Adequacy of the VA Persian Gulf Registry and Uniform Case Assessment Protocol (1998) / Chapter Skim
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Appendix E: Adequacy of the Comprehensive Clinical Evaluation Program: A Focused Assessment
Appendix E: Adequacy of the Comprehensive Clinical Evaluation Program: A Focused Assessment
Pages 105-112
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From page 105... ...
The committee believes that such change is healthy, that it reflects growth, and that it should be a natural part of any system having as one of its goals the delivery of high-quality heals care services. This appendix is excerpted from the Institute of Medicine report, Adequacy of the Comprehensive Clinical Evaluation Program: A Focused Assessment, Washington, D.C.: National Academy Press, 1997.
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From page 106... ...
The committee recommends that when patients presenting with medically unexplained symptom syndromes are evaluated, the provider must have access to the full and complete medical record, including previous use of services. The presence of such information is important
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From page 107... ...
The committee recommends that the CCEP be encouraged to identify patients in this spectrum of illnesses early in the process of their disease. In addition, primary care providers should identify the patients' functional impairments so as to be able to suggest treatments that will help improve these disabilities.
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From page 108... ...
The committee recommends that DoD provide to each about-to-be deployed soldier risk or hazard communication which is well developed and designed to provide information regarding what the individual can expect and the potentially traumatic events to which he or she might be exposed. The committee wishes to emphasize that the accurate diagnosis of patients with medically unexplained symptom syndromes and/or conditions induced or exacerbated by upsetting events requires the expenditure of time, time in which the provider and the patient interact.
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From page 109... ...
However, the committee believes that there are those who have some of the symptoms of PTSD or of depression but are not true PTSD cases yet might be helped with treatment oftheir symptoms. The committee recommends that any individual who reports any significant PTSD symptoms and/or a significant traumatic stressor should be referred to a qualified mental health professional for further evaluation and treatment.
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From page 110... ...
The committee recommends that DoD explore the possibility of using neurobehavioral testing at entry into the military to determine whether it is feasible to use such tests to predict change in functioning or track change in function during a soldier's military career. PROGRAM EVALUATION Most patients in the CCEP receive a diagnosis after completing a Phase I examination; some are referred to Phase II for evaluation; and a few have gone on to participate in the program at the Specialized Care Center.
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From page 111... ...
The VA conducts quarterly national telephone conference calls, directs periodic educational mailings to Persian Gulf Registry providers in each health facility, and conducts an annual conference on the health consequences of Persian Gulf service. The committee recommends that DoD examine the activities and materials for provider education developed by the VA to determine if some of the items might be used as educational approaches for DoD providers.
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From page 112... ...
In addition, a tremendous amount of qualitative infonnation could be used in developing case studies to help providers better understand diagnostic and treatment approaches that appear effective at improving individual patients' conditions. The committee recommends that CCEP information be used to develop case studies that will help educate providers about Persian Gulf health problems.
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