Army Medicine has Banner Year in 2015

WASHINGTON — Army medical researchers continued to make great strides during 2015 in new technologies designed to save lives, reduce injuries and improve Soldier physical performance.

Some of the biggest Army medical news this year came this month with the release of the first-ever Health of the Force report and the first-ever Performance Triad Sleep Summit.

HEALTH OF THE FORCE REPORT

The Health of the Force report, released by Army Medical Command, or MEDCOM, provides a snapshot of the health of active-duty Soldiers on all major U.S.-based installations in 2014.

A MEDCOM spokesperson said the report will become even more valuable over time, as data is tracked and collected, to show improvements or the need thereof in key health indicators: injuries, behavioral health, chronic disease, obesity, tobacco use, sleep disorders, hospital admissions, and other health measures.

The report was a wakeup call for the important issue of Army readiness. Medical readiness was not achieved by 17 percent of Soldiers, according to the report.

Noted also in the report, injuries affect nearly 300,000 Soldiers annually. Some individuals experience multiple injuries in a single year, impacting personal readiness and increasing the burden on medical systems. Approximately 1,295 new injuries per 1,000 Soldiers were diagnosed in 2014.

Also in the report, about 15 percent of Soldiers had a diagnosed behavioral health disorder. Among behavioral health diagnoses, adjustment disorder, mood disorders and anxiety disorders were most common.

There's more news in the report and it's available as a free pdf download on the MEDCOM site.

SLEEP SUMMIT

The Army Office of the Surgeon General-, or OTSG-sponsored Performance Triad Sleep Summit took place Dec. 7 to 9. Future sleep summits are planned once every two years, according to an OTSG spokesperson.

The Health of the Force report, released a day after the sleep summit, notes that one-third of Soldiers get five hours or less of sleep per night and 62 percent of Soldiers get less than seven. The report lists effects of inadequate sleep, including increased likelihood of injuries, behavior disorders, anxiety, post-traumatic stress and depression.

And, the report notes very sobering information that "individuals who routinely get five to six hours of sleep perform much like a person with a blood alcohol content of 0.08."

Experts at the sleep summit had their work cut out. They tackled a wide range of issues:

• Sleep data needs to be better tracked
• Physicians need better training in sleep therapy, not just prescribing medications
• Better sleep guidelines need to be published
• Sleep recommendations need to be in the curriculum at the school houses
• An Army-wide culture shift is needed in viewing sleep as a better performance resource

ARMY SURGEON GENERAL HONORED

Among big news this month was the retirement of the Army's Surgeon General Lt. Gen. Patricia Horoho.

During her retirement ceremony, Dec. 15, Army Chief of Staff Gen. Mark A. Milley said, "I was there [in Afghanistan] to witness her performance, and it was incredible. There are many, many lives today that would not be living without the efforts of Patty Horoho."

While deployed to Afghanistan, Horoho helped improve tactical combat casualty care, medevac procedures, getting needed care during the critical "golden hour" following wounds or injuries, tele-behavioral health and resiliency training. She encouraged sleep discipline, looking after women's health, health records improvements, and much more, Milley said.

Following her deployment, she was the first woman, and the first non-physician in any service to serve as a surgeon general, "and that's an amazing achievement," he added.

After Horoho's departure, Maj. Gen. Nadja West was sworn in as the Army's first African-American surgeon general.

EBOLA MISSION ENDS

The 20th Chemical, Biological, Radiological, Nuclear, Explosives Command, or CBRNE, departed West Africa in late May, following its success in combating the deadly Ebola virus as part of Operation Unified Assistance.

Col. Sven Erichsen, commander of the 48th CBRNE Brigade, said the highlight of deployment came in May, "when the World Health Organization declared Liberia Ebola-free after an epidemic that lasted over a year and took 4,000 lives."

The World Health Organization declared Liberia free of Ebola, May 9, after 42 days without any new cases. Liberia was the country most impacted by the outbreak. In September 2014, Liberia was reporting 300 to 400 new cases a week.

Leading the transitional headquarters for the humanitarian-assistance mission, Erichsen said his Soldiers served side-by-side with joint, interagency and allied organizations in Liberia.

In support of the U.S. Agency for International Development, the brigade worked together with the Centers for Disease Control, Uniformed Public Health Service, Disaster Area Response Teams and many other international and volunteer organizations.

The other major news on the Ebola front was that Army medical researchers made remarkable strides in protecting Soldiers and populations around the globe from Ebola and other diseases, said Army Vice Chief of Staff Gen. Daniel B. Allyn, citing a promising vaccine under development for Ebola.

