The Medical Readiness Assessment Tool: A Key Readiness Enabler

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The Medical Readiness Assessment Tool: A Key Readiness Enabler 3 August 2016 Sean Harap, MD, JD, FACP Regional Health Command Pacific (P) Honolulu, Hawaii The views expressed in this presentation are those of the author and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

Introduction Assessing Soldiers for risk factors that may impact their capability to deploy is a key component of maintaining a medically ready force The MRAT is a unit and Soldier-specific, prospective screening tool that identifies Soldiers at risk for medically related non-deployable status MRAT is being utilized to help reduce the proportion of medically non-available Soldiers through early detection and proactive management of treatable medical conditions This brief provides a brief overview of this powerful readiness tool

Readiness is #1

Utility of MRAT = Early Risk Projection The chief goal of the MRAT is to enable proactive identification and management of Soldiers with risk factors affecting future medical readiness at an earlier point than is currently feasible The MRAT uses a regression model-based approach to project the risk of an medically non available (MNA) status in the following twelve months (MNA risk score) The intent is to change the trajectory, through awareness from the MRAT, for high-risk Soldiers who are not yet medically not available to deploy

How the MRAT Works MRAT provides a two year historical summary for each Soldier MRAT projects the risk one year out MRAT then rank orders Soldiers based on risk of becoming MNA in descending order Top 5% in RED category Next 5% in AMBER category Remaining 90% in GREEN category Excludes those already MNA as the event (Nondeployability) has already occurred. Also excludes pregnant Soldiers as they are expected to return to duty (12 mo. Forward)

The MRAT Consists of Three Tools The MRAT consists of three screens that allow visibility from the unit level to the individual Soldier level 1. The MRAT Leader Tool allows visibility at the unit level 2. The Screening Tool provides a rank order in any unit of the MNA risk at the unit clinician level 12 month prospective view 3. The 24 month Trend Tool allows clinic visibility on risk of future non-availability, interaction with medical facilities, BMI, annual physical fitness test scores, days on a medical profile (when applicable), as well as opioid and psychotropic medication use (when applicable) 24 month retrospective view

MRAT Leader Tool The Leader Tool supports an evidence-based management approach through: Peer unit comparisons Benchmark comparisons Trending of unit readiness by Unit Identification Code

MRAT Leader Tool

MRAT Advanced Data Functions

Screening Tool for Clinicians (Prospective) Clinician Tool For unit based clinicians, rank orders Soldiers in any unit by MNA risk for the next 12 months Provides information correlated with: BMI No show count History of musculoskeletal complaints On and Off Post Medical Encounters History of Tobacco use History and count of Opioid and Psychotropic Med use Days on Profile

Screening Tool for Clinicians (Prospective)

24-Month Trend Tool (Retrospective) Clinician Tool Displays by month information (for previous 24 months) regarding: Risk of future non-availability On and off post medical visits (health care utilization) Inpatient, ED and No-shows for medical appointments Days on profile Physical fitness test scores Opioid and psychotropic prescriptions Body Mass Index (BMI) Pain Scores Tobacco use Imaging studies

24-Month Trend Tool (Retrospective)

24-Month Trend Tool (Retrospective)

Conclusion The MRAT harnesses the power of predictive analysis to meet the medical readiness mission The MRAT is a tool that gives Senior Leaders and treating Clinicians early visibility on Soldiers who have a high risk of falling out of formation and becoming non-deployable By proactively identifying and then subsequently devoting the resources, time and attention to addressing the risk factors that may lead to a MNA status, military clinicians can reduce the MNA percentage, and increase the number of Soldiers ready to deploy in any given formation