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Gaps in military medical care continue despite congressional reforms, says GAO

Rep. Jackie Speier, D-California, is pictured during a hearing February 5, 2020 on Capitol Hill. Speier is the chair of the House Armed Services Committee’s subgroup on military personnel. (Stars and Stripes)

WASHINGTON — Congressional efforts to reform the military health care system have not led to marked improvements in patient care, House lawmakers said this week as a new surveillance study showed that facilities struggled with accreditation and documentation failures.

A preliminary review of four medical facilities and the Defense Health Agency found deficiencies in verifying providers’ medical licenses and other credentials, evaluating their performance, and properly documenting patient-threatening events, according to the Government. Accountability Office.

Concerns about preventable military deaths and injuries led Congress in 2017 to unify the Navy, Army, and Air Force health care systems under a single Defense Administration. Health Agency. Further reforms followed with the standardization of policies and the adoption in 2019 of the Act of Richard Stayskalwhich authorized medical malpractice claims for injuries and deaths caused by military hospitals.

Leading proponent of the malpractice legislation, Rep. Jackie Speier, D-California, said she was frustrated with the bill’s slow implementation and disappointed with the lack of noticeable changes in the treatment of patients in general, as evidenced by the government review.

“I haven’t seen any evidence that a real improvement has occurred,” Speier said Wednesday at a House Armed Services Committee subcommittee hearing. “In fact, I hear all too often of medical errors that cause serious harm to patients and of quality assurance investigations that drag on for years while suspicious providers continue to practice.”

Recent victims of these mistakes include Danyelle Luckey, a 23-year-old sailor who died of sepsis aboard the USS Ronald Reagan in 2016, and Dez Del Barba, a 24-year-old who lost his leg to a flesh-eating disease which he contracted during basic army training in 2019.

Del Barba and Luckey’s father, Derrick Luckey, told lawmakers on Wednesday that military medical professionals ignored symptoms of serious illness until it was too late.

“[Danyelle’s] death was entirely preventable,” Derrick Luckey said. “If the healthcare providers had given her a simple course of antibiotics instead of refusing her, she would be here today.”

Del Barba said he went to see a physical therapist in Fort Benning, Georgia six times for leg pain before he collapsed. He eventually needed 43 surgeries to replace the damaged tissue.

“The military health system is not listening to the needs of the military,” Del Barba said. “We go to ask for help and we are denied treatment.”

Derrick Luckey had hoped to seek accountability and justice for his daughter under the Stayskal Act, but the request was denied because Danyelle had not been treated at a shore-based military facility in the United States, it said. he declares. When Luckey’s family appealed the decision, a panel of military officials again dismissed the complaint, he said.

“It’s like the home team becoming their own referee in a football game,” Luckey said. “Without changes, the military will continue to monitor themselves.”

He urged lawmakers to close loopholes in the law and move the appeals process to an independent panel.

“The Department of Defense issued guidance that does not align with congressional intentions,” Luckey said. “Please fix the act so it works as you intended.”

Speier confirmed that the legislation was meant to encompass all military medical facilities, regardless of their location or whether it was a ship or a conventional building.

“If we need to clarify that in the National Defense Authorization Act this year, we will try to do that,” she said.

Rep. Ronny Jackson, R-Texas, a former Navy doctor, said practitioners must find a difficult balance between their medical training and military-specific operational demands that can lead to time constraints and impact patient care. He also noted that worst-case scenarios, such as those experienced by Luckey and Del Barba, can be difficult to spot because doctors are used to treating a young, healthy population.

“We will do our best to resolve this issue and fix it,” said Jackson, who rose to the rank of rear admiral and served as a White House medical officer.

The weaknesses highlighted by the government report are due to a lack of awareness and understanding of the new procedures implemented in 2019, said Sharon Silas, director of the Government Accountability Office’s healthcare team. Unclear language in the proceedings has led to differing interpretations and inconsistent actions, she said.

“It’s a massive transition that’s happening,” Silas told lawmakers. “This is going to require not only putting the right procedures in place, but also a culture change.”

Lt. Gen. Ronald Place, director of the Defense Health Agency, did not dispute the study’s findings during his testimony before the subgroup. He said the agency has improved its practices but is still working to implement changes prompted by congressional reforms.

“Very honestly, I agree with the preliminary results, I think they’re accurate,” Place said. “I think the GAO has helped us see ourselves better and see where we’re falling short of expectations.”

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