Annotations
BB. Are There Indications for Collaboration
with a Deployment Health Clinical Center (DHCC)?
OBJECTIVE
Determine whether collaboration with a DHCC will aid in the treatment of the
patient’s diagnosed illness.
ANNOTATION
Referral centers have been designated in both DoD and VHA facilities.
Consultation with these centers offers the clinician and patient access to clinicians
with special expertise and experience, entry into approved clinical trials, and
diagnostic testing and evaluation that may not be available locally or at other
referral centers.
If the clinical evaluation reveals
a well-defined diagnosis with a widely accepted treatment protocol, and
the patient is willing to accept this diagnosis as the cause of signs
or symptoms, the clinician should begin therapy at the local facility.
The clinician should attempt to reach an agreement with the patient on
an appropriate interval of time to reassess signs, symptoms, and concerns
and jointly determine whether further evaluation is necessary. The clinician
should consider collaboration with, and the possible referral to, a DHCC
to ensure that deployment-related health concerns receive full consideration.
If the clinical evaluation reveals
a diagnosis or disease entity that is newly defined or the effective treatment
protocol has not been established for the diagnosis, the clinician and
patient may benefit from collaboration with a DHCC. Collaboration may
occur through in-person, telephonic, or other written communication depending
on the level of clinical urgency. Consultation with these centers offers
the clinician and patient access to practitioners with special expertise
and experience, entry into approved clinical trials, and diagnostic testing
and evaluation that may not be available locally or at other referral
centers.
REFERENCES
-
Engel, C.C., Liu, X., Clymer, R., Miller
R., Sjoberg, T., and Shapiro, J. “Rehabilitative Care of War-Related
Health Concerns.” Journal
of Occupational and Environmental Medicine.
2000. 42(4): 385-390.
-
Engel, C.C., Roy, M., Kayanan, D., Ursano,
R. "Multidisciplinary Treatment of Persistent Symptoms After Gulf
War Service. "Military Medicine. 1998.
163(4): 202-8
