• Strategy 6. Implement a joint computerized patient record and other automated record keeping that meets the information needs of those involved with individual care and military public health.

In the report that follows, the committee outlines recommendations relating to each of these important strategies.


Use a systematic process to prospectively evaluate non-battle-related risks associated with the activities and settings of deployments. 1

Managing risk is a complex task that requires a strong partnership between the parties involved. Health risk assessment is a tool that can aid decision making and strengthen the military enterprise2. The process of risk evaluation performs optimally when it provides a comprehensive profile of the primary agents and activities that may affect the health of deployed troops, promotes reasoned choices by commanders and military planners, and is responsive to the legitimate questions of service members and their families. DoD and the military services have made progress in the programs and processes that they use to assess deployment-related health risks to service members. However, significant work is needed for better integration of the information gathered and for more effective conveyance of that information to decision makers. Particular challenges exist in assessing and integrating the risks from environmental chemicals, chemical and biological warfare agents, and the array of disease and non-battle injury risks to deployed forces. In this section, the committee describes additional initiatives required from DoD to assess deployment-related health risks and provide integrated information about these risks to commanders and medical personnel.

A systematic process is needed for evaluation of deployment-related health risks. This process should take into account not only potentially hazardous agents but also the likely steps and actions within a deployment that could expose service members to health risks. The methods could be similar to those used in pollution prevention efforts in both civilian and military settings, which involve review of the life cycle of hypothetical deployments to consider the ac-


In the first 2 years of the National Research Council-Institute of Medicine Strategies to Protect the Health of Deployed U.S. Forces project, Lorenz Rhomberg carried out a study charged with developing an analytical framework for assessing the risks to the health of deployed forces, particularly from disease and non-battle-related injuries or from chemical or biological warfare agents. The National Research Council report Strategies to Protect the Health of Deployed U.S. Forces: Analytical Framework for Assessing Risks (NRC, 2000a,b) describes the framework and is the starting point for this section. The executive summary of that report is found in Appendix B.


Health risk assessment includes consideration of both health endpoints and exposure assessment.

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