What is instruction is PHA for Individual Medical Readiness?
SECNAVINST 6120.3
What establishes policy and procedures to ensure the Individual and Medical Readiness of Navy and Marine Corps Active and Reserves component Service Members is complete?
Periodic Health Assessment.
SECNAVINST 6120.3
What is the primary tool to consolidate evidenced based clinical preventive services, occupational health and risk screening services, health record review, special duty physical exams, and individual counseling, testing, and preventive treatment?
PHA.
SECNAVYINST 6120.3
What are the six elements of IMR?
1. Individual Medical Equipment.
2. Immunizations.
3. Readiness Lab studies.
4. Dental Readiness.
5. Deployment Limiting Conditions.
6. Periodic Health Assessment.
What is used to review, verify, and correct IMR deficiencies?
PHA.
What are the elements of Deployment Health the PHA is used for?
Pre-deployment Health Assessment.
Post-deployment Health Assessment.
Post-deployment Health Reassessment.
How often should Active and Reserve component service members receive an individualized face-to-face assessment of their health status to include the PHA components?
Annually.
What are the factors that go into the appropriate performance of the PHA?
Members age, gender, family history, occupation, deployment status, health status, and behavioral risk factors.
What provides the opportunity to assess changes in health status, especially those that could impact a member's readiness to perform military duties?
PHA.
When is the PHA considered complete?
When all components have been addressed, issues identified, and the service member has either completed or been given a plan for indicated referrals, counseling, and testing.
What are approved sources for the PHA to be documented in?
1. Armed Forces Health Longitudinal Technology Application (AHLTA).
2. Dental Common Access System (DENCAS).
3. Shipboard Non-Tactical Automated Data Processor (SNAP).
4. Medical Readiness Reporting System (MRRS).
5. Members Health Record.
Who is responsible for scheduling the PHA and completing all referrals and IMR requirements?
Active and Reserve component service members.
When would Active duty service members, officers and enlisted, not be required to complete a PHA?
Newly accessioned members who have not completed initial active duty for training and follow-on technical skills training.
Service members who have completed medical in-processing within the previous year, will not require a PHA until when?
Their birth month.
Who is responsible for ensuring the individual medical readiness of the personnel assigned to their units?
Commanding officers.
What form is the Chronological Record of Medical Care?
SF 600.
What form is the Adult Preventive and Chronic Care Flowsheet?
DD 2766.
What form is the Adult Preventive and Chronic Care Flowsheet Continuation Page?
DD 2766C.
What form is the Active Duty/Reserve forces Dental exam?
DD 2813.
What form is the Pre-deployment health assessment?
DD 2795.
What form is the Post-deployment Health Assessment?
DD 2796.
What form is the Post-deployment Health Re-assessment?
DD 2900.
What form is the Annual Certificate of Physical Condition?
NAVMED 6120/3.
What trial form is used for the dental exam?
EZ 603.2
What from is used for the Periodic Health Assessment?
NAVMED 6120/4.
To facilitate a seamless and integrated process, it is strongly recommended that the services member's what, participate in the PHA process?
Primary care manager.
Reservists may use their civilian primary care manager for clinical preventive services and treatment of identified health risks and conditions except when?
The condition is service connected.
Who coordinates reservists PHA's when seen at a military MTF?
Operational Support Center (ORC) Medical Department Representatives or Inspector-Instructor MDR, and assessed by available provider assets.
Active duty service members will have their PHA's performed when?
Within 30 days of their birth month.
When will reservists be required to complete their PHA?
Annual requirements due date.
When feasible, the PHA will be accomplished in how many visits?
One visit.
The coordination of all health/medical components into one visit ensures what?
Comprehensive medical assessment, while minimizing time away from duty for the service member.
The health assessment process requires review of data from a variety of sources to include what?
Health Assessment Review Tool (HART).
Health record.
Electronic medical databases.
Medical history.
Member interview.
