A Regional Health Command -- Central health systems specialist, who has impacted virtual health for beneficiaries from all services of the Armed Forces -- both stateside and deployed - retires this month.

Over the last 47 years, Charles "Chuck" M. Lappan, spent time as a Peace Corps volunteer, an Army officer, a drilling Reservist, a member of the Active-Guard Reserve, military contractor and an Army civil service employee. All told, he has more than 22 1/2 years of federal active service. He began his career as a postal supervisor at the 5th Women's Army Corps Training Brigade, Fort Jackson, SC before going to Officer Candidate School, Fort Benning, GA. His first assignment after OCS was at Fort Polk, where he served under Capt. Glen Taplin, now retired Col. Taplin, RHCC Director of Strategy and Innovation.

Lappan began his tenure with RHCC in 2002 following his retirement from the Army when he was contacted by Gary Crouch, Telehealth Systems director, to "see if I was interested in a temporary position with the fledgling teledermatology program… I took the position thinking I would move on within a year or two," he said.

Nearly 17 years later, Lappan retires as the program manager of two programs - teledermatology and an email-based consultation program.

The email teleconsultation program, Lappan says, was his favorite job.

"When we started the program in 2004, we always envisioned it as a temporary telehealth solution until something better, more robust came along. We thought the program would probably end in about two or three years," he said. "Little did we realize when we proposed the program in August 2003 the program would last 14 years. We started with one specialty, dermatology, and within two years expanded to almost 20 with formal email groups and another 14 plus other specialties who supported the program when requested."

Although the program required seven-day a week monitoring, Lappan liked the work because it provided variety and he knew he was making a difference in the lives of medical professionals and their patients.

"It was humbling to be accepted as a colleague by the medical community because I do not have a medical degree," Lappan said. "We made a difference on thousands of Soldiers, Sailors, Marines, Airmen, Coast Guardsmen and foreign national patients we will never know."

The email consultation system facilitated 14,739 consultations from more than 3,755 different providers between April 2004 and October 2018. The consultations prevented more than 332 evacuations and saved more than $6.6 million dollars in transportation costs.

Under Lappan's management, the teledermatology program has been equally successful but he is quick to share the spotlight with others.

"The success of the teledermatology program is due in large part to several visionaries including retired Col. Ron Poropatich, retired Col. Hon Pak and retired Lt. Col. Gary Crouch," Lappan said.
He has built a great rapport with Crouch. "I have worked with Gary Crouch longer than many marriages last. I could not have asked for a better supervisor," he said. "We have a unique level of trust and he allowed me to grow the program with his guidance and direction, as I saw fit."

That teamwork paid off while programs at other commands began to rely on Lappan's program at RHCC for support.

"At one point we were supporting medical treatment facilities in every regional medical command," he said. "As telemedicine grew in importance, other facilities developed their own teledermatology program, but not to the extent of our program."

During his time, the teledermatology program answered more than 50,370 consultations providing patients in the Army, Navy and Air Force with increased access to dermatological care, according to Crouch. Lappan also trained consult managers at 68 sites, and developed a digital photography course to improve the imaging techniques used by technicians. He has provided instruction in telehealth programs and digital photography to more than 100 courses at the U.S. Army Medical Department Center and School, Health Readiness Center of Excellence, including Medical Corps and Physician Assistant Officer Basic and Career Courses, the Tropical Medicine Course, Joint Forces Trauma Course and the Medical Strategic Leadership Program, according to Crouch.

Lappan also conducted extensive analysis to identify opportunities to bring dermatology care back into the military health system rather than having patients go to civilian providers.

As he leaves federal service, Lappan offers this advice: "Do not be afraid to innovate. Be leaders. Sometimes we have to make decisions with only 70 to 85 percent of the information. If the outcome is less than expected, learn from it and move on. Sometimes we learn more from our failures than successes."

And in response to all of his telehealth accomplishments, Lappan says "My greatest accomplishment was not in the management of the telemedicine programs. My satisfaction and what motivated me came from the enhanced healthcare that was given to the thousands of patients who benefited from our program."