. Study, and Small Hospital Study, will shape the future force while minimizing Army Medical Command. “Instead, we inform the development of personnel adverse impacts to our valuable need to innovate; we need to use our management approaches that assist the MEDCOM employees existing resources and know-how to WF 2020 project team in developing The WF 2020 Project is part of a create value for our beneficiaries and the and standardizing processes to assist broader transformation to meet current Army. To transform from the traditional MEDCOM commanders in making and future mission requirements. healthcare system, we must refine our personnel decisions. “Our Nation has been at war over abilities and increase our reach.” Internal Forces: the last 12 years. With both conflicts Many questions surround the exact The implementation of new services coming to an end, the restructure of a nature and impact of the WF 2020 and capabilities coupled with current smaller, more agile Army, and changes Project. The fiscal and strategic nature force structure “initiatives” requires in the Military Health System, we of the current environment dictates that that we align our requirements, must appropriately assess and align “MEDCOM must change to survive,” authorizations, and funding, as well as the MEDCOM workforce to ensure says Klug. “The mission of Army provide the tools to enable commanders the right capabilities exist in the right Medicine is transforming. We can wait to identify future changes to missions/ locations across Army Medicine,” says for change to happen, or we can drive services (enduring, temporary, or non- Ric Fiore, MEDCOM chief of staff and the change to maintain relevancy and enduring) and align the workforce to project champion. value into the future. Our current and those enduring missions in order to To address changes driven by future state is simply not resourced as it retain our valued personnel. The intent multiple internal and external has been in the past.” is to provide options for employees in forces, Army Medicine is charting Although Klug readily admits that temporary or non-enduring missions/ a course that supports the strategic much is still uncertain, there is one services to move to enduring positions. reset of the Army. The AMEDD thing that is certain. “I can tell you Options include training to qualify Transformation Directorate (ATD) now, it’s really about the people,” says for an enduring position; permanent Program Management Office (PMO) Klug. “People are our most important change of duty station (PCS) to another is leading MEDCOM’s WF 2020 asset; they add the real value to this location where their valuable skill set project. Carey Klug, ATD director organization.” is needed in an enduring position; and and WF 2020 project sponsor, is External Forces: possibly other alternatives all focused tasked with developing the processes The DOD, Military Health System to minimize adverse impacts, on the to support force structure decisions (MHS), Defense Health Agency, and organization and our people, such as a that align workforce with future others influence how the WF 2020 Reduction in Force. mission requirements. The WF 2020 Project work group will identify and

9 | ARMYMEDICINE.MIL AMEDD GLOBAL FEATURE

Managing Change reshape. If we manage vacancies well, surgeon general’s vision to move Army “For the foreseeable future, we can minimize impacts.” Medicine to an Operating Company MEDCOM will be continually affected The transformation process is guided built around a System For Health. by multiple studies and resource by two key questions says Klug. “How ATD’s role is to deliver the technical and decisions that will drive change in our do we set ourselves up for success in the functional capabilities that will assist workforce structure, our facilities, and future? How do we respond to change leaders in communicating the Operating our services,” says Fiore. “There will while ensuring the workforce is aligned Company principles of consistency, be changes or reductions in the services with mission requirements?” clarity, and accountability when faced we provide to our beneficiaries at some Keeping people informed and aware with difficult workforce decisions and locations. There will be reductions in of the project is an important part of ensuing personnel actions. our military personnel and there will be the PMO’s directive. The WF 2020 “It comes down to one key point,” reductions in our Civilian personnel. work group is committed to leveraging says Klug. “We must take care of The key is to manage these changes in the multiple communication platforms the Soldiers, Civilians, and Families a way that minimizes the impact on within Army Medicine to provide entrusted to our care. And, our people our people. We can do this if we are updates as the project progresses. provide that care. Our future will deliberate in our hiring processes. We Leaders are looking at a culture be what we make of it and how we experience 6-8% attrition every year. change in the Army. The end state influence that is the biggest challenge we Every vacancy is an opportunity to for Army Medicine is to achieve the all face.”

National Children’s Dental Health Month Each February, the American Dental Association (ADA) sponsors National Children’s Dental Health Month (NCDHM) to raise awareness about the importance of oral health. NCDHM messages and materials have reached millions of people in communities across the country. Developing good habits at an early age and scheduling regular dental visits helps children get a good start on a lifetime of healthy teeth and gums. Whether you’re a member of the dental team, a teacher or a parent, the ADA has free online resources that can help you with oral health presentations, ideas for the classroom and coloring and activity sheets that can be used as handouts. We also have booklets, videos and other materials available for purchase through our ADA Catalog. To download the poster and planning guide visit, http://www.ada.org/5578.aspx

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©2013 American Dental Association. All Rights Reserved. AMEDD GLOBAL DOD Changing the Face of Modern Medicine – Walter Reed, MRMC the Gateway for Face Transplant Research By Dana Crudo, Health.mil The Defense Department’s unrivaled transplants could potentially solve even Veteran Mitch Hunter, who sustained investment in face transplant research bigger medical problems. facial damage from electrical wire, and has produced extraordinary results that “We are onto something that is Charla Nash, whose face and hands were have the potential to transform modern remarkably interesting, remarkably novel mauled by a chimpanzee. He completed medicine. and truly cutting edge,” Pomahac said. a fifth face transplant earlier this year Nearly a decade ago, the Defense Just 24 face transplant surgeries have on Carmen Tarleton, who was severely Department began collaborating with been performed worldwide, with seven burned after an attack by her estranged civilian clinics to research and advance occurring in the United States, primarily husband. face transplant surgery to eventually on civilian patients. Pomahac said that all of his patients help service members with devastating The U.S. surgeries, largely funded have done “remarkably well” and have combat injuries from fighting in Iraq by the Defense Department, were experienced “a lot of positive social and Afghanistan. performed at Cleveland Clinic in Ohio, outcomes.” These include reconnecting “We want to get them as close to how Brigham and Women’s Hospital, and the with family, getting married and they were before they got injured,” said University of Maryland Medical Center pursuing new hobbies that integrate Dr. Michael Given, program officer in Baltimore, Md. them back into society. at the Office of Naval Research in “None of this would have been While the first facial surgery Arlington, Va. possible without the vision and Pomahac performed was covered by Face transplant surgery, first leadership of the Defense Department,” the hospital, the last four surgeries at performed in France in 2005, offers a Pomahac said. “The military has $250,000 apiece have been paid for promising solution. The surgery goes absolutely played a critical role. “There by a $3.4 million grant from AFIRM. far beyond the traditional techniques are no other [funding] sources available The Biomedical Translational Initiative of facial reconstruction. The entire face for clinical research on face transplant provided funding to support the of a deceased donor -- skin, muscle, fat, surgery other than them.” hospital’s research efforts. The hospital nerves, blood vessels, bone and even In 2008, the Cleveland Clinic has received additional funding from the teeth -- is removed and then used to performed the largest and most institute for six more surgeries. restore the patient’s disfigured face. complex face transplant at the time, Three patients have already been The difference in patients before and replacing 80 percent of a woman’s chosen but are on a waiting list for after the surgery is vastly different, said face. The Armed Forces Institute of suitable donors. Dr. Bohdan Pomahac, who has led five Regenerative Medicine funded the 22- The Defense Department intends to face transplant surgeries at Brigham hour procedure. AFIRM is managed and continue funding immunosuppression and Women’s Hospital in Boston, funded through the U.S. Army Medical research and collaborating with civilian Mass. With these surgeries, doctors Research and Materiel Command medical centers to perform more face can “replace the central part of the face (MRMC) with additional funding from transplant surgeries. in one operation to an extent I could other military research branches, and “We want to keep making gains and never dream about,” he said. “Patients public and private funds. The clinic take care of injured folks who do not who had no solution before now have continues to receive funding from the have real good conventional options,” something.” institute and is currently evaluating Martin said. “We are actively involved “The face is the mirror to our souls, potential candidates for the surgery. in research and science that will help out not only because we show expressions The Brigham and Women’s Hospital not only injured service members, but on our face … but also because most has completed the lion’s share of face other folks who are victims of trauma.” of our senses are harbored in the facial transplant surgeries, with Pomahac Service members interested in face area,” he added. “I always say these are leading the first partial face transplant transplant surgery should contact Walter not life-saving, but life-giving surgeries.” in 2009 on Jim Maki, who had suffered Reed National Military Medical Center Successful face transplant operations electrical burns on his face. Pomahac to get evaluated as potential candidates. are only the beginning for what the also performed the first three full face Inactive duty and retired service Defense Department officials and their transplants in the United States in members are also encouraged to call. civilian counterparts hope to achieve. 2011. The patients were Dallas Wiens, Their continued research into face who lost his face in an accident, Army

11 | ARMYMEDICINE.MIL Patient Recognition Month “Partners in Health” National Patient Recognition Week Soldiers and other beneficiaries; reaffirm while continuing to create a System is celebrated the first week of February that we appreciate their sacrifices and For Health built on a foundation of each year with Feb 3. 2014 being contributions, and emphasize that we trust. We make the biggest impact on National Patient Recognition Day. care about their overall well-being by health by helping beneficiaries make While the entire month of February has helping them impact their Lifespace to better choices and getting quality sleep, been designated as Patient Recognition improve their health. Army Medicine engaging in activity, and improving Month by Army Medicine, we value our is committed to synchronizing nutrition. patients throughout the year. The intent our military healthcare efforts and is to reinforce our partnership with our redefining the patient care experience

Specialist Corps’ Optimization of the Performance Triad: From Garrison to the Battlefield By Lt. Col. Robert D. Montz, Medical Readiness Officer, FORSCOM Surgeons Office

The global shift in healthcare towards strides in these areas with a multifaceted order to maximize the overall operational prevention and the physical, mental, approach to readiness and human readiness of the unit. This knowledge and emotional demands placed on performance optimization that includes will allow the SP Corps to begin to Soldiers emphasize the critical need to injury prevention, nutrition, and mental change the mindset and mentality of the focus on performance, wellness, and the fitness. The Performance Triad’s intent Soldier and in turn, meet the surgeon health of the force. With the myriad of is to optimize the quality of life of general’s intent of the Performance humanitarian, disaster relief, and combat Soldiers and Families and to ensure a fit Triad. There is no other Corps in the deployments, how Soldiers eat, sleep, and ready force. The Performance Triad military better suited to implement these and remain active significantly impact is a comprehensive, multidisciplinary initiatives than the SP Corps. the overall readiness and capability of team approach that ultimately leads to our Army. The Army Medical Specialist enhancing the readiness and resilience of Corps (AMSC) or the SP Corps has our armed forces. The SP Corps is built optimized this capability during the last to spearhead, facilitate, and lead this 12 years of war and are key contributors initiative. to the Army surgeon general’s The SP Corps will ensure premium Performance Triad which is an Army healthcare is being delivered in a timely initiative aimed at optimizing Sleep, and efficient manner in the areas of Activity, and Nutrition. resilience, human performance, nutrition, The SP Corps, consisting of and sleep. With physical therapists occupational therapists, physical and physician assistants assigned at the therapists, dietitians, and physician unit level, they better understand and assistants, are perfectly situated to address appreciate the environment in which the these skills during all phases of the Soldier operates. This understanding Sgt. 1st Class AC Bryant III coaching Sgt. 1st Class Frederick McDuffy, the second place winner of the Army Force Generation (ARFORGEN) enables the SP Corps to better leverage Performance Triad Nutrition Challenge. cycle. The SP Corps is currently making the medical system to serve each unit in

