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Author: TriSec    Date: 03/05/2013 11:22:30

Good Morning.

Today is our 4,167th day in Afghanistan.

We'll start this morning as we always do; with the latest casualty report from our ongoing war, courtesy of Antiwar.com:

US Military Deaths - Afghanistan: 2,178
Other Military Deaths - Afghanistan: 1,080

We find this morning's cost of war passing through:

$ 1, 429, 628, 675, 000. 00



Diving right in, let's veer into healthcare for just a moment. Most of us have doctors, and some of us even visit them. Next time you're in the office, take a look around. There's probably a wall or even an entire room full of manila folders. These are your medical records.

I work in the Electronic Data Interchange segment of healthcare. It's revolutionized claim filing. In the old days, you had to mail things in. They'd languish for days before being manually entered in the system, then probably wait another month before chewing through adjudication and paying or denying. Nowadays, a lot of providers push a couple of buttons at the end of the day. Their claims compile and transmit overnight, and we process them the next day. Fallon is on a two-week adjudication cycle, so doctors get paid about two weeks after submitting their claims.

Medical Records are where claims were perhaps 10 years ago. The industry is just getting off the ground, and there is a standard called "HL3" that allows doctors and specialists to share information with just a couple of clicks. It's supposed to streamline record-keeping, increase accuracy, and more importantly, streamline the process and make it more efficient for patient care. It's been embraced by most segments of the industry and is rapidly expanding....except within the Veteran's Administration.

This has been an ongoing embarassment for a number of years, and considering the amount of waste that's been uncovered, it's going to go on for years more before it ever gets resolved. Of course, with the budget cuts happening, it may NEVER get resolved, and of course it's always the veterans that suffer.


WASHINGTON — The departments of Defense and Veterans Affairs have wasted about $1 billion in a failed effort to streamline medical record-keeping, the chairman of the House Veterans’ Affairs Committee said in a hearing Wednesday.

“I’m concerned we’re taking a step back toward a model that has been tried and failed,” said committee Chairman Rep. Jeff Miller, R-Fla., at a hearing to examine the project.

Defense and VA officials said this month they had abandoned an ambitious plan to integrate medical records for both active-duty service members and veterans into a single electronic system to make the records more accessible for patients and doctors.

After cost estimates doubled and technology problems persisted, they decided on a less expensive plan to keep their current systems while making them “interoperable.”

The project, which started in 2004, was meant to streamline health care for active-duty troops and veterans as they transition to civilian life. Officials hoped a centralized system would prevent delays in care caused by problems in sharing health records between separate systems. The plan was set to start in 2017 for a total cost of $4 billion, according to Pentagon estimates from last year.

Committee members criticized the departments for giving up on a program that has already cost about $1 billion.

“It’s inexcusable,” said Rep. Jeff Denham, R-Calif. “In the private sector this would be done by now — it would have to be.”

A “patchwork of initiatives” tried over the past 15 years has left veterans shortchanged by an outdated system, said Valerie Melvin, director of information management and technology resources issues at the Government Accountability Office, Congress’ investigative arm. Melvin authored a report released Wednesday that questions the departments’ ability to share health records with existing systems.

“This is the result of poor oversight and inadequate accountability,” Melvin testified. “The program has not been positioned to fulfill key management responsibilities. More is needed.”

None of the testimony or reports “makes me think we won’t be sitting here in another 10 years asking the same questions and having the same problems,” said Rep. Phil Roe, R-Tenn.


Whether or not the next story is tied to medical records is a matter of conjecture. But the fact remains that the current generation of soldiers has the highest suicide rate among active-duty personnel in all of American history. It's not truly known why military suicides have increased, but there is always the possibility of lack of resources, mis-identification of potential suicides, and of course the difficulty of sharing information and receiving appropriate treatment. It all makes for interesting reading, but doesn't alter the fact that about 18 veterans are going to kill themselves today.


The armed forces mourned a grim toll in 2012 when more troops took their own lives than died in combat, but a precarious question remains: Why is the rate spiking when military life has long been a suicidal deterrent?

Among the services, the Army lost the most active-duty members last year to suicide: 182. Inside that branch, as two wars raged then waned, the annual suicide pace climbed. During 2001, nine out of every 100,000 active-duty soldiers killed themselves, while, during 2011, the suicide rate was nearly 23 per 100,000, according to the American Foundation for Suicide Prevention.

