Army vice chief, surgeon general address future of Army Medicine

WASHINGTON (Army News Service, Sept. 10, 2014) -- The Army has made leaps and bounds in medical care during the last 13 years of war, said Gen. Daniel B. Allyn, in his first official speaking engagement since becoming Army vice chief of staff.

Allyn addressed a standing-room-only audience at a professional development forum, sponsored by the Association of the U.S. Army's Institute of Land Warfare on Wednesday. The theme was, "Strengthening the health of our nation by improving the health of our Army."

He talked about advances in prosthetics, tourniquets that cause immediate blood clotting, promotion of a healthy lifestyle and the role of resiliency in dealing with the stresses of life and the military profession in particular.

Even though these innovations in combat casualty care have increased survival rates on the battlefield and improved life after injury, Army Medicine intends to reset and transform as operations wind down in Afghanistan, according to the Army surgeon general.

Lt. Gen. Patricia D. Horoho kicked off the day-long, multi-panel forum zeroing in on patient harm and patient safety.

"Let's have a health care culture that embraces safety practices and removes for good any chance of preventable harm," she said. "Let's abolish unsafe practices -- no more incorrect medications, no more wrong-site surgeries, no more infections and communication issues with our patients, just to name a few."

She spoke about an American culture that promotes unhealthy food over healthier options, and a sedentary lifestyle over activity, and working longer instead of sleeping longer.

Horoho told the audience the Army needed to continue promoting healthy Soldier behaviors and lifestyles and that would have a positive, long-term impact on the nation's health while promoting national security.

She spoke of the country's obesity problem and how it was getting worse.

"Obesity is even a problem for our active-duty Soldiers and our veterans," she said. "Many of you already know this, but over 70 percent of our veterans are obese or overweight -- think about that -- that's almost three out of four veterans."

Horoho also said the Army was working to affect long-lasting behavioral changes by optimizing health and readiness of Soldiers through the performance triad.

"It improves health literacy and promotes life-style changes related to the three main behaviors tied to health -- sleep, activity and nutrition," she said.

The surgeon general concluded her remarks by asking for a renewed commitment to improve the health of the nation and lead culture change by spreading innovations and lessons-learned across all health domains, across the Army and across the nation.

Allyn then offered force leadership perspective on how Army medicine has dramatically changed, from World War II to the present.

"I was blessed to be a Ranger battalion commander back in 1998, when we were implementing lessons learned from Somalia, and taking the early steps in tactical combat trauma care at the point of injury," he recalled. "And, I'm not talking just about expanding the skills of our combat medics; I'm talking about training every Soldier to be as skilled as our combat medics used to be, to provide point-of-injury care that keeps our Soldiers alive until we can get them into the hands of the experts."

The vice added that during Somalia and Vietnam, seven of 10 battlefield deaths were caused by bleeding in the arms and legs, and going back to World War II, survival rates for an American with a combat wound were around 70 percent -- today, they're more than 97 percent.

The modern tourniquet and haemostatic dressings that cause immediate blood clotting are part of the reasons for such a high survival rate today. At the same time, surgeons have been moved forward on the battlefield, and Web collaboration through the joint trauma system has enabled physicians worldwide to discuss and access the best medical care and advice possible, he said.

"Accounting for lessons from past transitions, we are building a holistic modernization strategy to change the Army and deliver global land power capabilities to the Joint Force," Allyn said. "Force 2025 is not an end state, it is a waypoint toward our Army's future."

Allyn presented a three-fold context for Force 2025 and Army medicine.

"First, it is important to remember we are still a nation at war, and this morning 27,000 Soldiers are in Afghanistan, and our presence in Iraq is increasing," he said. "We depend upon the world-class trauma care and medical support for our deployed Soldiers and their families at home. It remains a top priority."

Secondly, the general voiced his concerns over the budget declining, saying it will get worse should sequestration return in 2016, as is currently planned. While he praised AUSA leadership for educating and influencing the public and Congress on the negative consequences of sequestration, he said he was "personally not optimistic" that sequestration would go away.

Lastly, Allyn expressed real concern for the state of the potential Soldier pool of the future.

"We are challenged by an unhealthy American population plagued by addiction and obesity," he said, adding that, "The Center for Disease Control and Prevention says that this could be the first generation of children in the United States that has a shorter life expectancy than their parents do.

"Approximately, 75 percent of our population of 17-to-24-year olds are not eligible to serve in the United States Army; three-quarters of these because of health-related issues," he said. "Some of our best and brightest are disqualified because they simply are not healthy enough to serve in our nation's armed forces -- a preventable outcome, and we must lead the effort to change our lifestyle culture."

Allyn concluded his remarks by challenging the Army Medicine team to be innovative, to allow ideas to flourish, and to set a clear focus for the future.

 By J.D. Leipold

  http://www.army.mil/article/133465/Army_vice_chief__surgeon_general_address_future_of_Army_Medicine/