The purpose of the health data review is to identify what?
Unresolved health issues.
Incomplete health care.
IMR deficiencies, completion of deployment health requirements.
Health risk factors.
Who will make recommendations to resolve any issues and reinforce healthy lifestyle behaviors as part of the continuing plan of care?
The reviewing approved health care provider.
Who are approved providers for the completion of a PHA?
IDC's, physicians, nurse practitioners, and physician assistants.
What services are included, but not limited to, during a PHA?
1. Height, weight, BMI.
2. BP measurement.
3. Visual acuity.
4. Individual Medical Equipment
5. Hearing.
6. Immunization status.
7. TB surveillance/screening.
8. Lab studies.
9. Annual Dental Exam.
10. Deployment Health Assessment and readiness.
11. Occup
During the annual PHA visit, when would you refer a service member to optometry?
If distance or near binocular visual acuity is worse than 20/40 or the member complains of decreased visual acuity.
What is the visual acuity standard?
20/40 visual acuity.
How often are reservists required to provide updated corrective lens prescriptions from their civilian provider?
Every 2 years.
What is used to perform the visual acuity test?
Snellen Acuity Chart.
Service members less than what age, do not require near vision testing unless they report difficulties with near vision?
45 years of age.
Reading acuity test is performed using what, and at what distance, with both eyes open?
Near acuity card, at 16 inches.
When performing visual acuity test, what line is recorded that is read without error?
The smallest line.
True or false? Contact lenses can be worn while testing visual acuity.
False.
How many pairs of glasses are service members required to have who require vision correction?
Two pairs.
What type of spectacles may be counted as one pair of spectacles to meet the requirement for two pairs of eyeglasses?
MCEP spectacle with optical inserts.
What are the types of individual medical equipment a service member may be required to have?
Two pairs of eyeglasses.
Ballistic protection optical inserts.
Protective gas mask inserts.
Medical warning tags.
What form is used to document the reference audiogram?
DD 2215.
When would you refer a service member for further hearing evaluation?
1. Missing DD 2215, Reference Audiogram.
2. Complaint of tinnitus that's not been addressed.
3. Complaints of changes in hearing since last test.
4. When existing hearing testing shows thresholds in either ear at 500 Hz, 1000 Hz and 2000 Hz that average 3
What are the hearing test thresholds that would require a service member to be referred for further evaluation?
When existing hearing testing shows thresholds in either ear at:
1. 500 Hz, 1000 Hz, and 2000 Hz that average 30 dB or greater.
2. 45 dB or greater at 3000 Hz.
3. 55 dB or greater at 4000 Hz.
The appropriate hearing referral may be to whom, depending on the nature of the hearing issue and the availability of specialty care?
Service members PCM.
Occupational medicine.
Audiology.
Immunization status will be reviewed and updated to ensure all required immunizations are current for when, such that medical readiness is maintained until the next annual review?
The next year.
What immunizations must service members have to be deployment ready?
Hepatitis A.
Hepatitis B.
IPV.
Tdap.
MMR.
Annual influenza.
What surveillance/screening is part of the PHA process and is not required to be tracked separately in IMR?
TB Surveillance/Screening and TB skin test.
What are the basic laboratory studies required for an individual to be deployable?
1. Blood type and Rh factor.
2. G6PD status.
3. DNA.
4. Current HIV.
What are the test results for G6PD?
Normal or abnormal.
Where must DNA have a verified receipt from?
Armed Forces Institute of Pathology repository.
Active duty service members shall be tested for HIV how often?
Every 2 years.
When should reservists be tested for HIV?
At the time of activation when called to active duty for more than 30 days, and if they have not received a HIV test within the last two years.
To maximize dental health, how often should a dental prophylaxis be provided to active duty service members?
Annually, and should be completed at the time of the annual dental exam.
A reservist must be in compliance with the requirement for an annual T-2 dental exam, and be classified into what dental class?
Dental class 1 or 2.