12 | ARMYMEDICINE.MIL Fit To Win: Your Free Pentagon Wellness Program In the middle of the DiLorenzo recognize and manage potential health offers a Running Gait assessment that TRICARE Health Clinic (DTHC) issues, and achieve a healthy weight. assists with finding the right running in the Pentagon lays a gold mine of Tobacco Cessation – It’s not a secret shoe based on the results from tests that information and activities aimed at that a smoke- and tobacco-free life is a measure your gait, biomechanics and assisting Pentagon employees in living a healthier life. The three-part Tobacco weight. healthier life. Cessation class, “Quit to Win” will arm Nutrition – Eating is a necessity of The Fit To Win Wellness Clinic, you with the tools you need to quit life. Learn how to do it right. Fit To established back in the late 1980s to for life. Active duty service members Win offers several classes on how to fuel operationally implement the Army’s will also get the opportunity to meet your body to maximize its efficiency, health promotion regulation, over with a provider to discuss prescription plan and cook a healthy meal for you the years, courses have been added assistance for quitting tobacco. Visit and your family, and manage weight. and altered to adapt to the military’s the DTHC website for monthly class Visit the DTHC website for monthly progressing wellness programs. These schedules. class schedules at: dthc.capmed.mil. courses include Healthy Base Initiative, Exercise – Fit To Win offers an array Operation Live Well, and the Army of tests to ensure you are functioning at Kim Markee, a dietitian and nutritionist at surgeon general’s Performance Triad. your best when you exercise including the Fit to Win clinic located at the DiLorenzo Nutrition and exercise are the Aerobic Capacity testing, Lactate TRICARE Health Clinic at the Pentagon foundations of this health promotion testing, Corrective Exercise screening, teaches a nutrition class. Fit To Win offers program and Fit To Win offers several Ultrasound Bone Density testing, several classes that help people understand how classes and activities that will help and Body Composition testing using to fuel their body the right way. Class schedules participants enhance their fitness the Bod Pod which will measure your can be found online at www.dthc.capmed. levels, quit smoking and using tobacco, weight and body fat. Fit To Win also mil. Elective Care vs. Non-Covered Care By Katherine Rosario, Lyster Army Health Clinic Public Affairs

Lyster Army Health Clinic refers patients out to Tricare- The rules are a little different for active duty Soldiers. approved network providers when specialty care not offered Soldiers referred to a network provider who wants to perform at the clinic is needed. It is important for patients to receive a additional care for the Soldier must see their Primary Care referral and only obtain the care detailed in the referral notes Manager (PCM) before accepting additional care. Only their to avoid extra charges not covered by the referral. PCM is authorized to submit a new referral for additional The specified care must also be received before the referral care. expiration date. Additional care offered by the network Patients are responsible for checking their www. provider must first be approved through Tricare before tricareonline.com account to view all approved and scheduling an appointment. disapproved referrals submitted on their behalf. They may also Communication is the key to knowing if additional care call their PCM, Managed Care, see a Tricare representative recommended by the network provider is approved by Tricare. at the Tricare Service Center or call the Tricare toll-free line The network provider is responsible for contacting Tricare for (1-800-444-5445) to confirm approved referrals. Contacting approval of additional care not noted on the original referral. TRICARE or Managed Care is also how patients can resolve

13 | ARMYMEDICINE.MIL cases where a bill is received that with Tricare themselves can alleviate the illness are also excluded. should have been paid or otherwise financial burden of an unexpected bill.” The Tricare Service Center inside covered. Non-covered care is care that Tricare LAHC has booklets available for Patients who receive additional care will not authorize, pay for, or reimburse. patients interested in finding out which without approval will be billed for the Services received electively, such as services may be obtained without a total cost of the additional care received. cosmetic surgery, and any complications referral. Some clinical preventative “Patients often have a procedure or arising months or years after the surgery services and mental healthcare services additional care only to find out later that needing medical attention will not be for Family members and retirees do not it has been denied either because it is a covered by Tricare unless it is considered require a referral. non-covered procedure or the provider life threatening. For a full list of what services do not did not provide enough information Tricare does not reimburse for need a referral visit, http://www.tricare. to Tricare and it wasn’t approved,” unproven drugs, devices, or medical mil/CoveredServices/SeeWhatsCovered/ said Sharon Jones, healthcare system treatments and procedures. Services PreventiveServices.aspx. Coverage and manager at LAHC’s Tricare Service and supplies that are not medically out-of-pocket costs may vary based Center. “Making sure their network or psychologically necessary for the on who you are and your health plan provider receives approval or checking diagnosis or treatment of a covered option. The Changing Environment of YOUR Healthcare By MEDCOM Office of Evidence-Based Management When it comes to your healthcare, General, Lt. Gen. Patricia Horoho varied from place to place. In an effort who is the most important decision announced that Army Medicine would to change this and make care more maker? If you said “I am” you are move from a Healthcare System to a consistent, there are now 24 CPGs exactly right! Your health is greatly System For Health. The goal is to help available to help your provider know influenced by where you live, work YOU improve YOUR health! what the research indicates is the best and play – your Lifespace - and what To better serve you as a patient, care for a particular condition or disease. you do when you are in each of those healthcare team members need to use There are also specific materials for your places. Healthcare team members available tools and provide services provider to give you so that you and appreciate that while you look to wisely. Some of those tools include the your Family are better prepared to live the Military Health System (MHS) VA/DOD Clinical Practice Guidelines with the specific condition or disease for appointments, prescriptions, (CPGs). Developed by subject matter covered in the CPG. Of course the treatments, and health education, the experts from the Army, Air Force, Navy care recommended in the CPG can be decisions YOU make impact YOUR and Veterans Health Administration, modified by the provider based on their health. Healthcare providers and staff the CPGs address the unique needs assessment and your wishes. Remember, are important members of your team of the military population. They YOU are an important member of but you are at the center of that team. translate research findings into everyday YOUR healthcare team. You determine the key decisions and applications for the healthcare team. A System for Health means that we the steps you will follow every day. In Historically, when one moved from one recognize that you need a healthcare appreciation of your involvement in installation to another, or as service system that is receptive to your needs. your health outcomes, Army Surgeon members transitioned to the VA, care For many in the healthcare system

14 | ARMYMEDICINE.MIL this means a change in our role and overeating, not getting enough sleep Medical Homes are now open in relationship with you. Healthcare team or being sedentary. Become actively many locations. Additionally, most members need to provide care differently involved in your care! Ask questions! Be installations have services available in than in the past. We will encourage and informed! Work with your healthcare the unit setting where Soldiers work. empower every Active Duty Service provider to let them know what YOUR Innovative programs available to help Member (ADSM) to optimize their own goals are and what you see as barriers to you “closer to home” include Relay health and ask questions if they have any improving your health. Your healthcare Health. Relay Health, Army Medicine’s concerns so that they are able to perform team is available to help you in these Secure Messaging Service (AMSMS), at their peak. The same holds true for and other areas, regardless of your allows you to communicate with your Retirees and Family members so that current health status. healthcare team electronically. You they can enjoy the best health possible. Across the Department of Defense can use it to request medication refills, It is recognized that sleep, activity, and there have been a variety of programs ask health related questions, get lab nutrition play an important role in and services implemented to help results, and more. Inquire as to how your health. Management of these three you live healthier. There are new you can sign up for it at your next life activities is a means to optimize wellness programs available in the clinic visit. While you are there, ask for health and performance. In order to military treatment facilities and more information about how you may improve your health, it is important across military installations. Most become involved as an active member that you are proactive in identifying of the clinics now have embraced in YOUR healthcare! Also visit: www. and modifying unhealthy behaviors, the Patient Centered Medical Home armymedicine.mil. such as tobacco use, alcohol abuse and model – which is focused on you misuse of medications, not to mention and your Family. Community Based

Members of the MEDCOM Office of Evidence-Based Practice (Front row, L to R) Marjory Waterman, CPG and medical management consultant; Ernest Degenhardt, chief, EBP; and Corinne Devlin, chronic disease consultant. (Back row, L-R) Bob Galarpe, warehouse manager; Jose Gracia, IT specialist; Dr. James Sall, chronic disease consultant; and Culver Washington, administrative officer. Not photographed Evelyn Patterson, population health consultant. (U.S. Army photo by Valecia L. Dunbar)

15 | ARMYMEDICINE.MIL TRICARE Ends Walk-in Admin Services at 189 Facilities By Jim Garamone, American Forces Press Service

TRICARE military health plan service million over the next five years, allowing center can handle the expected increase centers will end administrative walk-in TRICARE to invest in more important in volume. services in the United States on April 1, services.” The TRICARE service centers have Pentagon officials say. Fifty percent of the visits to the been around since the 1990s, and While the 189 facilities will stop centers are for in- and out-processing contractors staff them, Warren said. taking walk-ins, beneficiaries can and requests to change primary care “This is being driven by the fact that accomplish any administrative task providers, and the rest involve billing- technology has gotten so much better,” online or by phone, said Pentagon related questions, officials said. The he added. Customers who need the type spokesman Army Col. Steve Warren. Defense Department spends roughly of assistance that was being done in TRICARE service centers overseas are $50 million a year on these services, these walk-in service centers can quickly not affected, Warren said. and this type of customer service can be and efficiently receive help online or via “The change will not – let me repeat handled more efficiently by phone or phone, he said. that – will not affect any TRICARE online, they added. Beneficiaries can get more information medical benefit or healthcare service,” TRICARE gets about 38,000 hits and sign up for updates at http://www. he emphasized. “What it will do is per day on its website. Officials have tricare.mil/tsc. allow the department to save $250 run tests to ensure the website and call CONNECT WITH ARMY MEDICINE

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16 | ARMYMEDICINE.MIL SYSTEM FOR HEALTH.

Academy of Health Sciences Graduate School 3rd Annual Research Day By Phil Reidinger & Esther Garcia, AMEDDC&S Communication Office For the first time, military and civilian researchers (and graduate students) within central and southern Texas gathered at the Army Medical Department Center and School on Dec. 11 for the Academy of Health Sciences Graduate School, 3rd Annual Research Day to share healthcare research findings and build new collaborations. Civilian academic organizations participating in this one-day event included the University of Texas at San Antonio; University of Texas Health Science Center at San Antonio (UTHSCSA); University of Texas School of Public Health; University of the Incarnate Word; St. Mary’s University; Texas State University; research collaborations, conducting Overweight and Obese Soldiers. The Texas A&M University; and Baylor interprofessional education and research, Effects of Epinephrine and Vasopressin University. and other key research topics of on Survival from Cardiac Arrest Research day began with event interest. Following Desipramine Overdose in registration and remarks by Col. Military and civilian researchers a Porcine Model presented by Don Josef Moore, dean, AHS Graduate presented a total of 26 posters that Johnson, director, AHS Graduate School School, and Maj. Gen. Steve Jones, covered subjects such as: A Direct Program, director of research won for commanding general, Army Medical Observational Study Evaluating Best Poster Presentation. Department Center and School followed Prehospital Medical Documentation Development of a Traumatic Brain by keynote speaker, Col. Russ Kotwal, of a Simulated Combat Casualty by Injury Assessment Score using Novel director, Trauma Care Delivery, Joint Military Medical Providers; Effects Biomarkers Discovered Through Trauma System, U.S. Army Institute of of Tetrahydropalmatine on PTSD- Profiling presented by Maj. John Surgical Research. induced Changes in Rat Brain Gene Buonora, Emergency Medicine, received Participants then attended several Expression; The Application of the Best Platform presentation award. break-out sessions. Presenters from Moral Hazard in Healthcare: Gaps Dr. Leslie LaRo Hayes, Marriage and the Air Force, St. Mary’s University, in Moderating Variables and Relative Family Therapist, St. Mary’s University, Texas State University, UTHSCSA, Benefits; Relationship between Time said, “I am very excited to be here. I was and University of the Incarnate Word of Day Tested and Lumbar Spine able to see the medical side and hear the covered topics on forming effective Strength and Endurance; and Prevalence different views and conversations of the military and civilian academic of Abnormal Serum Lipids Among various topics.”

17 | ARMYMEDICINE.MIL SYSTEM FOR HEALTH.

