Periodic Health Assessment (PHA) for Individual Medical Readiness (IMR)

References: PHA/IMR
*DODI 6025.19 IMR 3 Jan 2006
*ASD (HA) Policy Memo 03-009 IMR Metrics of 2MAY03
*ASD (HA) Policy Memo 02-011 Oral Health & Readiness *Classification of 4JUN02
*SECNAVINST 6120.3 PHA for IMR of 14SEP07
*BUMEDINST 6110.14 Documenting and Reporting IMR Data of 6 Feb 2009
*NAVMED Policy: 06-005 Deployment Readiness of 31MAY06
*BUMEDNOTE 6150 Guidance for Completing Adult *Preventive & Chronic Care Flow Sheet (DD2766) & Interim Change to MANMED Article 16-23 of 19Jul07
References: Deployment Health Assessment Program
-DoDI 6490.03 Deployment Health of 11Aug06
-DoDI 6490.12 Mental Health Assessments for Service Members Deployed in Connection with a Contingency Operation
-OPNAVINST 6100.3A 10 Nov 2014 Deployment Health Assessment Process
-BUMEDINST 6100.9 21 July 2014 Mental Health Assessments for Members of the Armed Forces Deployed in Support of Contingency Operations
DISCLAIMER: This list of references is not all inclusive and the most recent updates may not be reflected. Commands are responsible for all instructions and guidance related to a particular program or inspectable area / Command POC:

