The Patient-Centered Medical Home in the Transformation From Healthcare to Health

Nathan, Matthew L.

doi:10.7205/milmed-d-12-00467

Cited by 8 publications

(4 citation statements)

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“…These findings underline the importance of multidisciplinary, integrated care across a variety of settings that treat active duty and veteran service members. While the military has progressively moved to a patientcentered medical home model, which employs a teambased approach for in-garrison managed care [65], additional measures to improve care for service members with multimorbidity may be warranted. Namely, inclusion of interdisciplinary rehabilitation, sports medicine, orthopaedic, and mental health specialists in deployed units may help with the prompt assessment, treatment, and disposition of patients with musculoskeletal pain, concussion, and mental health conditions [66,67].…”

Section: Discussionmentioning

confidence: 99%

Multimorbidity and quality of life after blast-related injury among US military personnel: a cluster analysis of retrospective data

et al. 2020

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Background: Blast injury emerged as a primary source of morbidity among US military personnel during the recent conflicts in Iraq and Afghanistan, and led to an array of adverse health outcomes. Multimorbidity, or the presence of two or more medical conditions in an individual, can complicate treatment strategies. To date, there is minimal research on the impact of multimorbidity on long-term patient-reported outcomes. We aimed to define multimorbidity patterns in a population of blast-injured military personnel, and to examine these patterns in relation to long-term quality of life (QOL). Methods: A total of 1972 US military personnel who sustained a blast-related injury during military operations in Iraq and Afghanistan were identified from clinical records. Electronic health databases were used to identify medical diagnoses within the first year postinjury, and QOL was measured with a web-based assessment. Hierarchical cluster analysis methods using Ward's minimum variance were employed to identify clusters with related medical diagnosis categories. Duncan's multiple range test was used to group clusters into domains by QOL. Results: Five distinct clusters were identified and grouped into three QOL domains. The lowest QOL domain contained one cluster with a clinical triad reflecting musculoskeletal pain, concussion, and mental health morbidity. The middle QOL domain had two clusters, one with concussion/anxiety predominating and the other with polytrauma. The highest QOL domain had two clusters with little multimorbidity aside from musculoskeletal pain. Conclusions: The present study described blast-related injury profiles with varying QOL levels that may indicate the need for integrated health services. Implications exist for current multidisciplinary care of wounded active duty and veteran service members, and future research should determine whether multimorbidity denotes distinct post-blast injury syndromes.

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Section: Discussionmentioning

confidence: 99%

Multimorbidity and quality of life after blast-related injury among US military personnel: a cluster analysis of retrospective data

et al. 2020

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“…First, the implementation of the Marine-Centered Model Home brought additional attention, resources, and accessible medical care to operational units. [15] Second, physical therapists and athletic trainers have been assigned with operational units in proximity to troop billeting and work centers. Reduction in the barriers to care likely increased medical access and capture of LAS diagnoses in these communities.…”

Section: Injury Rates Over Timementioning

confidence: 99%

Sex and occupation are salient factors associated with lateral ankle sprain risk in military tactical athletes

Fraser

MacGregor

Ryans

et al. 2021

Journal of Science and Medicine in Sport

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“…A variety of military wellness programs are showing significant improvements (again using standard metrics) in Warriors with TBI/PTSD. 8 , 25 – 27 …”

Section: Holistic Therapies Developed At the New Walter Reed 2006–201mentioning

confidence: 99%

Advanced Metrics for Assessing Holistic Care: The “Epidaurus 2” Project

Foote

Benson

Berger

et al. 2018

Glob Adv Health Med

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In response to the challenge of military traumatic brain injury and posttraumatic stress disorder, the US military developed a wide range of holistic care modalities at the new Walter Reed National Military Medical Center, Bethesda, MD, from 2001 to 2017, guided by civilian expert consultation via the Epidaurus Project. These projects spanned a range from healing buildings to wellness initiatives and healing through nature, spirituality, and the arts. The next challenge was to develop whole-body metrics to guide the use of these therapies in clinical care. Under the “Epidaurus 2” Project, a national search produced 5 advanced metrics for measuring whole-body therapeutic effects: genomics, integrated stress biomarkers, language analysis, machine learning, and “Star Glyphs.” This article describes the metrics, their current use in guiding holistic care at Walter Reed, and their potential for operationalizing personalized care, patient self-management, and the improvement of public health. Development of these metrics allows the scientific integration of holistic therapies with organ-system-based care, expanding the powers of medicine.

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The Patient-Centered Medical Home in the Transformation From Healthcare to Health

Cited by 8 publications

References 0 publications

Multimorbidity and quality of life after blast-related injury among US military personnel: a cluster analysis of retrospective data

Multimorbidity and quality of life after blast-related injury among US military personnel: a cluster analysis of retrospective data

Sex and occupation are salient factors associated with lateral ankle sprain risk in military tactical athletes

Advanced Metrics for Assessing Holistic Care: The “Epidaurus 2” Project

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