Defense Secretary Chuck Hagel Defense Secretary Chuck Hagel conducts a town hall meeting at the Center for the Intrepid Jan. 8. During his first official visit to Brooke Army Medical Center, Hagel visited with wounded service members, presented coins to outstanding staff members and spoke at a town hall meeting at the CFI. (U.S. Army photo by Robert Shields)

Gen. Campbell Presents Coin Vice Chief of Staff of the Army Gen. John F. Campbell, who is the second highest- ranking officer within the Department of the Army, presents a coin to Army Sgt. Joshua Hargis during a visit to Brooke Army Medical Center’s Center for the Intrepid Jan. 3. Campbell’s visit also included a leadership forum, bedside Purple Heart medal presentations, visits with several Wounded Warriors in the medical center and recognition of several outstanding BAMC staff with coins. (U.S. Army photo by Robert Shields)

Gifted Students from Barsanti Elementary School visit Blanchfield Army Community Hospital

Gifted students from Barsanti Elementary School listen to Blanchfield Army Community Hospital’s Laboratory Manager Maj. Anne Sterling at Fort Campbell, Ky. as she explains the many ways lab staff members help medical providers diagnose and treat patients. (U.S. Army photo by Laura Boyd)

Blanchfield Army Community Hospital’s blood bank technician Warren Myers shows gifted students from Barsanti Elementary School how blood is matched from donors to recipients at Fort Campbell, Ky. Gifted Resource Program teacher Sylvia Crawford brought the gifted students to BACH’s laboratory to help the children gain a hands-on learning experience to bolster their education outside the classroom setting. (U.S. Army photo by Laura Boyd)

18 | ARMYMEDICINE.MIL AMEDDC&S U.S. ARMY MEDICAL DEPARTMENT CENTER & SCHOOL Public Health Educational Affiliation between Texas A&M School of Rural Public Health and Academy of Health Sciences at the US Army Medical Department Center and School By Maj. Rosemary Wosky, AMEDDC&S

Due to the changing nature and While the Army training is challenges our military personnel are tailored to military populations, the facing related to public health around collaboration and affiliation with the the world, the U.S. Army Medical Texas A&M School of Public Health Department Center and School lays a foundation of core public health (AMEDDC&S) has developed a knowledge that may be translated collaborative educational public health into any setting. Military students affiliation with Texas A&M School of continue to earn graduate-level credit Rural Public Health. For the past five hours toward completion of a Master years, the Texas A&M Health Science of Public Health (M.P.H.) degree. Center, School of Rural Public Health Students learn the latest in core public has worked with the Department of health skills, including health policy endeavors with a major health-related Preventive Health Services at Fort Sam and management, epidemiology academic and research institution,” Houston to develop an educational and biostatistics, environmental and states Antonio Rene, Sr. associate affiliation that awards graduate degree occupational health, industrial hygiene, academic affairs dean at the Texas credits to selected Department of health promotion, community health, A&M School of Rural Public Health. the Army Officers and Civilians for a preventive medicine, and public health “The collaboration of Army, Navy and Military Preventive Medicine Program sciences. Air Force medical training centers of Instruction. The program, funded “The affiliation of the School of Rural at the AMEDDC&S as part of the by the Department of Defense, was Public Health and the AMEDDC&S military’s Joint Medical Training renewed recently for an additional five represents a collaborative vision that Center will also serve to strengthen the years through 2018. provides the Army with an accredited relationship with the School of Rural Based at Fort Sam Houston in San public health professions curriculum Public Health.” Antonio, Texas, the AMEDDC&S and an opportunity for joint research provides all public health and preventive medicine training to the U.S. Army. This continuing agreement with the Texas A&M School of Rural Public Health allows military students to earn 12 graduate-level college credits after completing the Principles of Military Preventive Medicine Course in the Department of Preventive Health Services. “This has been an outstanding program and we have developed a great relationship with the School of Rural Public Health over the past five years,” states Col. Mustapha Debboun, director of the Department of Preventive Health Services at Fort Sam Houston. “It is our hope that this program will continue for a long time.”

19 | ARMYMEDICINE.MIL ASBP ARMED SERVICES BLOOD PROGRAM Cross Training to Save Lives By Erin Longacre, ASBP Blood Donor Recruiter, Fort Gordon, Ga. There are many critical steps involved and to military medical facilities continued. “We need to have every in collecting blood products and — most notably, the Dwight D. available option in an emergency getting them to patients in need. Eisenhower Army Medical Center situation. Taking away factors like Each part of the process requires that which is just a few minutes away. The distance, traffic, and possible post gate dedicated professionals be trained and Eisenhower Army Medical Center’s closures could make a big difference if ready at a moment’s notice. When an blood bank maintains a supply on hand time is of the essence.” emergency arises, staff must be able to at all times, but occasionally a patient In addition to providing immediate respond quickly to the need. who is actively bleeding can exhaust support for ill or injured patients, the The Kendrick Memorial Blood that supply. Kendrick Memorial Blood Center must Center at Fort Gordon, Ga., like other Rozita Hunter, a medical laboratory be prepared to respond to an event like Armed Services Blood Program’s blood technician who regularly acts as a a disaster, disease outbreak or mass donor centers, takes great care and member of the collection team as casualty. pride in ensuring that team members well as working in the lot release and “The more staff members (who) be trained to work in multiple areas shipping section, was recently training are proficient in every area of our in support of collecting blood for our two Soldiers and helping them become operations, the better prepared we service members and their Families. more familiar with the process so that will be in the event of any kind of Staff members are proficient in they can be on-call for emergencies. emergency,” said Sgt. Miguel Cruz, doing everything from registering “Often we need to ship blood noncommissioned officer-in-charge of donors’ demographic information products over to the hospital quickly, component processing. in the computer system, to checking sometimes in the middle of the night Cruz, who has been mobilized in donors’ vital signs, to performing the or on a weekend,” Hunter said. “When support of the Armed Services Blood phlebotomy procedure. the call comes, Kendrick personnel Program since 2010 at both Fort However, the process of getting need to get to the donor center as soon Gordon and at the Landstuhl Regional volunteer blood donors in the door and as possible to get the required products Medical Center in Germany, has seen successfully collecting their blood is from the refrigerators, prepare them plenty of emergency situations arise. just the tip of the iceberg. properly for shipment, and update the “Our mission never stops,” Cruz said. After a unit of blood is donated, computer tracking system to maintain “That’s why we need to be available at a it must be tested, processed into accountability for every unit. moment’s notice, 24 hours a day, seven components, and properly labeled and “Having someone on-call who lives days a week.” shipped. Several layers of review are on post is key, because in an emergency Want to help keep blood supplies required to ensure that the donation they could be here in five minutes available for those in need? You can information, quality control measures, instead of thirty, for example,” Hunter help ensure preparedness by giving and blood testing results are accurately blood, plasma, or platelets at your local recorded. Once everything is verified ASBP center! to be safe and correct — a process To find out more about the Armed commonly called “lot release” — the Services Blood Program or to schedule staff can then start the unit on its way an appointment, please visit us online: to its destination. www.militaryblood.dod.mil. To Staff members at the Kendrick interact directly with some of our staff, Memorial Blood Center are taking see more photos or to get the latest more steps than ever towards quality news, visit us here: www.facebook. care for those who need blood products com/militaryblood, www.flickr.com/ fast by increasing cross-training in militaryblood and www.twitter.com/ packing and shipping blood. Their Medical Laboratory Technician Rozita Hunter trains militaryblood. Spc. Francis Koroma on the preparation and ship- normal operations include sending ment of blood products at Fort Gordon’s Kendrick blood downrange several times weekly, Memorial Blood Center.

20 | ARMYMEDICINE.MIL MRMC U.S. ARMY MEDICAL RESEARCH AND MATERIEL COMMAND New Bed Net Scores High Marks Against Mosquitoes By Merrie Aiken, Senior Technical Writer, USAMMDA Medical Support Systems Project Management Office A long-lasting dual insecticide- Systems, Inc., under the Army’s Small that conducted the tests following impregnated bed net developed by Business Innovation Research Program, Environmental Protection Agency- the U.S. Army Medical Materiel and collaborated with Walter Reed approved protocols. Development Activity’s Medical Army Institute of Research to develop “The working prototype introduced Support Systems Project Management the treated bed net prototype, known a dual impregnation of deltamethrin Office (MSSPMO) at Fort Detrick, as Egret. and permethrin,” said Alan Harner, Md., scored high marks in effectiveness When testing concluded, a computer MSS PMO product manager. Harner during recent chamber testing with program calculated the percent of explained that various mosquito uninfected mosquitoes. three types of knocked down and species show resistance to permethrin Results showed that mosquitoes will dead mosquitoes exposed to the dual alone, potentially endangering Soldiers not survive exposure to the treated bed insecticide-treated bed net and an deployed in endemic regions such as net fabric, thereby reducing Soldiers’ untreated control bed net over time. Korea and Afghanistan. exposure to diseases such as malaria, “The Egret treated bed net passed “There is a critical need for the dual Japanese encephalitis, and dengue and all requirements,” said Robin Todd, insecticide-impregnated bed nets in yellow fever viruses. executive director of i2L Research, Korea,” said Steve Hawbecker, MSS MSS PMO worked with Triton the Baltimore-area laboratory PMO project manager, “because of mosquito-borne malaria in the demilitarized zone and Japanese Encephalitis in southern regions.” Hawbecker said that more than 28,000 U.S. military are stationed in South Korea. Because of the dual insecticides used, the bed net must meet all the requirements for EPA registration. Arjan Giaya, vice president of technology for Triton Systems, Inc., suggested that there may be other uses for insecticide-treated fabric, once EPA registration is achieved. The next step is approval by the Armed Forces Pest Management Board to receive a National Stock Number, or NSN. Having an NSN means the Department of Defense may procure bed nets for deployed forces. The Egret bed net is simple in design, weighs little more than 3 pounds, allows the user to sit up on a standard or oversized cot, and provides better ventilation using a larger mesh size. The bed net would be carried in a small A Soldier demonstrates a dual insecticide-impregnated bed net prototype. (Photo courtesy of USAMMDA PAO) pouch attached to a Soldier’s backpack.

21 | ARMYMEDICINE.MIL PRMC PACIFIC REGIONAL MEDICAL COMMAND Pacific Regional Medical Command (PRMC) NCO Induction, SAMC Award Recognition Ceremony By Staff Sgt. Maurice Riggins, Tripler Orthopedic Clinic NCOIC

On November 14, 2013, Command Sgt. Maj. Robert Luciano, (far left), Sgt. 1st Class Susanna Kitchen, (center) and Col. Jennifer Bedick (far right, welcome Sgt. 1st Class Kitchen into the ranks of the prestigious Sergeant Audie Muprhy Club. Sgt. 1st Class Kitchen was recognized for her outstanding leadership ability and her testament of continued growth as a leader. Tripler Army Medical Center also inducted thirteen newly promoted Sergeants into the time honored United States Army, Noncommissioned Officer Corps. Induction into the noncommissioned officer corps is a long lived tradition that instills pride and distinction. Those inducted have proven through their performance that they are prepared to take on the increased responsibility and know that learning is (U.S. Army photo by Capt. Eren McBride) part of leading.

