JBLM opens new Soldier Centered Medical Home

By Suzanne OvelMay 13, 2014

Madigan opens new Soldier Centered Medical Home
Col. Louis Zeisman, commander of the 2nd Brigade, 2nd Infantry Division; Col. Ramona Fiorey, commander of the Madigan Army Medical Center; and Col. John O'Brien, Madigan's chief of primary care, cut the ribbon for the opening of the Soldier Centered ... (Photo Credit: U.S. Army) VIEW ORIGINAL

JOINT BASE LEWIS-McCHORD, Wash. -- Infantry Soldiers on Lewis North are now just a short walk away from getting comprehensive medical care, thanks to the new Soldier Centered Medical Home now located at Okubo Family Medical Clinic.

The hope is that with more convenient medical care, along with increased levels of immediate care available, Soldiers will get help and get back to their units quicker.

"We're trying to get ahead of injuries. You don't wait until your car light comes on to change the oil; you want to do it beforehand," said Col. Louis Zeisman, commander of the 2nd Brigade, 2nd Infantry Division.

This preventative care fits into their priority of readiness, said Zeisman.

"That's what the end state in this day is all about, is readiness and taking care of Soldiers," he said.

On May 7, Zeisman joined Madigan Army Medical Center Commander Col. Ramona Fiorey and Madigan's Chief of Primary Care Col. John O'Brien in cutting the ribbon at Okubo to officially open the SCMH for 2nd Brigade Soldier care. The "one-stop shop" will cut down on long trips to get medical care.

"It keeps them closer to their footprint, so it doesn't take them out of their training nearly as long," said Fiorey.

The center will serve as a medical home for Soldiers, where they will come for the majority of their care, she said.

"Their providers are going to know their needs better. We're going to be on top of things much quicker," she said, noting that areas like profiles and medical readiness will be much more easily managed in an environment where line and medical personnel align.

"This marks a new era in how (Medical Command and Forces Command) interact together in taking care of our Soldiers. That's what the Soldier Centered Medical Home project is all about," said O'Brien. Not only do the two commands collaborate to staff the SCMHs, first drawing from medical staff from the brigades and then supplementing with MEDCOM staff, but they also by the nature of creating and sustaining SCMHs create closer lines of communication.

"Now you have this better linkage between the line units and the hospital, whereas you don't always have that. I think the Soldier Center Medical Home helps to reinforce that. That's been a huge positive," said O'Brien, who oversees the development of SCMHs here.

Although 2nd Brigade units will still maintain battalion aid stations, they will focus more on conducting initial screenings and on triaging Soldiers for care. Soldiers' time waiting at sick call should be reduced as they either get sent immediately to the SCMH for care or are given appointments in the near future, freeing them up until that time, said O'Brien.

While medics will continue to man the battalion aid stations, the brigade's physician assistants will join the SCMH and will work directly with nurses and physical therapy staff, and will have better access to labs, radiology, pharmacy, and more-- all a part of the holistic approach the center offers.

"They'll be major assets to do a lot higher level of care than you could do at an aid station," said O'Brien.

In addition, the brigade's medics will rotate through the SCMH to assist in care, which will keep their skills honed as they work more closely with PAs and doctors stateside, said O'Brien.

"For our young Soldiers who are coming out of (advanced individual training) or a basic unit, they are working in a hospital-like environment. There's no better way to get experience than working here," Zeisman said.

O'Brien points to the success of JBLM's first SCMH for Soldiers with the 555th Engineering Brigade and 17th Fires Brigade; he sees the on-site physical therapy assets as the SCMH's primary success.

"I think that's been a game changer for that unit," said O'Brien. Given the convenience of the SCMH location to Soldiers' workplaces, he envisions Soldiers being much more able to commit to two or three physical therapy sessions each week. From there, the potential positive outcomes become a snowball effect: Soldiers will have less risk of re-injury, less risk of a profile, and ultimately less risk of being medically boarded, which can result in the Army retaining more experienced Soldiers.

Tied closely to the preventative health nature of SCMHs is how they will incorporate the Performance Triad's three components of health: sleep, activity and nutrition.

"We're going to train our behavioral health providers to do a really good job of screening why people aren't sleeping, and to be able to give advice on how to optimize your sleep," said O'Brien; while behavioral health is considered to be a part of the SCMH concept, they are housed in a separate building for the 2nd Brigade's SCMH. The on-site nutritionists and physical therapists will complete the focus on the triad, "which is really about preventative ways to improve your performance," he said.

Although the SCMH at Okubo is already seeing patients, O'Brien said they are still hiring to full strength. This SCMH is one of four that will be available on JBLM; two more will stand up on Lewis Main. O'Brien said that the medical homes need a grouping of 4000 to 5000 Soldiers to be efficient; any Soldiers not assigned to SCMHs in the future will be seen at Patient Centered Medical Homes instead, he said.

"I think we're pursuing the correct model, which is everybody working together to take care of the Soldiers. Everybody who sees the model and understands it says this is exactly what we're supposed to be doing," O'Brien said.