Post-Deployment Health Reassessment PDHRA

1. 1 Post-Deployment HealthReassessment (PDHRA) Clinician Training United States Marine Corps February 2006

2. 2 Background on the Post-Deployment Health Reassessment (PDHRA) Reassessment of the health of all re-deployed service members at 90-180 days post-deployment was ordered by ASD(HA) on 10 March 2005 ASN(M&RA) concurred on 05 July 2005 Implementation guidance for the Marine Corps is contained in two MARADMIN messages due for release in February 2006 The major reason for performing a health reassessment at 3 to 6 months post-deployment is concern over possible delayed mental health problems related to deployment stress All over the world, service men and women are making sacrifices on behalf of this country. There has never been a greater need for us to provide world-class,compassionate healthcare to those service members who are protecting this country. To ensure the health of service members around the world, the Department of Defense monitors and develops health initiatives that address the latest needs facing our service members.All over the world, service men and women are making sacrifices on behalf of this country. There has never been a greater need for us to provide world-class,compassionate healthcare to those service members who are protecting this country. To ensure the health of service members around the world, the Department of Defense monitors and develops health initiatives that address the latest needs facing our service members.

3. 3 PDHRA Key Elements Outreach: Directly asking Marines and Sailors about their health problems after deployment, instead of waiting for them to step forward Education: An educational brief must be delivered to all unit Marines and Sailors around the same time as the PDHRA, preferably immediately before it Health Reassessment: PDHRA is filled out by each Marine and Sailor electronically Detailed Evaluation and Treatment: Face-to face interview of each Marine and Sailor is required, with referral recommendations documented electronically Follow-up and Case Management: Referrals and treatment plans established on the PDHRA must be followed up to ensure compliance and adequacy In a nutshell, the PDHRA works very much like the PDHA, which is currently administered immediately upon return from deployment. Service members will be asked to answer a few screening questions using an electronic or web-enabled questionnaire, and then to discuss their health concerns with a healthcare provider to determine if more detailed diagnostic evaluation, additional treatment, or health-related information is needed. Those of us who have treated service members in the past, know how proud and strong these men and women are. It is vital that we support this initiative and these men and women with a great deal of care and respect.In a nutshell, the PDHRA works very much like the PDHA, which is currently administered immediately upon return from deployment. Service members will be asked to answer a few screening questions using an electronic or web-enabled questionnaire, and then to discuss their health concerns with a healthcare provider to determine if more detailed diagnostic evaluation, additional treatment, or health-related information is needed. Those of us who have treated service members in the past, know how proud and strong these men and women are. It is vital that we support this initiative and these men and women with a great deal of care and respect.

4. 4 Steps in the PDHRA Process Marines who are 90-180 post-deployment are identified by their current commands (including those who deployed with a previous command) Marines fill out the member portions of PDHRA, DD Form 2900, electronically via Naval Environmental Health Center (NEHC) Website Marine is interviewed by medical provider who attends to all positive responses Medical provider documents assessment and referral recommendations also via NEHC Referrals and appointments for medical follow-up are made through routine channels For more service member and medical provider info, see www-nehc.med.navy.mil/PDHA/Users_Guide.pdf All over the world, service men and women are making sacrifices on behalf of this country. There has never been a greater need for us to provide world-class,compassionate healthcare to those service members who are protecting this country. To ensure the health of service members around the world, the Department of Defense monitors and develops health initiatives that address the latest needs facing our service members.All over the world, service men and women are making sacrifices on behalf of this country. There has never been a greater need for us to provide world-class,compassionate healthcare to those service members who are protecting this country. To ensure the health of service members around the world, the Department of Defense monitors and develops health initiatives that address the latest needs facing our service members.

5. 5 PDHRA Overview:General Health (Questions 1-6) Demographics Overall health status Comparison of current health status with pre-deployment health status Injuries, wounds, or assaults during deployment Health care use since return from deployment Current health concerns that service member believes are related to the most recent deployment Questions 1 through 6 cover general, overall health status. These questions give service members an opportunity describe their general health and to voice any concerns they may have.Questions 1 through 6 cover general, overall health status. These questions give service members an opportunity describe their general health and to voice any concerns they may have.

6. 6 Role of Health Care Provider: General Health (Questions 1-6) Develop a sense of service member�s general health through interviewing Review service member�s DD 2795, 2796, and other health records available Refer health concerns identified during interview to Primary Care Provider (PCP) for evaluation and treatment or specialty care if warranted Attend to urgent or emergent care needs You should develop a sense of each service member�s health by reviewing their answers to the general heath questions and interviewing them further about their responses. If the medical records are available, you should compare their responses on the Pre and Post Deployment Health Assessment forms � labeled DD Forms 2795 and 2796. If not available, you can simply ask them about their health status before and after their most recent deployment. For active duty members, general health concerns and conditions that you identify during the interview that need additional assessment beyond the time and circumstances provided for this interview, should be referred to the service member�s Primary Care Provider for further evaluation or treatment under the DoD/VA Post-Deployment Health Clinical Practice Guideline.You should develop a sense of each service member�s health by reviewing their answers to the general heath questions and interviewing them further about their responses. If the medical records are available, you should compare their responses on the Pre and Post Deployment Health Assessment forms � labeled DD Forms 2795 and 2796. If not available, you can simply ask them about their health status before and after their most recent deployment. For active duty members, general health concerns and conditions that you identify during the interview that need additional assessment beyond the time and circumstances provided for this interview, should be referred to the service member�s Primary Care Provider for further evaluation or treatment under the DoD/VA Post-Deployment Health Clinical Practice Guideline.

7. 7 Question 7: �Do you have any persistent major concerns regarding the health effects of something you believe you may have been exposed to or encountered while deployed?� Exposure worry or concern even in absence of symptoms