22 | ARMYMEDICINE.MIL SRMC SOUTHERN REGIONAL MEDICAL COMMAND Wounded Troops Rev Up to Restore Cars, Lives By Elaine Sanchez, Brooke Army Medical Center Public Affairs

Army Veterans Chris Leverkuhn and Vic Hash talk with Soldiers from BAMC’s Warrior Transition Battalion during the grand opening of the Automotivation program in northeast San Antonio. Behind them is a hybrid vehicle wounded service members put together, then dubbed “The Beast.” (U.S. Army photo by Robert Shields)

Wounded troops soon will be trading through.” below the knee in a blast in Iraq, drew their rifles for wrenches as they gear up Roznowski dreamed up the idea from general automotive knowledge to participate in a newly launched car for an automotive skills/therapy and dove right in to help. First up was restoration and repair program dubbed program in 2006 after visiting a Soldier helping a group of wounded service Automotivation. recovering at BAMC whose hands had members tear down the Bronco. Rather After more than a year without a site, been badly burned in Iraq. “He said he than build it back up, they opted to the program raised the garage door hoped his hands would be well enough pull the body off of the Dodge and put on its new location in northeast San to work on a car with his dad when he it on the Bronco’s frame. “It took a core Antonio during a grand re-opening on returned home,” she recalled. “He was group of 15-20 guys, plus at least a 100 Dec. 9. Through the program, seasoned worried about disappointing his father. more who were hands-on in some way, mechanics share their automotive savvy I wanted to help in any way I could.” five years to build,” he said. with wounded service members from Roznowski had already launched a This hybrid of vehicles, now fondly Brooke Army Medical Center and with number of successful sports programs, referred to as “The Beast,” was on hand Veterans from throughout the city. including sled hockey and cycling, at the grand opening — as was their “Working on cars is good physical but decided to shift in a different next project, a donated 1966 Cobra kit and mental therapy,” said Janis direction. She rented a garage, loaded car built from the ground up in two Roznowski, director of the nonprofit it with two donated project vehicles years. Leverkuhn proudly showed off Operation Comfort, which sponsors — a 1984 Ford Bronco and a 1954 both cars to a group of Soldiers and the program. “It teaches them skills Dodge Power Wagon – and asked Army Veterans who had turned out for the they can take into the world and offers Veteran Chris Leverkuhn to oversee the ceremony. He raised the them a safe place to open up to others program. who understand what they’re going Leverkuhn, who had lost his right leg

23 | ARMYMEDICINE.MIL SRMC SOUTHERN REGIONAL MEDICAL COMMAND

hood of the Cobra as Army Staff Sgt. doing something.” join. The WTB, he explained, is Troy Drebenstedt, of BAMC’s Warrior Now housed in their new site, completing a contract that will allow Transition Battalion, checked out the Leverkuhn and Hash said they’re revved Automotivation to be recognized tricked-out engine. up for a new influx of budding car under the Career, Education and However impressive, these enthusiasts. Readiness Program, which provides automotive transformations are nothing They already have a project lined up: work studies, educational opportunities compared to the transformation he the restoration of a World War II-era and internships for medically eligible has seen within the wounded service WC-54 Army ambulance that belongs Soldiers. members, Leverkuhn said. Through the to the Army Medical Department “Given that the AMEDD Museum program, “guys went from being quiet Center for History and Heritage here. is contributing a World War II vintage and antisocial to talking to anyone Along with the 1942 Dodge Power ambulance to be repaired – our about anything and becoming great Wagon, AMEDD will also pass on a contract will recognize this project peers to fellow service members,” he second Dodge for parts. as another CER opportunity,” he said. “We saw quite a few who realized “This is a great opportunity to help said. “The therapeutic benefits and they could do a lot more than they wounded service members learn auto socialization gained in this type of initially thought.” skills and also help preserve history,” environment will certainly prove to Army Veteran Vic Hash credits said retired Army Col. Bob Driscoll, have a positive impact during their the program with helping his own chief of the AMEDD Center for rehabilitation phase of transition.” and countless others’ recovery. Hash, History and Heritage. Hash said he’s simply looking injured in Afghanistan in 2010, was “It’s a massive undertaking,” Hash forward to getting back under the being treated at BAMC when he first noted. “We’re going to completely take hood again. “It’s a huge mental boost heard about the auto program. The it apart and restore it, down to the to see a service member learn how to experienced mechanic and welder, who paint and original markings. Once we do something that they thought they rebuilt his first engine on a farm at age get it up and running, we’ll give it back couldn’t,” he said, “to see a guy with no 12, pitched right in to help and is now to the [AMEDD] Museum.” arms doing woodwork with a huge grin the program’s lead mechanic. Lt. Col. Eric Edwards, BAMC on his face.” “Guys would come in without Warrior Transition Battalion (WTB) Above all, the service members are arms and ask to learn to weld or to commander, said he’s expecting not just restoring vehicles, he said, woodwork,” he recalled. “We’d figure a few dozen Soldiers to initially “They’re restoring themselves.” it out. It helped me, and I know it helped others, get our minds off of the negative stuff.” He recalled a wounded Sailor, a double amputee with severe burns, who stopped by the garage week after week for six months – but only to observe. “He eventually came up and wanted to help,” Hash said. They gave him a modified wheelchair so he could work on an engine and he stuck with the program for months. “The last time I saw him, he was on his trike working out, sweating, engaging,” he said. “That’s the point- to get these guys re-engaged in life. Instead of sitting at home playing a Army Staff Sgt. Troy Drebenstedt, of BAMC’s C Company, Warrior Transition Battalion , peers under the hood of 1966 Cobra kit car during the grand opening of the Automotivation program in northeast San Antonio. video game, being an introvert and (U.S. Army photo by Robert Shields) bored and angry, they’re out there

24 | ARMYMEDICINE.MIL USAPHC U.S. ARMY PUBLIC HEALTH COMMAND USAPHC Ergonomist gets all shook up By Jane Gervasoni, U.S. Army Public Health Command

If you have ever ridden in a military worthiness of our equipment. We had to helicopter, you have felt the vibration prove that the testing equipment would that seems to shake your whole body not adversely affect either the aircraft or during even a short trip. What happens the crew,” said Chervak. to the aircrew and passengers who are Team members demonstrated how the exposed to prolonged and repeated equipment would be attached to both whole-body vibration? the helicopter and the members of the The U.S. Army Public Health aircrew to measure vibration at the seat Command (USAPHC) Ergonomics and on the helmet without interfering Program studied this question when with safety of the crew or passengers. asked to collect vibration data on the “Ken Forsythe, an industrial hygienist UH–60 M Blackhawk and the UH–72A with the Maryland ARNG, wanted us Lakota helicopters by the Vermont Army to target musculoskeletal pain, including National Guard. low back pain, and discomfort reported Steven Chervak, U.S. Army Public Health Com- mand ergonomist, notes aircrew postures and Coordinating the requirements to by members of aircrews,” according collects vibration data during a Blackhawk flight. conduct the study took more than eight to Chervak. “We installed equipment (U.S. Army photo by Lt. Col. Patricia Hammond, months and mountains of paperwork. to measure vibration and flew on the Vermont Army National Guard) While the data from the study hasn’t been helicopters to observe posture changes completely analyzed yet, it ultimately will among crew members in flight. We also are transported by helicopter and allow researchers to assess whether there looked at how their postures changed subjected to vibration as well. Often, are health impacts to aircrews and how to during day and night missions because patients are not seated, but strapped on reduce those impacts. As well, this project of flight conditions and additional stretchers attached directly to the floor is attempting to jump-start a program equipment such as night vision goggles.” of a helicopter. Measuring the vibration that will ultimately collect vibration Concern about musculoskeletal pain they experience can provide information measurements from all military rotary- and discomfort is not new among that will lead to better methods of wing aircraft that other researchers, military flight crews. Navy aviation transporting patients. laboratories and equipment designers reports have indicated that back pain can “The information we are collecting can use, according to Steven Chervak, even affect situational awareness in pilots with the help of our partners will provide USAPHC ergonomist. and crew members. insight into occupational exposures and “The ability to collect whole-body Suzanne Smith, senior biomedical provide additional data for research,” vibration data on an aircraft has been an engineer with the Air Force Research Chervak explained. “We are hoping to exercise in collaboration,” said Chervak. Laboratory, directed the vibration data be able to perform additional testing on “The cooperation among the Army, acquisition and will continue to work other types of helicopters and contribute Air Force and Army National Guard with USAPHC to share information and to the redesign of seats and equipment to (ARNG) to collect this data has been improve aircraft seat properties, explained help eliminate or limit the occupational extraordinary. It was a real team effort.” Chervak. hazards of flying in helicopters. Team members including the Program “The number of hours pilots and “Information collected in our studies Executive Office Aviation, Utility aircrew are in the air has increased during has the potential to affect not only Helicopter Division, Redstone Arsenal, deployments, and low back pain can military, but also civilian helicopters Ala., the ARNG and the Air Force interfere with mission accomplishment. that transport patients to hospitals,” Research Laboratory at Wright-Patterson Members of aircrews sit in one position he said. “This is a great opportunity Air Force Base, Ohio, and Chervak for long periods, which can hinder blood to demonstrate the importance of worked together as they prepared to flow, causing additional concerns,” ergonomics and to provide a real service collect data. according to Chervak. in support of our Soldiers.” “Before we could even begin collecting Vibration doesn’t just affect the data, we had to demonstrate the air- aircrews of helicopters. Many patients

25 | ARMYMEDICINE.MIL RECOGNITIONS BRDSS Team Earns AMEDD Wolf Pack Award By Steven Galvan, USAISR Public Affairs

The U.S. Army Institute of Surgical with decision making when managing deployed to the field. Research Burn Resuscitation Decision fluid resuscitation of the severely burned “The Army will buy and field the first Support System Team was selected as patient.” nine devices, with additional purchases to the winner of the prestigious U.S. Army According to USAISR Director of follow for outfitting all units and training Medicine Wolf Pack Award for the first Research David G. Baer, Ph.D., the centers,” added Baer. In addition to quarter of fiscal year 2014. Burn Navigator, also known as the Burn military use, several U.S. Burn centers are “The Institute of Surgical Research was Resuscitation Decision Support System- in the process of acquiring the device to recognized for their development of the Mobile, is the only medical device to ever assist in treating their most challenging Burn Navigator, a FDA-approved device start as a research project within the U.S. patients. that allows burn patients to be more Army Medical Research and Materiel “We are extremely proud of the efforts of safely managed,” Army Surgeon General Command, and then go through advanced this extraordinary team,” added Col. (Dr.) and Commanding General of the Army development, FDA clearance, and exit the Michael A. Weber, commander USAISR. Medicine Command, Lt. Gen. Patricia D. decision gate process into fielding. Baer “This team truly supports our mission of Horoho stated in a message congratulating added the BRDSS-M fully has transitioned optimizing combat casualty care through the winning team. “This technology is to Full Rate Production, which means their dedication to a device that will help first-of-its-kind [and] assists clinicians the device has been manufactured and save lives of those wounded on and off the battlefield.” The original BRDSS technology was developed for use at the USAISR Burn Center Intensive Care Unit about seven years ago. USAISR Research Task Area Program Manager for Comprehensive Intensive Care Research Jose Salinas, Ph.D, helped develop the BRDSS algorithm that generates recommendations of fluid intake for burn patients. It was designed to assist in avoiding problems related to over- or under-resuscitating by medical care providers who do not routinely care for burn patients. The Burn Navigator offers the tool in a mobile tablet that meets military specifications. “This much needed medical capability represents a huge advancement in medical science that will benefit the Army Medical Department and the nation well into the future,” stated Horoho. “Congratulations to Team ISR for its vision and outstanding achievement!” The Wolf Pack Award is a quarterly award presented by the Army surgeon general/commanding general, U.S. Army Medical Command, and acknowledges the teamwork of Department of Defense Civilian and military healthcare teams to Capt. Danielle Schaaf, a staff nurse at the U.S. Army Institute of Surgical Research Burn Center Intensive significantly advance Army Medicine. Care Unit, uses the Burn Navigator to input patient data. Photo by Steven Galvan.