Compare that sobering trend to conflicts and peacetimes past. During the final three years of World War II, the Army’s annual suicide rate didn’t budge above 10 soldiers per 100,000, and during the Korean War in the early 1950s, that annual pace remained at about 11 soldiers per 100,000, according to a study published in 1985 by the Walter Reed Army Institute of Research.

Between 1975 and 1986, the Army’s annual suicide rate averaged 13 deaths per 100,000 soldiers, falling to as low as 10 in the early ‘80s, according to series of papers published in the journal Military Medicine. The Army’s suicide rate in 2001 was less than half that for all American males (18.2 per 100,000). Since then, the pace of self harm among active Army troops has more than doubled — and that trend is not ebbing: In January, the Army classified another 33 deaths as "potential suicides" among active-duty, National Guard and Army Reserve soldiers, according to the Department of Defense.

“A once-protective environment has moved to be something very different,” said David Rudd, co-founder and scientific director of the National Center for Veteran Studies based at the University of Utah.

“We need to look at the big picture to really understand what's going on today, but we all too often lose historical perspective,” said Rudd, who testified before Congress on the issue last month. The Army’s suicide pace between 1975 and 1985 should be viewed as the branch’s “baseline” rate, he added.


Finally this morning....What's it like to come home? A larger number of troops are starting to return from the combat zone. Some return to civilian life without a hitch, while others have tremendous problems making the transition. But it's just as hard on the families of returning soldiers as the soldiers themselves. And of course this ties back to everything else posted today...without an adequate support network, and accurate records of care, the transition is that much harder.


Two and a half months wasn't a lot of time, but it felt like forever.

Not long after U.S. Marine Corps Cpl. Gaby Caban was deployed to Kandahar, Afghanistan, in July 2011, she was homesick for her husband, Jose, and family. But she especially missed her 1-year-old daughter, Jayda.

“It was hard leaving her,especially since she was so little,” said Caban, 23.

Between12-hour night shifts spent working on C-130 planes, Caban took every opportunity to connect with family back home. “I would Skype with them, I would e-mail every single day, and I would call almost every day,” she said, but it didn't feel like enough.

“It really wasn't the same,” Caban said.

Then more than two months into her deployment, after a work-related accident that required partial amputation of fingers on her right hand, she was sent home. And although her reunion with her daughter and husband was joyful, her transition from active duty to civilian life was difficult for Caban and her family, and it's still an ongoing process.

“I had no idea how it was going to be,” she said. “Of course you think it's going to be different. I think as a person, they prepare you, but as a parent, I don't think they prepare you. I don't think you really can prepare for that.”

Caban isn't alone. For many other returning service members, reintegrating into daily routines and re-establishing relationships with families, spouses and children isn't always quick and easy.

It can be especially tough for returning military moms who are eager to get back into mom mode and the way things were, said Nadean Sitter, women veterans program manager for the Erie Veterans Affairs Medical Center.

“They come home, and they want it to be just like it was when they left,” Sitter said.“They want to take over their role.”

But family dynamics change when the other parent takes over for an extended period of time.

“They've developed their own norms, their own rules,” she said. “The kids, no matter what age they were, are older, and they're used to the new rules and the way things are.”

Or it can be the exact opposite. A returning mom might be expected to slip back into normal life, but she isn't ready to take on the stress.

“She's coming home, and he's like ..., 'I'm going to go back to my other life that I had before,'” Sitter said.“All o fa sudden, there's maybe a lot of pressure on this person to do things they might not be ready to do.”

Some situations are made even more complicated by issues like post-traumatic stress disorder or guilt for coming home when other comrades can't. It's also unknown how the lifted ban on women in combat, announced by the Pentagon on Jan. 23, will affect future military women.

“Some spouses don't understand that their wives really miss their unit, they miss the people they were with, they miss the camaraderie,” Sitter said.“So then there's conflict that can happen there.

“There are so many pieces. The most important things families can do is give it time.”


And I imagine we'll see more stories like all 3 of these as we go further into the process of getting the hell out of Afghanistan. It is a non-sequitir, but think about this for a minute. When we got into Afghanistan, Javi was just two months old. He turns twelve this summer.

67 comments (Latest Comment: 03/06/2013 01:22:14 by TriSec)
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