What form is used to record a reservists dental exam by a civilian dentist?
DD 2813.
How often is a military dental officer required to examine a reservist?
Every 3 years.
What dental class is considered world wide deployable?
Dental class 1 and 2.
What dental class compromises unit combat effectiveness, is considered at increased risk to experience a dental emergency, and is normally not regarded to be world wide deployable?
Dental class 3 and 4.
Service members who are deploying with operational units, without organic dental assets, are expected to have what type of dental exam, projecting their dental risk status through the duration of their deployment?
Annual Type 2 dental exam.
What must be in the health records of active duty or reservists who are deployed or have redeployed during the prior year?
DD 2795, Pre-deployment health assessment.
DD 2796, Post-deployment health assessment.
DD 2900, Post-deployment health re-assessment.
Unresolved deployment related issues for reservists will be referred to whom, and coordinate with what program?
Referred to Navy Operational Support Center (NOSC) MDR.
Coordinate with N1RM Line of Duty program.
What must be reviewed for the assessment for future deployability?
Medical history and administrative issues.
What are the limiting conditions that would prevent a service member from being deployable?
Limited duty.
Physical evaluation board (PEB).
Pregnant.
Postpartum period.
Collaboration with whom, is required to ensure that service members are up-to-date with job-specific requirements?
Occupational Medicine.
Occupational screenings should be documented on what form?
DD 2766, Adult Preventive and Chronic Care flow sheet.
What are the cardiovascular risk factors screened during a PHA?
Age, gender, family history, elevated blood pressure, abnormal lipid profile, heart disease, smoking, and diabetes.
What is the preferred method to measure cardiovascular risks?
Framingham Risk Score, found on the Navy Environmental Health Center (NEHC) PHA website.
Service members will complete what, with results serving as the basis for health risk prevention counseling?
Health Assessment Review Tool (HART).
Service members should have at least how many day supply of prescription medications when they deploy?
90 day supply.
Assessment and review of all prescribed and over-the-counter medication, nutritional supplements, ergogenic aids, and herbal agents will be documented where?
DD 2766, Adult Preventive and Chronic Care flowsheet.
What must be completed within the preceding 12 months to participate in the Navy semiannual PFA?
A current PHA.
True or false? The PHA is in addition to and does not replace the requirement for a Physical Activity Risk Factor Questionnaire (PARFQ).
True.
Where must the disposition of the medical evaluation be documented for the PFA?
DD 2766, Readiness section, fitness subsection.
If a medical waiver for the PFA is required, the provider will document and complete what form?
SF 600.
Medical waiver forms are available where?
Physical Readiness Information Management System (PRIMS).
Who is responsible for ensuring that their service members comply with the PHA requirements?
Commanding officers.
Any member of the health care team may perform what elements of the PHA?
1. Identifying who needs a PHA the following month.
2. Sending a hit list to the PHA monitor.
3. Perform Health record/dental record review.
4. Create an itemized list to complete the PHA.
5. Input data into approved databases.
Hospital Corpsmen or above may perform what elements of the PHA?
1. Blood pressure
2. Height, weight, BMI.
3. Visual acuity.
4. Immunizations.
5. Phlebotomy.
6. Administer the HART.
7. Health risk prevention, health promotion, and clinical preventive services counseling.
Who performs a final review and signature on all PHA's and applicable documentation?
Approved providers.
Who performs the PHA on all service members who identify health issues and documents the clinical encounter?
Approved providers.
Who tracks to conclusion any unresolved deployment related health issues?
Approved providers.
Who makes and documents appropriate referrals as needed for PHA's?
Approved providers.
Who are the only dental health care providers privileged to perform the annual dental exam on active duty members?
U.S. military dental officers, U.S. military government contract, and government service dentists.
Who is responsible for the completion and ongoing maintenance of the DD 276?
Entire health care team.
What provides immediate visibility of current health status and future screening requirements?
DD 2766.