Returning Veterans with Health Returning Veterans with Health Concerns and Emerging Concerns and Emerging

Problems:Problems:How can they get help?How can they get help?William M. Keyes, QMC (SW) U.S. Navy (Retired)

Program Support Specialist/Outreach Coordinator

War Related Illness & Injury Study Center (WRIISC)

NJ VA Healthcare System

The War Related Illness and Injury Study Center The War Related Illness and Injury Study Center (WRIISC, pronounced “(WRIISC, pronounced “riskrisk”) is a National Department ”) is a National Department

of Veterans Affairs (VA) program established to develop of Veterans Affairs (VA) program established to develop and provide expertise in post-deployment health for and provide expertise in post-deployment health for

Veterans and healthcare providers.Veterans and healthcare providers.

We recognize that deployed Veterans have unique We recognize that deployed Veterans have unique healthcare problems. We strive to improve the health of healthcare problems. We strive to improve the health of

Veterans with war related illnesses and injuries.Veterans with war related illnesses and injuries.

Three National Locations:Three National Locations:East Orange, New JerseyEast Orange, New Jersey

Washington, DCWashington, DCPalo Alto, California Palo Alto, California

What is the WRIISC? What is the WRIISC?

We provide specialized clinical and referral services to Veterans and their health care providers for a wide variety of post deployment health concerns.

Each WRIISC has a multidisciplinary team of health care professionals who are experts in responding to a wide variety of post-deployment health concerns.

These include exposure related concerns and symptoms and syndromes that do not have a clear medical explanations.

What is the WRIISCWhat is the WRIISC(continued)(continued)

Medical doctors Physician assistants Nurses Nurse practitioners Specialists in environmental

exposure assessments Psychologists Neuropsychologists Social workers

Chaplains Risk communication specialists Health education specialists Health care professionals that

specialize in Complementary and Alternative Medicine (CAM) such as:

Acupuncturists Yoga instructors

The WRIISC has access to a wide variety of medical professionals including:

GoalsGoals

Provide clinical services to Veterans with deployment-related health concerns and illnesses to improve their health-related quality of life

Advance knowledge of ways to care for Veterans with medically unexplained symptoms to improve their health-related quality of life

Advance knowledge of and improve communication among Veterans, the health care community and researchers regarding deployment-related health concerns and illnesses

Advance knowledge of medically unexplained symptoms in Veteran and other populations

WRIISC ComponentsWRIISC Components

Clinical Education Risk Communication Research

Our Clinical ServicesOur Clinical Services

Comprehensive medical evaluations of medically unexplained symptoms for Veterans from any era or conflict

Comprehensive medical evaluations of OEF/OIF Veterans with health concerns related to deployment

Clinical Services cont…Clinical Services cont…

Comprehensive reviews of military exposures from Veterans form any era or conflict

Screening evaluation for mild traumatic brain injury in combat Veterans

Provide Support/Re-integration groups for Veterans experiencing difficulty adjusting

OEF/OIF EvaluationsOEF/OIF Evaluations

1 day evaluation to address deployment related concerns

Practice primary prevention Ensure primary care provider

has been assigned Get Veteran smoothly

transitioned into the VA system

Comprehensive Evaluations of Comprehensive Evaluations of Medically Unexplained Symptoms Medically Unexplained Symptoms

2 day evaluation Veterans of any conflict Must be referred by their VA primary care

provider Focus on MUS (CFS, FM, IBS) and symptom

management

Clinical Evaluation Clinical Evaluation ComponentsComponents

History and Physical Psychological Evaluation Neuropsychological Evaluation Exposure Assessment Social Work Interview Education Session Complementary and Alternative

(CAM) Labs, X-ray's, EKGs, PFTs

Clinical Evaluation Clinical Evaluation ComponentsComponents

Final meeting with the Veteran and the team to discuss the findings and recommendations

Veteran is provided with a treatment “roadmap”

Clinical Evaluation- Follow Clinical Evaluation- Follow upup

Follow up by social work at 1mo, 6 mo and 1 year post evaluation

Follow-up health survey: 6 mo post eval How satisfied? Barriers to recommendation implementation? Symptom management?

SummarySummary

1. The WRIISC was established to be a VA National Resource with staff that are experts in post-deployment health.

2. We provide comprehensive clinical evaluations on Veterans that have returned from combat.a) These examinations allow us to help the individual Veteran and

their providers to better address the Veteran’s post-deployment health issues.

b) These evaluations also enable us to identify emerging post-deployment health problems and concerns that may effect large numbers of Veterans Nationally.

c) We also educate the VA and non-VA provider community about post-deployment health problems and concerns.

Summary (cont.)Summary (cont.)

3. We focus on prevention – through post deployment care, research, education and communication.

4. We specialize in providing Veterans a roadmap for managing their chronic symptoms

Questions??Questions??