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Additional Hearing Conservation Outcomes For Surveillance:

Additional Hearing Conservation Outcomes For Surveillance: . Treat Individuals, Think Populations. Thomas Helfer US Army Center for Health Promotion & Preventive Medicine. Military Audiology Short Course Salt Lake, UT, April 5-7 2004. Overview. *Evidence-based Practice 1 st principles

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Additional Hearing Conservation Outcomes For Surveillance:

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  1. Additional Hearing Conservation Outcomes For Surveillance: Treat Individuals, Think Populations Thomas Helfer US Army Center for Health Promotion & Preventive Medicine Military Audiology Short Course Salt Lake, UT, April 5-7 2004

  2. Overview *Evidence-based Practice 1st principles *Review Audiology clinic data as basis for population health “situational awareness” *Lessons learned from other Public Health surveillance contexts *Applying lessons learned to Evidence-based Hearing Conservation

  3. Fitting Ambulatory Data Module (ADM)Hearing Losses Into Public HealthSurveillance? Age Race Gender ICD-9CM multi-purpose data for statistical analysis Monitor Symptom Disease Injury Clusters Host Vector Agent Environment

  4. Clinical Path STS Assessment From DOEHRS/SADR Follow up (f/u) 1 & out- comes annual surveillance outcomes f/u2 * & out- comes Audiology referral & outcomes Rule out (R/O) sensory loss PTS- Rule in Sensory loss normal normal normal STS STS STS new reference F/u audio F/u audio Audiology clinic annual audiogram t-> NO New ref no f/u1 no f/u2 Force Health Protection Measure thru Active Surveillance no referral visit record

  5. Non-DOEHRSADMICD-9CM Codes ENT Periodic Audiogram Medical Board Audiology Clinic Administrative Action Other event Deploy- ment Related Surveillance Acoustic Trauma/ Tinnitus TM perfs Hearing Loss Limiting duties &/or retention (H-3, H-4 - A/AF) PTS

  6. Public Health Surveillance Take action based on information Present to Commanders & Med Staff Decision Support Information Refresh Policy Health Data Acquisition Staging Clinical Data Storage Decision Support Analysis Refreshment Process Real World Events

  7. Present Day--The MHS Bad News There is no DOD Public Health System!

  8. The Good News!! DOD COMPREHENSIVE HEALTH SURVEILLANCE MASTER PLAN Now recognized that Public Health resources ($$$ & people) need to be fencedin order to be effective

  9. Defense Center for Health Statistics and Surveillance (DCHSS) Integrate Extensive Current Capabilities ESSENCE DMSS CHPPM AFIOH WRAIR-GEIS NEHC AF PHSO NHRCAFIP AFMIC Safety Centers

  10. DOD Military Injury Metrics Working Group New Military Injury Surveillance Standards

  11. Analysis Processing 1 copy database 2 Populate injury data set Reporting * outcomes rate by category * at installations * service-wide * DOD-wide DMSS Source data @ MDR Raw SADR ASCII SADR ADM@ MTF’s DMSS Injury Metrics Data Flow

  12. Analysis Processing *Query target codes *Populate outcome data set Reporting *n of pt visits by syndrome *situational alerts *multi-level reporting ESSENCE Source data @ MDR Raw SADR Syndromic Surveillance Data Flow ASCII SADR ADM@ MTF’s

  13. DOD COMPREHENSIVE HEALTH SURVEILLANCE MASTER PLAN “The first priority is to get actionable health information to the local levels where responses must be conducted.”

  14. "We are very short of money. So we must now begin to think." Lord Rutherford, 1926

  15. 1 CHPPM 2 Processing 1 Query target ICD-9 codes 2 Populate outcome data set CHPPM HCP Web page Reporting monthly * n of ea hearing injury category * At installations under RMC’s * Total injuries per installation * Gender/age stratification for each injury category Source data @ MDR Raw Data Medical Metrics M-2 Database Scrub data ASCII SADR ADM@ MTF’s Army Hearing Loss Data Flow

  16. ADM Hearing Loss Reports-Army MEDCOMPTSAcousticTinnitusTMH-3H-4Total Trauma perf RMC installation n n n n n n n installation n n n n n n n RMC installation n n n n n n n installation n n n n n n n Army-wide n n n n n n n Grand totals

  17. ADM Hearing Loss Reports-Local InstallationPTSAcousticTinnitusTMH-3H-4Total Trauma perf Bn UIC n n n n n n n Bn UIC n n n n n n n Bn UIC n n n n n n n Bn UIC n n n n n n n Web-enabled data collection & monthly reports

  18. Main Goal: Deliver "Actionalble Health Information" Visible at multi-levels of Command Empowers installation HCPM’s Show Mobilization Readiness Focus on Force Health Protection

  19. Conclusions Need tokeep goals in mind Speed reports generation for installations Apply existing surveillance report formats Apply evidence-based public health practice Provide actionable information to unitCommanders

  20. Questions Contact information: Tom Helfer, PHD E-mail: Thomas.Helfer@.US.Army.mil Phone: 410-436-3797 DSN: 584-3797

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