Estimating the Clinical Care Performed During the Periodic Health Assessment

Area of Science:

• Military Health
• Preventive Medicine
• Healthcare Administration

Background:

• The Periodic Health Assessment (PHA) is a mandatory annual screening for active duty military personnel.
• Current PHAs involve self-assessment, record review, and a clinical encounter, including mental health assessment.
• Concerns exist that many PHAs are administrative and may not identify new health issues.

Purpose of the Study:

• To investigate the prevalence of "low-risk" PHAs within the Naval Medical Forces Atlantic (NMFL) area of responsibility (AOR).
• To identify potential workflow improvements for the PHA process.

Main Methods:

• Analysis of calendar year 2022 PHA data from MHS MART (M2) within the NMFL AOR.
• Definition of "low-risk" PHAs as those with no follow-up actions (referrals, labs, radiology) initiated within 5 days.
• Collection of data on provider workload and specialties performing PHAs.

Main Results:

• Over 84,000 PHAs were conducted by 857 providers in 2022.
• Approximately 86.7% of PHAs were categorized as "low-risk" with no follow-up actions.
• Nurse practitioners, physician assistants, and other advanced practice providers performed the majority of PHAs.

Conclusions:

• The current PHA process imposes a significant administrative burden on healthcare providers.
• An estimated over 333,000 provider-hours are spent annually on low-risk PHAs with minimal medical benefit.
• Reducing the administrative load of PHAs can free up clinician time for complex cases, enhancing force and medical readiness.