26 | ARMYMEDICINE.MIL ARMY MEDICINE 2013 YEAR IN REVIEW YEAR IN REVIEW Introduction

ABOUT THIS YEAR IN REVIEW ABOUT ARMY MEDICAL medical education, health professional This 2013 Year in Review recaptures COMMAND (MEDCOM) education, and medical research and some of the major events occurring over MEDCOM is one of 11 Direct innovation. the course of the past year that speaks to Reporting Units (DRUs) in the Army. the mission and accomplishments of the It manages a $13.8 billion budget and Army Medicine provides responsive people within Army Medicine. While provides medical care for more than services and influences health to not all inclusive, the product attempts 3.94 million beneficiaries worldwide improve readiness, save lives, and to highlight the people and events that including active-duty service members, advance wellness in support of the have made a significant impression on Retirees, and their Family members. Force, military Families, and all those our global footprint. The command also oversees graduate

Lt. Gen. Patricia D. Horoho Command Sgt. Maj. Donna A. Brock Maj. Gen. Brian C. Lein The Surgeon General and Command Sergeant Major, Deputy Surgeon General/ Commanding General of the U.S. Army Medical Command Deputy Commanding General, Operations U.S. Army Medical Command U.S. Army Medical Command

Brig. Gen. John L. Poppe Brig. Gen. Patrick D. Sargent Mr. Robert L. Goodman Deputy Chief of Staff for Support, Deputy Chief of Staff, G-3/5/7 Deputy Chief of Staff, G-8/9 U.S. Army Medical Command and U.S. Army Medical Command Chief, U.S. Army Veterinary Corps

28 YEAR IN REVIEW | ARMYMEDICINE.MIL YEAR IN REVIEW

efforts. The Army’s Office of The • 64 births Surgeon General oversees joint field • 12,494 radiology procedures entrusted to its care. Army Medicine operating activities for the secretary of • 54,048 outpatient pharmacy is a seamless chain of care stretching defense, and medical units participate prescriptions back to fixed hospitals in Europe and in many multi-service deployments and • 50,420 laboratory procedures the U.S., where Soldiers and others exercises. • 1,961 veterinary outpatient visits receive state of the art care. The Army • $23.2 million worth of food surgeon general wears a dual hat as the Snapshot of a day in Army Medicine: inspected commanding general of the U.S. Army • 41,986 clinic visits Medical Command (MEDCOM). In • 374 patients admitted addition to veterinary support provided • 1,214 patient beds occupied to all Services, Army medical personnel • 26,600 dental procedures are engaged in many joint-service • 5,879 immunizations

Mr. Uldric L. Fiore Brig. Gen. Norvell V. Coots Brig. Gen. David J. Bishop Chief of Staff Office of The Surgeon General Deputy Commanding General – Support/ Assistant Surgeon General of Warrior Care and U.S. Army Medical Command Assistant Surgeon General – and Transition and Commander of the Force Projections Warrior Transition Command U.S. Army Medical Command

Maj. Gen. Louis H. Guernsey, Jr. Brig. Gen. Mary E. Link Brig. Gen. David E. Wilmot Deputy Surgeon General for the ASG Force Management, Mobilization, Deputy Chief of Staff for Readiness/ Army National Guard Readiness & Reserve Affairs Assistant Surgeon General for Mobilization, U.S. Army Medical Command Readiness, and National Guard Affairs

29 YEAR IN REVIEW | ARMYMEDICINE.MIL YEAR IN REVIEW January 2013

• U.S. Army Medical Research and committed to ensuring we will restore and industry to develop innovative Materiel Command (MRMC) changed our Warriors to health.” medical solutions to fully restore leadership on Jan. 11. Brig. Gen. Warriors with traumatic injuries. (now Maj. Gen.) Joseph Caravalho • Injured service member Brendan Jr., assumed command from Maj. Marrocco, who lost both of his legs • Evans Army Community Hospital team Gen. (now ret.) James Gilman. Under and arms from war injuries, reveals his members receive the MHS Healthcare Maj. Gen. Gilman’s leadership, “The two new arms transplanted in a first- Innovations Program (HIP) award. MRMC has been changing battlefield of-its-kind surgery performed at Johns Awardee in the category “Experience medicine,” said Lt. Gen. Patricia Hopkins Hospital and funded in large of Care” is Lydia Kreighbaum for Horoho, U.S. Army surgeon general part by the Department of Defense her abstract titled: Soldier Centered and commanding general U.S. Army and the U.S. Army Medical Research Functional Restoration Program, and Medical Command. “The survival rate and Materiel Command via a program also awarded is Julie Gandara-Miller of those wounded on the battlefield far called the Armed Forces Institute of RPh, Clinical Pharmacist & Project exceeds 90 percent and continues to go Regenerative Medicine designed to Officer, Pain Clinic. up. Much of the credit for that belongs bring together the world’s leading here at MRMC and to its leaders scientists and physicians from academia February 2013 • During National Patient Recognition Blanchfield Army Community Hospital Month MEDCOM engaged in special Public Affairs, Fort Campbell, Ky. celebrations to personally demonstrate our appreciation and gratitude to our • The nurses of Kenner Army Health Soldiers, Family members, and other Clinic, Fort Lee, Va., marked the beneficiaries. anniversary of the Army Nurse Corps and their more than 112 years of faithful • Army Nurse Corps celebrated 112 years. and dedicated service in a ceremony held at the clinic on Feb. 1. • MEDCOM public affairs team members win Department of the Army • Madigan Army Medical Center’s General treatment of cutaneous leishmaniasis recognition awards for excellence in Surgery program, under the leadership of (skin sores), showing the combination public affairs. The MG Keith L. Ware Col. Tommy Brown, received a five-year cream has a cure rate of 81 percent. Public Affairs Competition recognizes accreditation from the Accreditation Cutaneous leishmaniasis has affected Soldiers and Department of the Army Council for Graduate Medical more than 3,000 U.S. service members Civilian employees for excellence in Education, the highest award possible. since 2003, and affects millions of people achieving the objectives of the Army in 98 countries throughout the world. Public Affairs Program. Steven Galvan • Madigan Army Medical Center’s USAMRMC and its partners are now of MRMC received 2nd place for his Maternal Fetal Medicine program, under working towards FDA approval, and personality feature article titled: “Where the leadership of Col. Pete Napolitano, then evaluating potential partners for They Are Now: Wounded Warrior ‘Full received a five-year accreditation from manufacturing and distribution of the of Heart’” and Stefan Alford of ERMC the American Board of Obstetrics and treatment. won 3rd place for his story series titled: Gynecology, the highest award possible. “TRICARE and Transformation.” • Vice President Joe Biden, Dr. Jill Biden, MEDCOM was awarded 2nd place in • The U.S. Army Medical Research and and Deputy Secretary of Defense Ashton the broadcast Command Information Materiel Command (USAMRMC) Carter visit Landstuhl Regional Campaign category for the submission completed its third Phase III clinical titled “Suicide Prevention” by study for Topical Paromomycin for the

30 YEAR IN REVIEW | ARMYMEDICINE.MIL YEAR IN REVIEW

Medical Center (LRMC) in Landstuhl, • Medical specialists from 18th Medical Centered Medical Home from the Germany on Feb. 3. The party met with Command (Deployment Support) lead National Committee for Quality Wounded Warriors and thanked their a joint mobile training team of specialists Assurance on Feb. 14. BAACH becomes medical caretakers. “Even if there were no to the Sri Lankan Army Humanitarian the first military healthcare facility in Wounded Warriors here to visit today, we Demining Unit’s Camp Boo-Oya to Korea to achieve this milestone. wanted to stop by and visit with you to unfold the first phase of a Humanitarian say thank you for all that you do for them. Mining Action Program that will help • On Feb. 22, the U.S. Army Institute of What you do is truly breathtaking,” said the Sri Lankan Army enhance its medical Surgical Research Burn Flight team set the vice president. “And, because of you, efforts and ability to remove mines that a new record for the longest continuous our Wounded Warriors can return home were left from the country’s civil war. flight by flying for 19 hours on a non- alive to their mothers and fathers, to their stop flight from Singapore to San wives and husbands, and to their sons and • Brian Allgood Army Community Antonio, and traveling more than 9,850 daughters.” Hospital (BAACH) receives the highest miles, surpassing its previous longest level-3 recognition for its Patient- flight by more than 3,000 miles. March 2013 • The motto for National Brain Injury “out of the fight.” More than 13,000 102nd anniversary with the theme Awareness Month was “Educate, service members sustained some form “Go First Class” - reinforcing the Train, Treat and Track.” Maj. Sarah of concussion since 2010 and 95 Army’s emphasis of strength to our Goldman, program director of Army percent were returned to duty. nation, and the need to maintain the Traumatic Brain Injury at the Office organizational stamina, individually of the Surgeon General Rehabilitation • Enlisted Medical Corps celebrated its and collectively. and Reintegration Division, 126th anniversary. emphasized that seeking help more • AMEDD Civilian Corps celebrated often than not does not take a Soldier • Dental Corps celebrated their their 17th anniversary on March 26.

31 YEAR IN REVIEW | ARMYMEDICINE.MIL YEAR IN REVIEW March 2013 • Kimbrough Ambulatory Care $1.4 million renovation project that • Sgt. Blayne Peterson, a combat medic Center celebrated the opening of transformed the old clinic into a with the 7203rd Medical Support its new Multi-Service Clinic with a bright, modern facility. Unit, Central Medical Area Readiness ribbon-cutting ceremony March 4, Support Group, is named the Army 2013. The new clinic, located on the • Irwin Army Community Hospital Reserve Medical Command NCO of second floor, expands Kimbrough’s was granted American Association of the Year. Spc. James Freitas, a combat services: gastroenterology, including Blood Banks (AABB) accreditation medic assigned to the 5010th U.S. endoscopies and colonoscopies; hand for transfusion services. AABB is Army Hospital, Southeast Medical and upper extremity; chronic pain an international, not-for-profit Area Readiness Support Group, from management; and podiatry. association dedicated to the Fort Gordon, Ga., is named Army advancement of science in, and the Reserve Medical Command Soldier of • As part of Brain Injury Awareness practice of, transfusion medicine and the Year. Month, Womack Army Medical related therapies. Center, Fort Bragg, N.C., provided • Madigan’s emergency medicine an opportunity to learn and gain • Behavioral Health Task Force Releases residents received exceptional scores further knowledge of traumatic brain Report: “There are no systemic issues on their in-training examinations with injuries and concussions by hosting a of Soldiers being disadvantaged in our 19 scoring above the 90th percentile discussion panel March 7 at Weaver healthcare process,” Lt. Gen. Horoho and all scoring above the 50th Auditorium. tells reporters about findings from percentile. the Army’s Task Force on Behavioral • Baby talk filled the halls of Womack Health and the Corrective Action Plan • Madigan Army Medical Center’s Army Medical Center, Fort Bragg, (CAP). Preventive Medicine department N.C., March 9 as nearly 400 expecting received a five-year accreditation Families attended a Maternity Fair. • Tripler Army Medical Center in from the Accreditation Council for In its tenth year, the fair offers Hawaii is named a top Psychologically Graduate Medical Education, the information to Families who are Healthy Workplace for 2013 by the highest award possible. expecting a child, new parents, or American Psychological Association. couples wishing to start a Family. Tripler is the first organization within • The Tacoma-Pierce County the Department of Defense to be Board of Health honored Lt. • The newly-renovated Lois B. Wells honored with the national award since Col. (Dr.) Christopher Littell, Memorial Healthcare Clinic, an annex the program began in 2006. Each year, Madigan Preventive Medicine, clinic of Kenner Army Health Clinic, only four organizations within North for his commitment to enhancing Fort Lee, Va., officially reopened America receive the award. Tripler collaboration between Joint Base during a ribbon-cutting ceremony won in the government/military Lewis-McChord and regional civilian on March 18. The ceremony marks educational institution category. public health agencies. the completion of an eight-month, April 2013 • Medical Specialist Corps celebrated 66 that the military child makes as their • Madigan Army Medical Center’s years of service. parent or parents serve our nation, it Radiology breast service was awarded is during April of each year that all the Gold Seal of Accreditation by the • Secretary of Defense Caspar W. branches of service provide special days American College of Radiology for Weinberger in 1986 designated each and events to honor the Family and Mammography. April as “The Month of the Military their children. Child.” Recognizing the contribution • The Kenner Army Health Clinic and

