Director of the Joint Staff Vice Adm. Dennis C. Blair and Army Surgeon General Lt. Gen. Ronald R. Blanck reported today on the status of initiatives to improve force medical protection. These initiatives constitute a "revolution in medical affairs" that is part of the overall Revolution in Military Affairs (RMA) affecting doctrine, operational concepts and capabilities for U.S. military forces.
These force medical protection initiatives make best use of advanced technologies and lessons learned during and since the Gulf War to protect deployed forces from environmental and medical threats, reduce the disease non-battle injury rate, improve lifetime medical care for service members, and provide more complete individual medical histories.
Force medical protection and surveillance policies, doctrine and planning guidance issued by the Department of Defense and the Joint Chiefs of Staff, and fully supported by the theater Commanders-in-Chief (CINC's), Service leadership and joint task force commanders, have resulted in dramatic successes. The non-battle injury rate, including cases of disease, for U.S. forces deployed to Bosnia has been the lowest in history, 76 cases per 1,000 service members per year, as compared to a rate of 153 cases per 1,000 service members per year deployed to Operations Desert Shield and Desert Storm, and 419 cases per 1,000 service members per year deployed during the Vietnam conflict.
As part of the Defense Department's new health surveillance initiatives, pre-deployment medical activities for Operation Joint Endeavor (Bosnia) included comprehensive health screening, the collection and storage of serum samples from deploying service members, and extensive education to highlight health risks and preventive measures. Commanders, assisted by the medical community, have ensured the maintenance of data on the deployment of individuals, and accurate records of health-related events. Post-deployment medical activities have included complete health screenings and serum collection from individuals prior to leaving theater or
within 30 days of return to the service member's parent unit. Effective surveillance helps both the Department of Defense and the Department of Veterans Affairs to provide better care for our service members and veterans.
Environmental and medical surveillance in Bosnia has been extraordinary. Over 2,200 soil, water and air samples were collected and subjected to 112,000 analyses. Forward-deployed medical laboratories provided immediate diagnostic support. The results were used to ensure deployed forces were not subjected to environmental threats. For example, early detection of the threat of tick-borne encephalitis (TBE) and prompt vaccination has resulted in no cases of TBE among deployed U.S. forces.
Historically, medical record-keeping and documentation has been imperfect, especially during deployments. One promising technology currently being developed in a wide-ranging effort to overcome this challenge is the medical Personal Information Carrier (PIC). The PIC is a small, rugged, tag-like device intended to store an individual's medical status and history, to include medical documents, X-rays, and vaccination records. The PIC will be carried by service members and updated by medical personnel using portable computers whenever the service member is examined or treated. The PIC will be only one aspect of a full electronic theater medical record system. PIC information will be transmitted to consolidated databases to ensure that medical information is not lost if the PIC is lost or damaged. The military services, under the auspices of the assistant secretary of Defense for Health Affairs, are developing the concept of use and determining the specific information to be contained in the PIC. Those requirements will be established by January, 1998. Operational testing of the PIC will be conducted during 1998, with deployment of the device beginning in fiscal year 1999.