Echelon

Reference / Standard / Yes / No / 2 / 3 / 4 / 5 / Comments/Notes
SECNAV 6120.3; enclosure 1 3c
BUMED 6110.14; 5; 1b. / Does the MTF have a well-defined program for maintaining IMR/PHA?
•Is there a designated command IMR/MRRS subject matter expert who is responsible for program oversight?
•Is there a Standard Operating Procedures (SOP) manual that guides IMR/PHA staff members?
•Is there an approach that considers the continuum of routine IMR and Pre/Post-deployment care? / √ / √ / √ / √
BUMED 6110.14
4a / Does the MTF have a process to maintain the IMR of their staff?
  • Check-in/Check-out
  • Birth Month/Annual PHA
/ N/A / √ / √ / N/A
BUMED 6110.14
5
SECNAV 6120.3 encl (1) / Does the MTF provide Periodic Health Assessments to active duty personnel who rely on the military treatment facility (MTF) for their primary care?
Is a one-stop process in place? / N/A / √ / √ / N/A
BUMED 6110.14
5 / Does the MTF have the ability to provide Commanding Officers IMR updates?
Details on the IMR/Deployment Health status of members? / N/A / √ / √ / N/A
DODI 6025.19
5.4.7
Pg 3 / Does the Command meet the minimum overall medical readiness goal of more than 75% of SMs fully medically ready (FMR)? Is the FMR plus the Partially Medically Ready (PMR) at least 82%? / √ / √ / √ / √
BUMED 6110.14
5 / Does the MTF serve as a resource to Line commands for MRRS access and guidance to manage the IMR status of their personnel?
This may include:
  • Track and trend supported commands IMR status
  • Providing MRRS access/training to command liaisons
  • Assisting Line Commands in the monitoring of IMR/Deployment Health metrics
  • Branch Health Clinics
  • Identify commands within respective AOR
  • Uses MRRS for reporting/tracking and AHLTA for documentation
/ N/A / √ / √ / N/A
BUMED 6110.14
4a(1) a-d / Is there appropriate electronic or paper medical record entry documenting PHAs?
  • AHLTA AIM form?
  • NAVMED 6120/4?
/ √ / √ / √ / √
SECNAV 6120.3
5a-e / Is the MTF documenting the service topics reviewed during the PHA on the DD Form 2766, Adult Preventive and Chronic Care Flow sheet?
  • Review health record
  • Conduct tracer of process
/ N/A / √ / √ / N/A
BUMED 6110.14
3a(1)a; 3(2)(a) 3(6)6b2 / Does the MTF have a process in place to ensure that all IMR requirements are entered in appropriate electronic data systems in accordance with BUMED Instruction 6110.14?
  • AHLTA/MRRS/DENCAS/
MEDBOLTT
  • Six IMR elements are addressed
/ N/A / √ / √ / N/A
SECNAV6120.3
Encl(1)2a-p / During the PHA, does the MTF review, as a minimum, the PHA requirements outlined in the current directives?
  • B/P measurement
  • HT/WT measurement/BMI
  • Assess Visual Acuity
  • Individual Medical Equipment
  • Assess Hearing
  • Immunization Status
  • TB Surveillance/Screening Testing
  • Laboratory Studies (lipid screen)
  • Annual Dental Exam
  • Deployment Health Assessment and Readiness
  • Occupational Medicine Surveillance
  • Cardiovascular Risk Factors Screen
  • Male/Female-specific requirements
  • Colorectal Cancer Screening
  • Health Risk Assessment/Counseling
  • Physical Fitness Assessment
  • PHA review and counseling conducted by approved provider
/ N/A / √ / √ / N/A
E4 A1.3
page 25 / Does the deployment health record (DD Form 2766) contain the individual’s blood type/Rh factor; prescribed medications and/or allergies; corrective lens prescription; all immunizations in the Services’ electronic immunization tracking database and the patient deployment health record (must include type of immunization, date administered, dose and the vaccine administrator identifying information such as their initials; completed DD Form 2795, when required; and medical summary sheet identifying past and current medical conditions and screening tests)? / √ / √ / √ / √
DODI 6490.03
Pg 6
5.5.7
OPNAV 6100.3A
P / Are completed DD Form 2795s submitted to the Defense Medical Surveillance System (DMSS) via the Navy and Marine Corps Public Health Center (NMCPHC) (formerly NEHC)? Describe the process. / √ / √ / √ / √
DODI 6490.03
E4.A1.2
Pg 23-26
E4 A1.1.2
E4A1.1.3
E4A1.1.4
E4A1.1.5
E4A1.1.6 / Pre-Deployment Health Assessment
Are/Is:
  • Individual medical readiness (IMR) deficiencies and deployment-specific health readiness deficiencies corrected and documented in the Service’s electronic tracking system for IMR requirements?
  • Deployment specific or occupational-related immunizations, prophylaxis, and any medical countermeasures or protective measures, as indicated, administered?
  • Force Health Protection Prescription Products (FHPPPs) prescribed, as indicated?
  • Pre-deployment tuberculosis screening performed?
  • Occupational personal protective equipment (e.g., hearing or industrial respiratory protection) and monitoring devices (e.g., thermo luminescent dosimeter (TLD badge) as required by occupational specialty or personnel issued?
Pre-deployment serum specimens drawn? / √ / √ / √ / √
E4A1.1.7
E4A1.1.8
E4A1.1.9
SECNAV 6120.3
5a-e / Is/Are:
  • Human Immunodeficiency Virus (HIV) testing (or as required for HIV threat or country requirements conducted?
  • Bio-monitoring baselines as required for potentially at-risk personnel conducted?
  • A minimum 90-day supply of prescription medications other than FHPPPs prescribed?
  • Medical records and deployment health records (DD Form 2766) updated?
Describe the process. / √ / √ / √ / √
DODI 6490.03
E4A2.6 / Are inpatient and outpatient medical and dental deployment encounter documentation (including medical and dental treatment records on DoD personnel from allies and coalition partners) combined with the individual’s permanent medical and dental records within 30 days of redeployment? Describe the process. / √ / √ / √ / √
DODI 6490.03
E4.A3.2.3
E4.A3.2.4
E4.A3.2.5 / Are the visits for deployment-related medical concerns documented using the Post Deployment Health Clinical Practice Guideline diagnostic International Classification of Diseases code V70.5_6 in the patient’s medical record? / N/A / √ / √ / N/A
DODI 6490.03
E4.A3.2.6
E4.A3.2.7
E4.A3.2.8
E4.A3.2.9
E4.A3.2.10
E4.A3.2.11 / Is/Are:
  • All medical encounter documentation integrated into the medical record?
  • Post-deployment tuberculosis screening accomplished, if required?
  • Post-deployment serum samples drawn (if pre-deployment serum samples were required)?
  • Bio-monitoring performed, when indicated?
  • Post-deployment health debriefings and risk communications conducted?
  • Medical surveillance in place to identify post-deployment health problems?
This is not a deployment health assessment question.
Describe the process. / N/A / √ / √ / N/A
DODI 6490.03
E4A2.6 / Are inpatient and outpatient medical and dental deployment encounter documentation (including medical and dental treatment records on DoD personnel from allies and coalition partners) combined with the individual’s permanent medical and dental records within 30 days of redeployment? Describe the process. / N/A / √ / √ / N/A
DODI 6490.03
E4.A3.2.1.1
E4.A3.2.4
Table E4.T3 / Are medical referrals and follow-up medical visits for deployment-related medical concerns and issues accomplished? Describe process. / N/A / √ / √ / N/A
OPNAV 6100.3A / Does the commanding officer track the compliance of their eligible members with this program? / √ / √ / √ / √