32 YEAR IN REVIEW | ARMYMEDICINE.MIL YEAR IN REVIEW April 2013

Bull Dental facility campuses and Education (ACGME), is presented • Irwin Army the areas between went tobacco-free annually to honor directors of medical Community beginning April 1. The initiative is part residency programs that exemplify Hospital, Custer of Army Surgeon General, Lt. Gen. patient-centered professionalism in Hill, and Farrelly Primary Care Clinics Patricia Horoho’s push to change Army medical education. Shriver received were recognized by the National Medicine to a System For Health that the award March 1 in Orlando, Committee of Quality Assurance focuses on prevention and wellness Fla., during the ACGME’s Annual as a Level 3 Army Patient Centered promotion for optimizing individual Education Conference. Medical Home. health and readiness. • Following the Boston Marathon • Medical Specialist Corps observed its • Northern Regional Medical Command bombing April 15, physicians and 66th anniversary. Team Wolf, a diverse team of military, nurses from the 804th Medical Brigade government Civilian employees and responded to save dozens of lives. • The U.S. Army was recognized as one contract supporters, was awarded Col. Joseph Blansfield, an emergency of the Top 100 Global Innovators the Army Medical Command Wolf room nurse, was on scene and taking on Thomson Reuters’ second annual Pack Award for the second quarter care of patients at the Boston Medical innovators list. In their report, Reuters of fiscal year 2013. The Wolf Pack Center where he worked full-time. Lt. highlighted USAMRMC and the Award recognizes exceptional work by Col. David King, a general surgeon, Army’s work to develop technology in military and Civilian teams in support finished the Marathon just minutes diverse areas ranging from computing of Army Medicine. prior to the blasts and immediately and software, weaponry, and general reported to the operating room at military technology including • Col. (Dr.) Craig Shriver wears many Massachusetts General Hospital. communications and imaging to hats at Walter Reed National Military “Because of the wars in Iraq and diagnosis and treatment of diseases Medical Center (WRNMMC). He Afghanistan, there are many people in such as malaria and the Ebola virus. is chief of general surgery service, the country that are skilled in treating director of the John P. Murtha Cancer traumatic injuries like amputations • Evans Army Community Hospital Center, professor of surgery at the and traumatic brain injuries,” noted awarded the Excalibur Award for Uniformed Services University of the Alex Horton, an Iraq-war Veteran who Clinical Operations. Individual Health Sciences and director of the now blogs for the VA. “Physicians awards include the MHS Female National Capital Consortium’s General have a larger breadth of knowledge Physician Leadership award which Surgery Residency Training Program. about these injuries than a dozen years went to Capt. (P) Meghan Raleigh and It is for the latter Shriver was recently ago, and lessons learned from the Chief, Army Medical Specialist Corps presented the 2013 Parker J. Palmer wars undoubtedly saved many lives Award of Excellence was awarded to Courage to Teach Award. The award, in operating rooms in and around Capt. Rebecca Hawkins. created in 2002 by the Accreditation Boston.” Council of Graduate Medical May 2013 • Congress designated the month of • Warrior Transition Battalion’s Sgt. Warrior Transition Battalion to go to May as National Mental Health Joshua Andrew came away from the the 2013 games, which were held in Awareness Month and Army Medicine Department of Defense’s 4th Annual Colorado Springs, Colo. is an important part of the partnership Warrior Games in May with a gold to spread the word about why medal in the shot-put and a silver • During one week each May, healthcare pathways to wellness are so important. medal in the discus competition. providers observe National Women’s Andrew was the only Soldier from the Health Week to remind women about

33 YEAR IN REVIEW | ARMYMEDICINE.MIL YEAR IN REVIEW May 2013 the importance of taking care of their had been a smoking area someplace Medicine Award for the U.S. Army. bodies. National Women’s Health Week outside of each facility. He was recognized for his excellence as encourages and empowers women to an HIV researcher and leader in global make their health a priority through • What do football players and Soldiers health. routine medical exams and preventive have in common? Besides team spirit screenings, being active, paying and commitment, they sometimes • For the first time in its 70-year attention to mental health, and avoiding share an injury that has raised history, the U.S. Army Institute of unhealthy activities. Kenner Army questions in both the military and Surgical Research at Joint Base San Health Clinic, Fort Lee, Va., welcomed the NFL — traumatic brain injury, or Antonio-Fort Sam Houston received beneficiaries May 13, with a display of TBI. Both the NFL and the Army see 510(k) clearance from the U.S. Food women’s health information and services a large number of concussive related and Drug Administration for their available through the Women’s Health injuries every year, and statistics show development of the Burn Navigator, Clinic or local network providers. The football players and military personnel a first-of-its-kind algorithm-based display included a National “Go Red have an increased risk for TBI. This decision assist system for use in for Women” advocate who promoted year on Fort Bragg, there were nearly managing fluid resuscitation of the the nonprofit health education group’s 13,000 screenings for TBI, as well as severely burned patient. The FDA uses current campaign titled “The Time is 1,800 Soldiers diagnosed with TBI. the 510(K) pre-market submission Now.” Because of this high statistic, the to ensure a medical device is safe for Defense and Veterans Brain Injury use on patients. The approval process Center on Fort Bragg is currently is arduous, expensive, and can take conducting 13 active institutional several years to complete. review board research projects on concussive injuries. In an effort to raise • Madigan was named one of the U.S.’s awareness on TBI, the United Service Most Wired Hospitals according to Organization and the NFL Carolina the results of the American Health Panthers partnered with Lenovo (a Association’s 2013 Most Wired Survey. technology brand) on May 14 to conduct a question and answer panel • For the second year in a row, • May is Asthma Awareness Month, and on TBI. Madigan Army Medical Center this year professionals at Ireland Army was awarded the Most Prestigious Community Hospital, Fort Knox, Ky., • For the 2013 Warrior Games, the Environmental Achievement Award offered free asthma screenings May 19 Warrior Transition Command hosted presented by Practice Greenhealth, in the PX lobby. Adults and children 16 training clinics and eight selection a national membership organization with symptoms such as wheezing, camps for athletes to compete for a for healthcare facilities committed coughing or shortness of breath found spot on Team Army. At the Games, to environmentally responsible out if they were at risk for asthma. held May 14 in Colorado Springs, operations. Colo., Team Army finished second to • Patients, staff members, and visitors the Marine Corps in the overall medal • Madigan Army Medical Center to Andrew Rader U.S. Army Health count. Team Army beat its 2012 medal received The Environmental Clinic, Joint Base Myer-Henderson count by 18…33 Gold, 26 Silver, 22 Leadership Circle Award, recognizing Hall, Va., can no longer light up, Bronze (81 medals compared to 63 in healthcare facilities that exemplify chew, or use any other tobacco 2012). environmental excellence and are product on the facility’s campus. setting the highest standards for Rader Clinic Commander Col. Laura • Col. Nelson Michael, director of environmental practices in healthcare. R. Trinkle said there has been a U.S. Military HIV Research Program no-smoking policy inside treatment at the Walter Reed Army Institute facilities operated by the U.S. Army of Research in Silver Spring, Md., Medical Command for years, but there received the Hero of Military

34 YEAR IN REVIEW | ARMYMEDICINE.MIL YEAR IN REVIEW June 2013 • Army celebrated its 238th birthday. female two-star general, and the first Harvard Medical School’s Brigham in the active component of the Army. and Women’s Hospital in Boston – • America’s leading Veterinary Medical West currently serves as the joint staff recently accepted an invitation from Team celebrated 97 years of service. surgeon. Walter Reed officials to visit and learn about the latest medical and surgical • Medical Service Corps celebrated 96 • Wounded Warriors had an opportunity advances in similar blast injuries seen years. to explore the numerous recreational in Wounded Warriors. activities available to them during • For the first time in more than 15 Adaptive Sports Day at Walter Reed • Three Soldiers recovering at Walter years, a red blood cell storage solution Bethesda. The event, an extension Reed National Military Medical was approved by the Food and Drug of the Military Advanced Training Center received the Purple Heart Administration. Hemerus Medical Center’s (MATC) Adaptive Sports and Medal at Mount Vernon, Va., June LLC, in partnership with the U.S. Community Reintegration program, 3 to commemorate the 238-year- Army Medical Materiel Development offered to patients currently in old heritage of the U.S. Army. The Activity, a subcommand of the U.S. rehabilitation, is held twice a year – in ceremony which honored Sgts. Cory Army Medical Research and Materiel the spring to showcase spring/summer Doane, Sean Karpf, and Spc. Arael Command, received FDA approval sports, and in the fall to highlight fall/ Lopez set off a week-long series of of the New Drug Application for winter sports events in the National Capital Region its SOLX® System (LEUKOSEP® to celebrate the Army’s Birthday. HWB-600-XL Leukocyte Reduction • Wounded Warrior amputees at Secretary of the Army John M. Filtration System for Whole Blood Walter Reed National Military McHugh pinned the three Wounded with CPD Anticoagulant and SOLX® Medical Center got a chance to share Warriors with the Purple Heart after Additive). The SOLX® system is a the wisdom and experience they’ve placing a wreath at the tomb of whole blood collection system that gained through tough rehabilitation the nation’s first president and the produces Leukoreduced red blood and prosthetic fittings with a man Army’s first commander, Gen. George cells and plasma. This system has who lost a leg during the April 15 Washington. He said he appreciated been approved in the United States by Boston Marathon bombings. J.P. the opportunity to begin the Army the FDA for six-week red blood cell Norden and his brother, Paul, were Birthday celebration at the home of storage and was previously approved in cheering on a friend at the finish George Washington, which also marks Europe for eight-week red blood cell line of the marathon when they were the beginning of the Purple Heart storage. injured in the second bomb blast. Trail. Each brother lost a leg. The brothers’ • Maj. Gen. Nadja West became Army surgeon – Dr. E.J. Caterson, chief of • Barbara Holcomb was promoted to Medicine’s first African-American plastic and reconstructive surgery at Brigadier General on June 6 and

