Ask the Flight Surgeon / By MAJ Sonya Heidt, MD: Q: My FS recently told me that I need to bring in my permanent profile from two years ago to get it added to a new profile system. He also said I need to complete a PHA in addition to my annual flight physical. What changes are occurring within the Army Medical Department?
FS: In GEN Mark Milley’s initial message to the Army as the 39th Chief of Staff, he stated, “Readiness is #1, and there is no other #1.” Medical readiness is a significant aspect of the U.S. Army’s combat readiness. To be medically ready to lead this fight, the command needs to be aware of the numerous medical tasks for the unit. They are as follows: annual hearing screens, annual vision checks as well as all corrective lens accoutrements updated with current prescription, annual dental exams and any necessary completed procedures, routine immunizations, routine labs, annual health assessments with a provider, temporary and permanent profiles, and on-hand medical warning tags, when necessary (i.e. “medication allergy tags”). When preparing to deploy in the imminent future, the Soldiers must also be medically ready in the additional categories: specific theater and country immunizations, required routine medications on-hand for medical conditions, medications available for infectious disease prophylaxis, and health assessments (pre-deployment, post-deployment, and post-deployment health reassessment).
Commanders are able to track these requirements via a new Commander Portal to help give them oversight on their entire unit and trends. If they get an urgent deployment notice, commanders need to know their readily available combat strength. As outlined in Army Directive 2016-07 (Redesign of Personnel Readiness and Medical Deployability), commanders are now reporting their personnel as “deployable,” as compared to the prior terminology of “available.” Deployable Soldiers are able to be present within 72 hours and are medically ready to deploy to meet the unit’s mission.
Medical readiness benefits the individual, as well. As any Soldier knows, you have been well-vaccinated against many harmful diseases, above and beyond the normal population. When injured, you have access to a provider who has a magnificent communication tool (e-profile) to relay to your commander what your physical limitations are. In the event that you forget when your last vision and dental check was, you can simply sign in to AKO and check on your status and when your next exam is due. While medical leadership cannot effectively prevent all medical issues, there are excellent preventive health systems in place to protect you from a constantly evolving operational environment.
You will need to complete a Periodic Health Assessment separate from your annual flight physical. While the DODI 6200.06 [Periodic Health Assessment (PHA) Program] does not explicitly state it has to be done separately, many aviators have already completed their annual flight physical for this fiscal year and are still coming up as delinquent for their PHA.
The Department of Defense will implement the new Periodic Health Assessment (PHA) in late October 2017, per the Spring 2017 issue of the Medical Readiness Reader published by the U.S. Army G-37 Medical Readiness (MR) Division. They summarized the key changes into three main categories: core questions, cardiovascular screening, and record reviewer. Each PHA will have a standard set of core questions but will also have additional questions for age, gender, and positive or negative prompts. Each provider will apply the U.S. Preventive Services Task Force guidelines, as opposed to the prior Army guidelines of standard labs and electrocardiogram for Soldiers who were over 40 years old. An Army nurse or medic will have the enhanced capability to review the service member’s responses, review medical records, and annotate additional commentary in the PHA prior to provider’s review.
Another medical readiness issue that commanders face is updating old profiles into the new electronic system. Soldiers must give a copy of any profile written before 1 June 2016 to your provider. Their provider will then validate the profile and decide if it needs to be entered into the new physical profiling system (e-Profile). This action needs to be complete before 30 September 2017 as the prior profiles (written before 1 June 2016) will expire on 30 September 2017, in accordance with Army Directive 2016-07. In the Spring 2017 issue of the Medical Readiness Reader, the new system is in place to combine both permanent and temporary conditions into one profile. It also functions to effectively communicate limitations, anticipated APFT availability date, and total days on temporary profile in the last 12 as well as 24 months.
The changes in the Army’s medical readiness will benefit both the Soldier and unit. They will more effectively communicate current medical conditions and ensure preventive health measures are in line with the latest evidence-based medicine.
MAJ (Dr.) Sonya Heidt is a flight surgeon at the U.S. Army School of Aviation Medicine, Fort Rucker, AL.