1

Deployment Health Assessment Program

Reference / Standard / Yes / No / 2 / 3 / 4 / 5 / Comments/Notes
DoDI 6490.03
DoDI 6490.12
OPNAVINST 6100.3A BUMEDINST 6100.9 / Does the program manager have knowledge of current guidance and polices governing deployment health assessment policies that impact all echelons of care? / √ / √ / √ / √
DoDI 6490.03
BUMEDINST 6100.9
Pg 3
6.a / How does the program manager interface with Navy Marine Corps Public Health Center and Armed Forces Health Surveillance Center to ensure data flow and updated data files? / √ / √ / √ / √
DoDI 6490.03
BUMEDINST 6100.9
Pg 3
6.a / Does program manager serve as the Navy Medicine representative on program related working groups, committees, at meetings, and conferences? / √ / N/A / N/A / N/A
Reference / Standard / Yes / No / 2 / 3 / 4 / 5 / Comments/Notes
DoDI 6490.03
BUMEDINST 6100.9
Pg 3
6.a / How does program manager:
1. Engage in collaboration with Navy and USMC leadership to support program implementation and compliance? Please describe.
2. Effectively plan and manage budget as evidenced by the adequate availability of clinical, program management, and IT resources to support program implementation? Please describe. / √ / √ / √ / √
DoDI 6490.03
BUMEDINST 6100.9
Pg 3
6.a / How does program manager provide subject matter expertise in the form of consultation, reports, information papers, and decision briefs? Please describe. / √ / √ / √ / √
DODI 6490.03
Pg 23
E4 A1.1 thru 1.1.1.1
OPNAV 6100.3A (updates the 120 day requirement).
Pg 3.
5.a.(1) / Pre-Deployment
Do Service members deploying OCONUS “boots-on-ground” for greater than 30 days to a location with non-fixed military treatment facilities complete a Pre-Deployment Health Assessment (DD Form 2795) within 120 days of their expected deployment date?* / √ / √ / √ / √
Reference / Standard / Yes / No / 2 / 3 / 4 / 5 / Comments/Notes
DODI 6490.03
Pg 27
E4A3.2.1.2
OPNAV 6100.3A
Pg 3 5.a.(2) / Post-Deployment Health Assessment
Do Service members returning from an OCONUS “boots-on-ground” deployment of greater than 30 days at a location with non-fixed military treatment facilities complete a Post-Deployment Health Assessment (DD Form 2796) as close to redeployment as possible, but not earlier than 30 days prior to the expected redeployment date and not later than 30 days after redeployment?* / √ / √ / √ / √
DODI 6490.03
Pg 29
E4.A3.2.12
OPNAV 6100.3A
Pg 3
5.a.(3) / Post-Deployment Health Assessment
Do Service members who have returned from an OCONUS “boots-on-ground” deployment of greater than 30 days at a location with non-fixed military treatment facilities complete a Post-Deployment Health Re-assessment (DD Form 2900) within 90 to 180 days after redeployment?* / √ / √ / √ / √
Reference / Standard / Yes / No / 2 / 3 / 4 / 5 / Comments/Notes
DoDI 6490.12
Pg 2
3.c
3.d
BUMEDINST 6100.9
Pg 2
4.a.(3)
4.a.(4)
4.b.(2) / Do Service members who have returned from an OCONUS “boots-on-ground” deployment of greater than 30 days at a location with non-fixed military treatment facilities complete a Deployment Mental Health Assessment (DD Form 2978) in conjunction with the Periodic Health Assessment process 7-18 months and 18-30 months after redeployment?* / √ / √ / √ / √
DoDI 6490.12
Pg 6
Enc. 2.c
BUMEDINST 6100.9
Pg 2
4.d / Did the mental health assessment include a review of the health record? / √ / √ / √ / √
Reference / Standard / Yes / No / 2 / 3 / 4 / 5 / Comments/Notes
DODI 6490.03
Pg 21
E4.A1.1.1.3
DoDI 6490.12
Pg 7
Enc. 2.d
OPNAVINST 6100.3A
Pg 4
5.a.(3).d
BUMEDINST 6100.9
Pg 3
5.a / Are completed DD Forms 2795, 2796, 2900 and 2978 placed in the individual’s permanent medical record? Is the DD Form 2795 placed in the individual’s deployment health record? / N/A / √ / √ / N/A
Reference / Standard / Yes / No / 2 / 3 / 4 / 5 / Comments/Notes
DODI 6490.03
Pg 28
E4.A3.2.3
E4.A3.2.4
Table E4.T3
OPNAV 6100.3A
Pg 7
6.e.(5) (CO responsibility) / Are referrals for medical/mental health concerns resulting from the completion of DD Forms 2795, 2796, 2900, or 2978 (Deployment Mental Health Assessment) properly executed and tracked to completion? / N/A / √ / √ / N/A
OPNAV 6100.3A
Pg 8
7.d / Does the commanding officer track DD Forms 2795, 2796, and 2900 compliance for eligible members? / √ / √ / √ / √
Tracer question / How many staff members require a PDHRA? / √ / √ / √ / √
Tracer question / When new staff members report, do you have a process to determine if they have previously deployed and are in need of a Deployment Health Assessment? / √ / √ / √ / √

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