By Staff Sgt. Victoria Greenia, 158 Fighter Wing
/ Published September 10, 2015
South Burlington, Vt. -- The 158th Medical Group says that on June 6 it outperformed itself for efficiency by processing more than half the base's Preventative Health Assessments (PHAs) and Occupational Health Medical Examinations (OHMEs) with a percent increase in one day compared to last year's pilot run.
The medical group has dubbed the new process PHAst Track, a play on words because the program's new design cuts average wait times so much that it saves the National Guard roughly 1000 man-hours.
"There's a lot of moving pieces [to medical exams] and what PHAst Track has done is pulled all those pieces together to be done at one time," Chief Master Sgt. Kathleen Corcoran, senior health technician and chief enlisted manager, said about the program that has streamlined what was once a cumbersome process. She also said the base will never return to month-to-month preventative health processing.
It used to be that Airmen would have medical reviews during drill of their birth months, sometimes resulting in people waiting an hour or more for a five minute visit with a provider. This often created a time crunch for both the medical staff and patients who would still need to complete other training requirements and routine duties.
But this old paradigm came under scrutiny when Corcoran, along with fellow VTANG medical members Tech. Sgt. Emily Santillo, Master Sgt. Eric Holbrook, and Physician Assistant Lt. Col. Jack Cook, took a trip out west. Their Fargo, N.D., counterpart had started to consolidate PHEs with a line of booths, or checkpoints, for a majority of the base in one large push and the VTANG medical group got to watch the process.
Impressed by the saved time in the new design, the group immediately discussed how it could be tailored to VTANG needs and set a plan in motion. If doing normal PHAs in one day was so successful, doing both PHAs and OHMEs at once would be a serious gain for the base.
"We took it to the whiteboard," Santillo, a health services technician, said, "and tailored it to our Wing. We made some changes and came out with this awesome idea of accomplishing OHMEs and PHAs all on the same day with two separate facilities on base processing Airmen."
It was a project that would require lots of initial planning, but had such a high payoff that the crew eagerly embraced it. They knew organization would be essential, starting with how Airmen were going to be scheduled. Obviously when dealing with hundreds of people, having all of them show up in one gigantic line wasn't going to save any time, and Holbrook, the non-commissioned officer in charge of public health, said he spent hours scheduling patients so that no shop would be undermanned at any given time.
The next step was to devise a way to separate Airmen into groups by medical needs, which was solved by colored folders; one color meant a quick non-occupational health assessment with only a possible lab draw and review with a provider; another color also indicated a non-occupational health assessment, but means the patient is also due for a five-year checkup of vision, dental, and skin exams; and a third color was given to Airmen in fields that require yearly occupational health exams which have special auditory, respiratory and blood tests.
Due to the nature of OHMEs having additional requirements, they decided to keep them separate from the quicker PHEs. Santillo managed the first two groups together in a similar fashion to that of a deployment processing line, while Holbrook was in charge of developing OHME stations. In order to process all the Airmen requiring hearing tests in one day, extra audiogram booths had to be brought in.
The first year, a civilian contractor provided the extra equipment, nearly quadrupling the amount of Airmen being processed at a time. This time around the Reserve Health Readiness Program, a National Guard Bureau contract, came with their equipment to help.
"They saved us a lot of time in the back-end because their technicians upload everything into the software program for us," he said, "whereas last year we had to manually enter all the data. We would love to have that contract continue in the future, because it was really successful."
There were other things the PHAst Track team changed from the previous year that either eliminated steps or improved the process. The initial colored folders that Airmen received became sheets of colored paper with instructions - this way, Santillo said, personal information was protected, which is always a priority in a medical setting.
Another huge time-saver was merging the medical roster with labeling software to create stickers to put on everyone's folders and lab work; patients no longer had to fill out medical sheets, they only had to confirm that the information printed was correct. As well as shortening time, a happy benefit to this was a near-zero discrepancy rate with lab specimens.
It's a really successful system, she said.
"Having the Wing accomplish this in one day is just the way to go," she said. "Other units have reached out to us, and Fargo as well, and I think this is going to be the new standard."
Both she and Holbrook say the program would never have been successful if they didn't have "base buy-in." Wing Command approved the pilot run and Airmen from the Wing's civil engineer squadron and communications flight helped set up the booths and make sure computer systems were working during PHAst Track operations. Unit health monitors facilitated agreeable scheduling between shops and the medical group, resulting in less delays and no-shows.
Also essential, they said, were base members filling out the web health assessment (Web HAs) forms two months ahead of time. In some cases, these advance Web HAs allowed a health services technician to review and complete the PHE process without the Airman having to go to any PHAst Track booths at all.
No longer having to worry about a flood of health exams each drill, medical staff now has the time to prepare and attend mandatory meetings such as the Deployment Availability Working Group and the Aeromedical Council. Santillo also noted that Airmen in the medical group are grateful that the extra time allows them to explore other aspects of being in the Air National Guard, like participating in the Junior or Senior Non-Commissioned Enlisted Councils.
With patient wait time now down to mere minutes, IMR rates steadily "in the green," less paperwork and discrepancies, and more time for medical staff members to expand their professional military education, the program is drawing the attention of other Guard bases. Santillo believes that it's shaping a new image of an innovative and attentive medical group with staff eager to ensure a mission-ready Wing.