Army using tech to shift medical focus from treatment to prevention

Army tech shifts medical focus from treatment to prevention

The Army is making a paradigm shift in healthcare, moving away from the reactive model of treating disease to a model focusing instead on wellness.

“Our number one goal is readiness,” said Todd Hoover, program manager for Wellness Centers in the Army’s Public Health Command. Traditional healthcare focuses on managing problems after they have developed. “What we wanted to do was go upstream and look at primary prevention.”

The result is 13 Army Wellness Centers in the United States and five in Europe, with another 17 currently planned in this country and two more in Asia. The idea is to promote healthy lifestyles to improve the overall well-being of soldiers, retired service members and family by addressing health factors that can be controlled, including smoking, blood pressure, cholesterol, diabetes, weight and physical activity.

To date the centers have served more than 50,000 people, most of them active duty Army personnel. What distinguishes these centers – in addition to their focus on prevention – is the standardization and integration of equipment and data, and the centralized database serving all of the centers worldwide.

“That was our neatest innovation,” Hoover said of the database. “One of the things we saw early on was that we needed to centralize the data.”

The database uses proprietary algorithms developed by the Public Health Command to make assessments of a patient’s condition. It analyzes both self-reported information and the standardized data produced by diagnostic tools in the wellness centers such as those measuring metabolic and oxygen consumption rates. It then creates health and fitness programs to meet individual needs and goals. Through a web portal patients can see and input data and also manage their programs with clinicians.

The central source of data has been the key to making the centers effective, Hoover said. “The technology is great, but if you can’t make it actionable, it has no value.”

The technology that generates the data comes from COSMED, an Italian manufacturer of metabolic diagnostic equipment including the Bod Pod, an air displacement plethysmography unit that measures the change in air pressure when a person enters the chamber to determine body volume. Together with body weight it provides a density that measures body fat to within 1 percent accuracy. COSMED provides the Bod Pod as a turnkey system, with software running on the Windows 7 operating system.

Bod Pod

The Army’s Wellness Center program began in 2005 in Heidelberg, Germany. Programs focusing on disease prevention were becoming an industry best practice, and the Army wanted to make use of it. The Regional Public Health Command in Europe did a survey of existing Army health and wellness programs. “We found 77 of them, and no two were the same,” Hoover said. These programs are gradually being replaced with standardized metrics and evaluations.

Each wellness facility contains the same equipment and is staffed by a director, health educator, health promotion technician and administrator. The Army’s Public Health Command operates a school for directors at Fort Bragg. In fact, the White House medical unit opened its own Wellness Center based on the Army’ standardized model in 2013.

The assumption is that the centers will serve from 15 to 25 percent of the Army population that is at risk for poor health. Patients can be referred by doctors or by themselves, or can be soldiers who have failed to meet fitness or performance standards.

Results from the Wellness Centers so far have been positive. Out of a group of about 21,000 patients, 62 percent decreased their body mass index by an average of a little more than 14 percent.

The goal is to eventually have 299 Wellness Centers operational with the ability to serve 450,000 people a year. “We think it has great potential,” Hoover said.

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