35 YEAR IN REVIEW | ARMYMEDICINE.MIL YEAR IN REVIEW June 2013 now serves as the U.S. Army Forces resiliency for Soldiers and players. Cho addressed the issues of post- Command surgeon. For the first time The Army hosted a panel in New traumatic stress disorder and traumatic in Army Medicine history, Nurse York on June 13 to address building brain injury during an awareness event Corps general officers are serving at and maintaining resilient Soldiers, on Capitol Hill in Washington: “The three-star, two-star, and one-star ranks Families, and Department of the invisible wounds – post-traumatic simultaneously. Army Civilians. Vice Chief of stress disorder and traumatic brain Staff Gen. John F. Campbell was injury – are just as damaging as the • Maj. Gen. M. Ted Wong relinquished joined by National Football League visible ones. They impact the Families command of Southern Regional Commissioner Roger Goodell; Dr. as well as the Soldiers.” Medical Command to Maj. Gen. JoAnn Difede, director of the Program Jimmie O. Keenan on June 6. for Anxiety and Traumatic Stress • Capt. Stephanie Hightower and Keenan concurrently serves as chief Studies; and Army Surgeon General Capt. Erica Chabalko of Madigan of the Army Nurse Corps. Wong Lt. Gen. Patricia Horoho. “Each Army Medical Center competed in concurrently serves as chief of organization here represents a different the 2013 Armed Forces Triathlon the Army Dental Corps and leads facet of resiliency, and the common Championship at Naval Base Ventura the Northern Regional Medical goal is to come up with policy and County Point Mugu, June 1. The Command in Fort Belvoir, Va. procedures, at least for the Army triathlon consisted of a 1,500-meter and maybe for other organizations, ocean swim, 40-kilometer bike ride, • Sexual Harassment/Assault Response to really preserve and protect the and a 10-kilometer run. and Prevention Summit held at Joint long-term health and wellness of our Base Andrews June 10-11. There are people,” Campbell says. • Madigan Army Medical Center: The some in the Army who may not yet Clinical Informatics department won fully appreciate the gravity of the • At a Pentagon symposium on the 2012 AMEDD Mercury Award sexual assault situation in the Army, Traumatic Brain Injury (TBI) hosted in the category of IM/IT Special Act said Gen. Ray Odierno, chief of staff, by Secretary of Defense Chuck Hagel Strategic Impact Team Award. Clinical in his opening remarks. “I will tell on June 12, Lt. Gen. Patricia Horoho Informatics was honored for efforts you, from the things I see, we still remarked that, “It may come as a in support of the Medical Evaluation have people out there who tolerate surprise to many that the vast majority Board Review Tool that was used by sexual assault and sexual harassment.” of TBI cases incurred by the military over 500 users across the AMEDD to Ordierno notes, “Until we solve that occur within garrison, which means conduct a congressionally mandated problem, it’s going to get worse.” in noncombat accidents, rather than review of MEB cases spanning the while deployed, or in areas of hostile last twelve years. The team built and • The commander of the Army’s training activity. From 2000 to 2012, 83 deployed a global tool in five days to enterprise remarks; Army leaders percent of TBI cases occurred within meet a hard MEDCOM deadline for must overcome their “naiveté” when the garrison. Suffice it to say, TBI will starting the process. it comes to realizing and addressing remain a military concern long after the problem of sexual harassment U.S. combat forces are withdrawn • Madigan’s Cross Country team won and sexual assault in the ranks. from Afghanistan sometime in 2014.” first place in the JBLM Intramural “When you study the typical sort of Cross-Country Series. The Series pattern of behavior, how these sexual • John M. Cho received his first star consisted of three separate four-mile assaults occur today, it is absolutely on June 21, and is the first Active races on the running trails behind the eye-opening,” says Gen. Robert W. Component American Soldier of Soldiers Field House on Lewis Main. Cone, head of the Army Training and Korean descent to become a general Doctrine Command. officer. Brig. Gen. Cho currently • The Madigan-Puyallup Community heads the Western Regional Medical Medical Home won the Business • Army, NFL partnership focuses on Command. A day after his promotion, Examiner’s 2013 Healthcare

36 YEAR IN REVIEW | ARMYMEDICINE.MIL YEAR IN REVIEW June 2013 Champion Award for innovation and and Madigan Commander, Col. Dallas champion in the South Sound. excellence in providing healthcare to Homas, in which they were honored for the community. The Puyallup team their delivery of patient-centered care • Irwin Army Community Hospital was recognized at a reception at the to our beneficiaries. Madigan has been celebrated the Fort Riley Army Tacoma Glass Museum with eight recognized four consecutive years by Wellness Center Grand Opening. representatives from the Puyallup crew the Business Examiner as a healthcare July 2013 • The Army Medical Corps celebrated medically evacuated by the USAISR • Sgt. Piero Lopez, a combat medic with 238 years of service. Both the Army Burn Flight team, from Ramstein the Arkansas Army National Guard’s Medical Department and the Army Air Base, Germany, to the San Headquarters and Headquarters Medical Corps trace their origins to Antonio Military Medical Center in Company, 2nd Battalion, 153rd July 27, 1775, when the Continental Texas. She is the first patient ever to Infantry Regiment was named the Congress established the first Army be flown across the Atlantic while Army National Guard Soldier of the Hospital to be headed by a “Director on the Extracorporeal Membrane Year in an awards ceremony following General and Chief Physician.” Oxygenation (ECMO) machine, a the 2013 Army National Guard Best specialized lung bypass machine. Warrior Competition on July 23. • On July 10, an Army wife was August 2013 • The month of August is designated Day. The System For Health represents named the 2013 MEDCOM Best as National Immunization Awareness a paradigm shift from a healthcare NCO; Spc. Erik Eaton, a laboratory Month. Immunizations have saved system focused on disease, to a system specialist from the U.S. Army Medical more lives than any other medical focused on prevention; to sustain Research and Materiel Command was measure in history and really are the health, readiness, and resiliency. The named MEDCOM Best Soldier. They best protection against many common key tenets of the Performance Triad – are the winners of MEDCOM’s Best and communicable diseases. sleep, activity, and nutrition – provide Warrior Competition hosted by the the foundation upon which Soldiers U.S. Army Public Health Command • Maj. Gen. Steve Jones assumed and their Families can make healthy Aug. 19–23. command of the Army Medical life choices. “As we wind down from Department Center and School nearly 12 years of combat operations, • Kimbrough Ambulatory Care Center, effective Aug. 1 during a ceremony we – as an Army and as a nation – Fort Meade, Md., opened its new at the Army Medical Department have a golden opportunity to reset, satelite refill pharmacy May 1. The Museum on Sept. 19 following an refit, and refocus. That focus should wait time for customers picking up assignment as commander, Joint be on maintaining, restoring and refill prescriptions decreased from an Task Force National Capital Region improving health – using improved average of 15 minutes to two to three Medical (JTF CapMed). sleep, physical activity, and nutrition minutes. A year prior, patients waiting habits to foster increased readiness and to pick up a refill prescription at • On Aug. 8, Lt. Gen. Patricia resilience,” Horoho said. Kimbrough Ambulatory Care Center’s Horoho officially announced Army pharmacy would have an average Medicine’s System For Health and the • Sgt. 1st Class Ronnie Reynolds, a wait time of 15 minutes. Sometimes, Performance Triad at a MEDCOM- combat medic at the Army Medical depending on the time of day, that wide Stand Up For Health Training Department Center and School, was wait could last up to 30 or 40 minutes.

37 YEAR IN REVIEW | ARMYMEDICINE.MIL YEAR IN REVIEW August 2013

• Approximately 1,500 surgeries were (AWC), Fort Drum, N.Y., during a Robert Wood Johnson Foundation performed at Fort Eustis, Va., in 2012. ribbon-cutting ceremony Aug. 29. (RWJF) Executive Nurse Fellows In 2013, the McDonald Army Health The 5,000-square-foot facility is the program. Armstrong, the regional Center (MCAHC) planned to perform 12th wellness center to open across the nurse executive for the Northern another 2,000 – and that’s the lowest Army. It offers standardized services Regional Medical Command estimate. After opening in June, the and state-of-the-art equipment free of (NRMC), Fort Belvoir, Va., is the first new operating rooms at MCAHC, charge to all DOD ID-card holders. active duty military nurse selected have given medical professionals Bringing an AWC to the North for the very competitive fellowship. new patient care capabilities, faster Country was a team effort among the She is one of only 20 nurse executives recovery times, and additional services. 10th Mountain Division (LI), Fort selected for the program in 2013. The “We spent $5.5 million renovating Drum garrison, U.S. Army Medical purpose of the fellowship is to develop the whole second floor of the health Department Activity (MEDDAC), executive nursing leaders who will center,” said Maj. Anissa Buckley, U.S. Army Forces Command influence the transformation of the nursing and patient support services (FORSCOM), U.S. Army Installation nation’s healthcare system through assistant deputy commander. “As well Management Command and U.S. professional development, coaching as updating other surgical clinics on Army Medical Command, according and education. “I’m very excited about the floor, we acquired two state-of-the- to Col. Matthew E. Mattner, Fort this opportunity,” Armstrong told art operating rooms.” Drum MEDDAC commander. RWJF. “In addition to the program curriculum itself, I expect to learn a lot • Soldiers, Civilians, and Family • Col. Rachel Armstrong broke ground from interacting with the other new members celebrated the opening for all Army nurses when she was Executive Nurse Fellows.” of the new Army Wellness Center selected in August for the prestigious

38 YEAR IN REVIEW | ARMYMEDICINE.MIL YEAR IN REVIEW

September 2013

• September is Suicide Prevention Base Initiative. The initiative is part seen instead, if the first patient had Month and the Department of the of Operation Live Well, a program canceled the appointment.” Army joined our nation and the world aimed at making healthy living the in observance. easy choice and the social norm. • Lt. Gen. Horoho received the Participating in the Healthy Base Humanitarian Award from the • On Sept. 10, 2009, the President of Initiative will help the Defense American Red Cross of Massachusetts the United States of America issued Department encourage an alternative at a ceremony held in Boston on a Proclamation declaring Sept. 11 as to the national trend toward obesity Sept. 24. Horoho, whose mother “Patriot Day and National Day of and tobacco use, Charles E. Milam, was a Red Cross volunteer as a candy Service and Remembrance” to honor DOD’s principal director for military striper, is credited with saving dozens the victims of September 11, 2001. community and Family policy, told of lives via first aid she provided at American Forces Press Service. the Pentagon on 9/11. • Maj. Gen. Jimmie O. Keenan, commanding general of the Southern • The Wilkerson Pediatric Clinic now • Researchers unveiled the world’s Regional Medical Command, operates under a Patient Centered first thought-controlled bionic assumed directorship of the San Medical Home (PCMH) model of leg Sept. 25, funded through the Antonio Military Health System’s care, which offers a more personalized U.S. Army Medical Research and enhanced Multiservice Market on experience for beneficiaries. Families Materiel Command’s Telemedicine Sept. 12 during a transfer of authority using the clinic are assigned to a single ceremony with the Air Force’s 59th team that will be responsible for their Medical Wing, Lackland Air Force children’s specific healthcare needs. Base. The medical home team will provide treatment, coordinate referrals, follow- • Brig. Gen. Jeffrey B. Clark up with specialists, and establish care assumed command of Walter Reed plans for children with chronic illness National Military Medical Center and more. (WRNMMC) on Sept. 19 from Navy Rear Adm. Alton L. Stocks, who • Operating at maximum efficiency served as the first commander of the has become a primary goal for every nation’s largest joint military medical unit at Joint Base Langley-Eustis, Va. center. As one of 14 pilot installations While many units work internally and Advanced Technology Research in the Defense Department’s Healthy to reach this goal, U.S. Air Force Center (TATRC) and developed Base Initiative, this Maryland post Hospital Langley and McDonald by researchers at the Rehabilitation will share its best practices and Army Health Center need help Institute of Chicago (RIC) Center for lessons learned across DOD to from their patients to ensure every Bionic Medicine. promote healthier and more resilient dollar healthcare facilities spend goes service members, Families, Retirees, towards the community’s welfare by • In September 2013, the Warrior and Civilian employees, a senior avoiding missed appointments. “We Transition Command established the defense official said. have a saying here at MCAHC,” Cadre Resilience Course (CRC) to said U.S. Army Capt. Jose Sanfeliz, train the twelve skills identified to • Col. Brian P. Foley, the Fort Meade MCAHC clinical support division build resilience. The program is the garrison commander, announced chief. “‘An appointment missed by you foundation for ensuring the welfare of during a ribbon-cutting for Fort is an appointment missed by two.’ It the nation’s wounded, ill, and injured Meade’s new Army Wellness Center means whenever someone misses their Soldiers and their Families. While the that the post has been named a appointment, another person who 29 Warrior Transition Units (WTU) demonstration site in the Healthy was waiting for a slot could’ve been or nine Community

39 YEAR IN REVIEW | ARMYMEDICINE.MIL YEAR IN REVIEW September 2013 Based WTUs located in CONUS and Medicine’s Environmental Health MEDCOM and WRMC nominee for OCONUS, including Puerto Rico, find Service Branch and Logistics the 2013 Latina Style Distinguished similarities to other Army line units, the Division’s Environmental Services Service Award. Ms. Miranda mission to heal and transition is quite Branch. Both branches were co- is a Health Systems Specialist distinguishing. The job of WTU cadre champions of Madigan’s recycling and with Madigan’s Department may not require the extreme physical other waste improvement programs. of Occupational Medicine and demands of battle, but it can be The Department of Nursing, Deployment Health. mentally and emotionally demanding. DOAOS, Pathology, Nutrition Care The CRC will be institutionalized at the Division, Safety Office, and the • William Beaumont Army Medical Army Medical Department Center & Infection Control Office were also Center holds a Grand Opening for the School and implemented to the WTU key contributors. For winning second new Wellness Center at Fort Bliss. Cadre Training Program. place, Madigan received a $7,500 award for the Troop Command’s • Madigan won second place in the MWR Fund. JBLM Green Team competition. Special thanks go to Preventive • Ms. Anna Miranda was the

