Could procrastination be the smoking gun?

Could procrastination be the smoking gun?

March 4, 2010 ~ Apparently mental health providers treating our deployed troops are too busy to do their paperwork.  Bob Brewin of Nextgov obtained an internal message dated January 11, 2011, from the Army Office of the Surgeon General which stated that “Army units…..have become “saturated” with paper behavioral health records because mental health providers who treat these soldiers are not entering data into the theater electronic health record known as AHLTA-T.

All I can ask is “Why not?”

Why aren’t these mental health providers finishing their job at the end of the day?  I’m sure they are overworked and understaffed, but I doubt our troops are working easy 9:00 to 5:00 shifts with an hour for lunch every day.  Seems to me that if one is hired to go overseas and provide mental health care for troops who are on the front lines, they should understand the significance of their assignment.  They are not handing out candy to babies.  They are dispensing psychotropic medications to people who carry deadly weapons 24/7 because their lives are in danger every minute of every day.  (I have to question the sanity in this concept but that argument will be saved for another blog post on another day.)

I’m as guilty as the rest for procrastinating.  I can be found guilty of avoiding the laundry pile for a few days and I’ve been known to find cause to buy one of those “belated birthday” cards sitting on store shelves,  but when it comes to something really important, something like recording medical records, I’m not sure choosing to procrastinate is an option.

This isn’t even about one doctor who never does his paperwork.  This is about an entire system of health care providers who are not documenting their treatment for our troops standing in harm’s way.  This is about thousands of paper records not being entered into AHLTA-T.

According to Brewin, the internal message originating from the Army’s Office of the Surgeon General directs that “all ‘loose’ paper records be collected, collated and identified by patient name and Social Security number.  Any that cannot be positively identified ‘will be destroyed,’ the message said.”

I see more than one problem here.  For starters it seems like a violation of privacy to leave records lying around with patient names and Social Security numbers.  Why are these documents “loose” and not filed away properly? And what about the records that will be destroyed because they couldn’t be positively identified?  What happens to the soldier who has no records of his treatment when he returns to the states?  What if it is found that certain medications cause a negative reaction for a soldier?  How will the next mental health provider know NOT to prescribe that same drug to the same patient?

With the high incidence of Post Traumatic Stress Disorder and mild Traumatic Brain Injury, and the number of suicides taking place amongst our military and veteran populations, it seems to me that these records could mean the difference between life and death.

I personally know two families who have lost a Marine to suicide. Both Marines were diagnosed with PTSD.  I also know two families who had their sons return home from deployment only to find that they died in their sleep because they took prescribed medications to help them rest. I know another family who fought to get the attention of military doctors because they knew that prescribed medications were destroying their soldier.  Once the soldier was discharged from the military, he was soon back in the same desperate situation because the VA prescribed the very same medications which had already been proven to cause significant, even life threatening, problems for the soldier.

How could this happen you ask?  One reason might be that the DoD and the VA are not sharing medical information as they are required to do.

Back on October 30, 2008, Dr. Steven L. Jones, principal deputy assistant secretary of defense for health affairs stated that one of the chief goals of DoD-VA interoperability efforts is to supply computerized health data so providers in both departments “will have the necessary health information background to be able to provide better quality care.”

In the case of the soldier previously mentioned, he was given prescriptions which nearly resulted in death.  When the family inquired as to why their soldier was prescribed these drugs when it was known that his medical records stated that he should not take said medications, the VA stated that they had no records on the soldier from the DoD.  Why not?  Who couldn’t stay at work long enough to enter the documentation into the electronic system?

How does a medically retired disabled veteran arrive at the VA for medical services without the medical documentation to prove he receives benefits?  He should arrive with the record in hand if these two systems can’t press the “send” button and use our modern day computer system and electronic mail to get the job done.

According to Brewin’s article, “a spokesman for the Military Health System said it is a matter of clinical practice, not policy, to record mental health encounters…” Apparently, the undersecretary of Defense for personnel and readiness has chartered a work group to evaluate a policy for mental health records. The MHS spokesman told Brewin that the work group will establish an official definition for a mental health record and develop a policy for retention and disposition of such records in all of the services.

How many combat veterans will die in their sleep or take their own lives while the work group develops an official definition and a policy?  How many more will die while they figure out how to implement the policy?

Is it acceptable to take a chance on losing even one more combat veteran to suicide or death as a result of a prescription drug cocktail overdose?  I don’t know how you feel about it, but it seems to me that somewhere along the way these mental health providers should have been made to stay a little bit later at the office to allow the needed time to enter the information into the computer system.

Would any of these providers leave the job undone if it they knew it was going to be their loved one lying in a casket as a result?

Originally published by the author at fellednot.com 

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