"The rapid development of a promising vaccine illuminates the incredible ability and capacity of this team," Allyn told researchers after touring the Walter Reed Army Institute of Research, or WRAIR, May 20.

A clinical trial at WRAIR of VSV-EBOV, a promising Ebola vaccine, preceded large-scale vaccine trials in Africa now. New vaccines like this one may help stave off future Ebola epidemics, Army researchers said.

The work of Army Medical Command, WRAIR and the U.S. Army Medical Research Institute of Infectious Disease helped get the Ebola outbreak in West Africa under control, saving hundreds of thousands of lives, Allyn said.

The Ebola outbreak in West Africa was projected to reach 1 million cases, Allyn said.

"This team … helped stop it at 11,000 - that's 989,000 lives saved," he said. "What the Medical Command, specifically this team of professionals, achieved is absolutely remarkable."

ENLISTED-TO-DOCTOR PATHWAY

For years, some had dreamed of becoming a doctor, a physician or a surgeon, but life had different plans. For a variety of reasons, they wound up enlisting in the military, some as medics, some in non-medical fields, some even made it to special operations. That first dream became something to be pursued someday, in another life, after the military.

In the Army, doctors and senior noncommissioned officers also spent years losing their most talented Soldiers to that dream, wishing they could offer them more opportunities while on active duty.

"This is something that I've wanted to see happen since I've been on active duty," said retired Command Sgt. Maj. Althea Green-Dixon, director of recruitment and outreach for the F. Edward Hébert School of Medicine at the Uniformed Services University of the Health Sciences, or USUHS, and director of the new Enlisted to Medical Degree Preparatory Program.

In the new EMDP2 program, which the USUHS runs with George Mason University, qualified service members have the opportunity to devote two years to classroom study and preparing for the Medical College Admission Test, or MCAT. During that time, they don't have to worry about deploying or training. Their sole duty is to be students.

ROBOT-ASSISTED SURGERY

Robots are increasingly assisting surgeons in operating rooms. For instance, take the one at Womack Army Medical Center, or WAMC, on Fort Bragg, North Carolina.

WAMC began using the da Vinci Surgical System in September for laparoscopic urology and gynecology surgeries. Two surgeons are using the system and additional surgeons are training to start performing procedures in the near future. The robot is already assisting with urology and gynecology surgeries and, once everyone is trained, will help perform general surgeries, as well.

"This is a relatively new technology initially intended for challenging surgeries in small places," said Maj. Patrick McDonough, chief, Urology Services, WAMC. "It's wristed, meaning that the arms have a full range of motion, and able to make precise, steady movements. It also allows you to see everything better while you're operating."

McDonough said that studies have shown that after a robot-assisted surgery, patients experience less post-operative pain, shorter stays in the hospital after surgery and less blood loss during the procedure.

Meanwhile, surgeons at Brooke Army Medical Center, or BAMC, on Joint Base San Antonio, Texas, are using their own robot.

They and the robot performed surgery on Jose Collado Jr., age 2, son of Maj. Jose Collado and his wife Alma, in June, to remove a large cystic mass from behind his bladder. The procedure marks BAMC's first robot-assisted pediatric surgery.

"The surgery was very successful," said Lt. Col. Thomas Novak, BAMC's chief of pediatric urology. "We were incredibly pleased at the outcome and at the impact we made on Jose's future quality of life."

Robotic technology, he explained, offers numerous benefits: it's minimally invasive, more agile in small spaces, offers 3D high-resolution magnification for better views of the surgical site, and typically involves a quicker recovery time.

'MOST WIRED' HOSPITAL

For the fourth consecutive year, San Antonio Military Medical Center, or SAMMC, at Joint Base San Antonio, Texas, has been named one of the nation's "Most Wired" medical facilities for its innovative use of health information technology.

The Hospitals and Health Networks magazine named only two Army Medical Command facilities as "Health Care's Most Wired" out of more than 2,213 U.S. hospitals. SAMMC and Madigan Army Medical Center on Joint Base Lewis-McChord, Washington, were among the 338 organizations which made the list.

To be named "Most Wired," hospitals must meet requirements in the following areas: infrastructure; business and administrative management; clinical; quality and safety (inpatient and outpatient hospital); and clinical integration (ambulatory, physician, patient and community). This year, hospitals also were required to demonstrate meaningful use of technology.

SAMMC was recognized for demonstrating some of the most advanced information technology, or IT use and adoption in the nation, said Lt. Col. David Bowen, BAMC's chief information officer.