Foundation for Integrating Employee Health Activities for Active Duty Personnel in the Department of Defense

the Authors Describe Current Department Of Defense Safety And Occupational Health Programs And Health Information Systems, As Well As Employee Health Programs Outside Of Dod To Provide A Foundation For Considering A More Integrated Department Of Defense Employee Health Program. Preface......Page 4 Contents......Page 6 Tables......Page 10 Figures......Page 12 Summary......Page 14 Abbreviations......Page 22 CHAPTER ONE- Introduction......Page 26 The DoD Work Environment......Page 27 How This Monograph Is Organized......Page 28 CHAPTER TWO- Project Goal, Methods, and Definitions......Page 30 Employee Health Care Encounters in DoD......Page 31 Employment Phase: Examples of Health Care Encounters During Time in Service......Page 33 Post-Employment: Examples of Health Encounters at Exit from the Service......Page 34 What Are Occupational Health and Preventive Medicine in DoD?......Page 35 Civilian Definition of an Integrated Employee Health System......Page 36 Defining an Integrated Employee Health System for DoD......Page 37 DoD Policy Parallels Civilian Initiatives......Page 38 DoD Has Faced Unique SOH Challenges......Page 39 Increased Attention to Deployment Health Following 1991 Gulf War......Page 40 Recent Focus on Safety......Page 41 Implications of the Recent Focus on Safety......Page 42 Activities Related to Health Promotion and Wellness......Page 43 Policy Documents Related to SOH......Page 44 Policy Documents Related to Health Promotion and Wellness......Page 45 Safety and Occupational Health Organization......Page 46 Army......Page 49 Navy and Marine Corps......Page 51 Air Force......Page 52 Summary and Conclusions......Page 54 IT Requirements in an Integrated Employee Health System......Page 56 Organization of Information Management and Information Technology Within the Military Health System......Page 57 IT Systems for Health Care Data (in Garrison)......Page 59 IT Systems for Periodic Health Assessment Forms......Page 62 IT Systems for Occupational and Environmental Exposures......Page 64 IT Systems for Troop Location......Page 66 IT Systems for Health Care Data......Page 67 IT Systems for Occupational and Environmental Exposures......Page 68 Cases and Methods......Page 70 Motivation Behind Integration Efforts......Page 71 Johnson & Johnson......Page 72 Common Elements......Page 73 Johnson & Johnson......Page 74 FedEx......Page 75 Other Companies......Page 76 Common Elements......Page 77 Johnson & Johnson......Page 78 Outcomes: Measuring the Effects on Health and Health Care Costs......Page 79 Johnson & Johnson......Page 80 Summary and Conclusions......Page 81 CHAPTER SIX- Observations and Conclusions......Page 84 Observation: Leadership Attention Is an Important Aspect of Civilian Integrated Employee Health Programs......Page 85 Observation: Data Will Be Needed for Post-Deployment Health Studies......Page 86 Conclusions......Page 87 APPENDIX A- Time Line of Safety and Occupational Health Policies and Programs, 1970–2007......Page 90 APPENDIX B- Semistructured Interviews with DoD Officials......Page 96 References......Page 98 If the Department of Defense (DoD) moves toward a more integrated employee health system, a foundation of information about the current system and requisite elements for such integration will be needed. The authors reviewed the research literature and DoD policy documents and interviewed DoD personnel to make several observations about the current state of safety and occupational health (SOH) arrangements in DoD. Currently, SOH policy cuts across several organizations at high levels in the Office of the Secretary of Defense, and SOH programs are implemented by each of the military services. Recently, leadership attention has focused on safety, mostly apart from occupational health, as a separate priority. DoD and the services have made efforts to increase coordination, including both high-level formal councils and through informal relationships among SOH practitioners. Health promotion and wellness have received considerable attention within DoD through periodic health assessments and educational programs, yet these areas have not benefited from the same increased coordination. As DoD contemplates a more integrated approach, the authors considered what DoD might learn from civilian experience with integrating employee health activities. To address this, the authors reviewed civilian models of integration to identify promising approaches and practices that might inform DoD efforts. The review of activities related to employee health in DoD -- including industrial hygiene, safety, health promotion and wellness, occupational health, and its relatively mature health information technology infrastructure -- indicates that there might be little need for DoD to introduce new programs but more need to make use of the information generated by the existing programs in a more coordinated, integrated manner
The authors describe current Department of Defense safety and occupational health programs and health information systems, as well as employee health programs outside of DoD to provide a foundation for considering a more integrated Department of Defense employee health program.