October 2013

• MEDCOM celebrated its 19th Planning, Medical Logistics, Health this time, there has been a shift to anniversary on Oct. 2. Information Technology (Hit), and more preventive and outpatient care,” Pharmacy are all part of the initial said Maj. Matthew K. Marsh, hospital • October is National Depression launch. Acquisition, Budget and alteration transition officer. Education and Awareness Month. Resource Management, Medical Education/Training, and Medical • At the Association of the U.S. Army • During Breast Cancer Awareness Research will be implemented by Oct. (AUSA) conference in Washington Month, Army Medicine was joined 1, 2015. on Oct. 21-23, Lt. Gen. Horoho by other health system partners addressed the shift of Army Medicine’s to increase the overall awareness • As technology and medical treatments focus from healthcare, the treatment and sharing of information among continue to progress, facility of disease, to wellness, the preservation Soldiers, Family members, and improvements are a high priority to of health. Horoho tells conference beneficiares on the the importance of maintain proper care of patients and attendees that sleep, activity, and breast cancer screening. their Families. Womack Army Medical nutrition are the keys to wellness Center has recognized the need and can avert what she called a crisis • Defense Health Agency (DHA) began for improvement and is renovating in America, where, “Nine out of operations Oct. 1. Directed by Air approximately 79,000 square feet ten of us in this room will die of a Force Lt. Gen. Douglas J. Robb, DHA of existing space to provide the best preventable illness. Most of us accept aims to streamline processes, reduce possible care for its patients. “The this as inevitable, not a matter of if, complex operations, and achieve construction is necessary to adapt to but when,” Horoho said. “But it’s not reductions while improving care to the ever-changing face of healthcare. when, it’s if. The decisions we make beneficiaries. Ten shared services are When this facility was constructed in every day determine if, not when, placed under the DHA umbrella. the late 1990s, the primary focus of we will contract one of these life- The TRICARE health plan, Facility care was in the inpatient setting. Since threatening conditions.”

40 YEAR IN REVIEW | ARMYMEDICINE.MIL YEAR IN REVIEW October 2013

• Col. Timothy Hudson, Army an inspirational man,” says Lt. Gen. national standards for healthcare Medicine’s System For Health Horoho in her keynote address, but quality and safety in ambulatory lead, told Army leaders that the he was also “a tireless advocate for the care organizations. The accreditation Performance Triad is part of the larger advancement of nursing education, award recognizes the MEDDAC’s System For Health partnership among research, and clinical practice. He dedication to continuous compliance Soldiers, Families, leaders, health was instrumental in the founding of with the Joint Commission’s state- teams and communities to promote the Uniformed Services University of-the-art standards. Guthrie readiness, resilience, and responsibility. Graduate School of Nursing. He Ambulatory Health Care Clinic, Hudson says the goal is to have the also shepherded legislation through Conner Troop Medical Clinic, Performance Triad become a way of congress that endowed the Tri-Service Preventive Medicine, Obstetrics and life, like the Army Core Values. Nursing Research Fund.” Gynecology, and Behavioral Health Services underwent a rigorous, • Uniformed Services University • Western Regional Medical Command unannounced on-site survey in May. Graduate School of Nursing was changed leadership on Oct. 31. Brig. A team of Joint Commission expert renamed the Daniel K. Inouye Gen. John Cho assumed command surveyors evaluated the organization Graduate School of Nursing in honor from Maj. Gen. Richard Thomas, who for compliance with standards of care of the late Senator Daniel Inouye moved on to Defense Health Agency. specific to the needs of patients. at the 20th anniversary celebration of the Graduate School of Nursing • Fort Drum’s USA MEDDAC earned held Oct. 29. Not only was Senator the Joint Commission’s Gold Seal Inouye “an American hero, a servant of Approval® for accreditation by leader, an advocate, a mentor, and demonstrating compliance with

41 YEAR IN REVIEW | ARMYMEDICINE.MIL YEAR IN REVIEW November 2013 • November is Warrior Care Month, Sully Sullenberger. Also among the called on you as it has never called on and this year’s focus was on “Building medal recipients were sisters Mrs. its sons and daughters before.” a Ready and Resilient Force.” This is Dorothy Levitsky Sinner and Mrs. the time for the Army to celebrate the Ellan Levitsky Orkin who served • The Spouse Wellness Conference resilience and strength our wounded, in France as part of the U.S. Army kicked off Nov. 5 as part of the ill, and injured Soldiers demonstrate Nursing Corps during WWII. Healthy Base Initiative at the everyday, and to pay tribute to those Family Readiness Group Center and who have sacrificed so much in the • On Nov. 6, Lt. Gen. Patricia defense of the nation. Horoho, Army surgeon general, announced Capt. Kenneth Roberts • On Veterans Day, Command Sgt. of the Northern Regional Medical Maj. Brock and Army Surgeon Command’s (NRMC) Human General Patricia Horoho extended Resources (G-1) as one of the gratitude to all Veterans past and four Army Medical Department present who have served our country (AMEDD) winners of the Lt. Col. and especially those who made the Karen Wagner award. The award is ultimate sacrifice. named for the late Lt. Col. Karen Wagner, the only AMEDD officer to Hercules Physical Fitness Center, • Military Family Month - honoring lose her life during the 9/11 attack Fort Bragg, N.C. The HBI program military Families for their on the Pentagon. It is presented has been developed for military contributions and sacrifices. annually to outstanding AMEDD service members, their Families and Human Resources Professionals in Department of Defense Civilians to • In November, the AMEDDC&S four categories: the Regular Army, educate them on the importance of celebrated its 30-year anniversary Army Reserve, Civilian focusing taking charge of their health through of accreditation by the Council on in Military Human Resources, and nutrition and fitness. This is the first Occupational Education (COE). Civilian focusing in Civilian Human time the conference has taken place The COE is recognized by the U.S. Resources. Capt. Roberts won for the on Fort Bragg. Over 230 spouses Secretary of Education as a reliable Army Reserve Component from a showed up to listen to keynote authority on the quality of education field of 18 nominees. speaker, Karen Reivich, co-director offered by the AMEDD Center & of the Penn Resiliency Project and to School. • Maj. Gen. M. Ted Wong, take advantage of the workshops in commanding general of the Northern more than 30 wellness areas. • U.S. Army Surgeon General Lt. Regional Medical Command and Gen. Patricia Horoho received chief, U.S. Dental Corps, said today’s • Leonard A. Smith, Ph.D., a senior France’s National Order of Legion Soldiers have chosen a strenuous scientist at the U.S. Army Medical of Honor, Chevalier (Knight) Award profession that over the past 12 Research Institute of Infectious for her career accomplishments and years has called for great strength Diseases at Fort Detrick, received the commitment to French-American of character and commitment. Department of Defense Distinguished medical cooperation. The award was Wong made the remarks at a mass Civilian Service Award Nov. 18 in a presented by Mr. Frederic Dore, reenlistment ceremony held on Pentagon ceremony. The recognition the Deputy Chief of Mission at the the grounds of the U.S. Capitol, is the highest award given by the Embassy of France at a ceremony held Washington, D.C., Nov. 15. Fifty- Secretary of Defense to career in the French Embassy in Washington, two Soldiers reenlisted, representing employees. D.C. Previous American recipients of eight health-related commands across the award were: General Dwight D. the National Capitol Region. “The • The Healthy Base Initiative was held Eisenhower; General George Patton; profession of arms demands much of at Fort Bragg, N.C., Nov. 11-16. A General Douglas MacArthur; Major those who serve at any time,” Wong series of events aimed at optimizing Audie Murphy; Admiral Michael said. “But over the past decade of health, resilience, and readiness are Mullen and US Airways pilot Captain perpetual combat, the nation has staged at the installation that serves

42 YEAR IN REVIEW | ARMYMEDICINE.MIL YEAR IN REVIEW November 2013 as both a Performance Triad pilot site • Sgt. Sarah Deckert, chef and personal • William Beaumont Army Medical and one of 14 selected for a DOD aide to Gen. Horoho, is named Center opened the Rio Bravo assessment of its success in overall Enlisted Aide of the Year for the Community Medical Home in El community healthy eating and active Department of Defense on Nov. 13. Paso, Texas. living. December 2013

• “Jingle Walk,” with some participants following individuals – Capt. vignette abstract competition. Special dressed up in holiday costumes, at Victoria Sullivan received 1st place congratulations go to the following MEDCOM Headquarters in Falls in the podium competition for the three individuals – 1st place: Capt. Church, Va., on Dec. 13, is the first of submission titled: Common Variable Evelyn Slaughter (research podium a planned monthly event throughout Immunodeficiency Masquerading competition; co-authors Christina the command, with an emphasis on as Sarcoidosis (co-author Lt. Col. Schofield, MD; Maj.(P) Cristin fun and promoting unit camaraderie. Patty Short); and Capt. Heather Mount) - Changes in Red Blood Pomerantz received 1st place in the Cell Width Distribution as a Novel • Madigan Army Medical Center and poster competition for her submission Biomarker for Bacteremia; 2nd place: its Department of Medicine’s internal titled: A Complex Case of Sarcoidosis- Capt. Evelyn Slaughter (clinical medicine residents were recognized Associated Pulmonary Hypertension vignette abstract competition; co- for their outstanding contributions to (co-author Col. Alex Niven). authors Capt. Nikhil Huprikar; Mary the Washington and Army Chapter Anne McDonald, MD) - A Rare Case Meetings of the American College of • Samuel Barnett made Army Medical of Amiodarone Induced SIADH; 3rd Physicians (ACP), marking the first Department (AMEDD) history by place: Capt. Brian Pomerantz (clinical year in the program’s history that becoming the second 68W (Combat vignette abstract competition; co- Madigan residents have swept all Medic) to receive The Guard, Tomb author Col. Alex Niven) - Secondary major awards at both of these meetings of the Unknown Soldier Identification Pneumothorax During Flight: A Late in a single year. Badge and is the first junior enlisted Complication of H1N1-Associated AMEDD Soldier to earn this honor. ARDS. • Bassett Army Community Hospital awarded 2013 MEDCOM Wolf Pack • Madigan Army Medical Center’s • December was global health of the Year. Department of Medicine sponsored engagement month in the military its first annual Research Day in health system. Download a monthly • Madigan residents were selected for 4 combination with the Army ACP computer desktop wallpaper calendar podium and 16 poster presentations Chapter’s first virtual meeting, which to participate in health awareness at the Washington ACP Chapter featured an outstanding intern campaigns and share pride in the meeting, with submissions that clinical vignette competition that military health system. Select and made up almost 40% of the resident was won in a close decision by Capt. download at: health.mil/News_And_ abstracts submitted from the four Joseph Howells. The Army ACP Multimedia/MHScalendar.aspx residencies in the state of Washington. meeting featured a resident research Special congratulations go to the podium competition and a clinical

43 YEAR IN REVIEW | ARMYMEDICINE.MIL YEAR IN REVIEW

CPT MORENO, Jennifer M. 1SG STAPLEY, Tracy L.

66H 68W Madigan Army Medical Center, Joint Base 308th Medical Logistics Company, 139th Lewis-McChord, Washington Medical Support BDE, Independence, MO San Diego, California Clearfield, UT 6-Oct-2013 3-Jul-2013 SPC TOWSE, Cody J.

68W 3rd Battalion, 41st Infantry Regiment, 1st BCT, 1st Armored Division, Fort Bliss, TX Elk Ridge, UT 14-May-2013 44 YEAR IN REVIEW | ARMYMEDICINE.MIL Serving To Heal...Honored To Serve