Journal 012915

Vol. 27 No. 4 www.cnic.navy.mil/bethesda/ January 29, 2015

By Sharon Renee TaylorWRNMMC Public Affairs

staff writer

The National Intrepid Centerof Excellence (NICoE) recentlyearned honors for merit in infor-mation technology (IT), innova-tion and teamwork.

NICoE, dedicated to provid-ing cutting-edge evaluation andtreatment to service membersdiagnosed with traumatic braininjuries (TBI) as well as psy-chological health disorders, re-ceived special recognition fromGovernment Computer News forsuccessful innovation of the con-tinuity management tool NICoElaunched in 2014.

The continuity tool, alsoknown as the NICoE ContinuityManagement Tool (NCMT) proj-ect, enables NICoE clinicians tocollect thousands of data pointsper patient, electronically. TheNCMT also pulls additionalsets of information from largeclinical and research databasesto form a robust repository ofTBI-related health data in theDepartment of Defense (DOD),dating from 2008 to the pres-ent — supporting researchers instudies and clinicians in formu-lating new treatment options tomaintain excellence in TBI care.

The development of theNCMT had been somethingthat was underway from thevery building of the center of ex-cellence, and the original intentof that tool was very expansive,according to Navy Capt. Sara M.

Kass, who serves as Special As-sistant for the NICoE to WalterReed Bethesda Director, ArmyBrig. Gen. Jeffrey B. Clark.

“The goal was to have one

tool that could really manageall resources including person-nel, space, and supplies, as wellas collect clinical data and havethat data be available for re-

search purposes and allow forcase management of patients,”she said. Kass named Dr. JesusJ. Caban, NICoE’s chief of clini-cal and research informatics,

along with Eddy Bueno, NICoEchief of administration, as the“heavy lifters” of the effort.

NICoE Bridges Clinicians and Researchers, Earns IT Award

File photo

The National Intrepid Center of Excellence (NICoE), located on Naval Support Activity Bethesda, recentlyearned honors for merit in information technology (IT), innovation and teamwork. The center is dedicated toproviding cutting-edge evaluation and treatment to service members diagnosed with traumatic brain injuries(TBI) as well as psychological health disorders.

See NICOE page 6

NSAB PublicAffairs Office

Naval Support ActivityBethesda (NSAB) will takepart in exercise Solid Curtain- Citadel Shield 2015 (SC/CS15) Feb. 2 - 13 in order to testthe installation and its tenantcommands’ security readiness

and response to hostile situa-tions.

Coordinated by U.S. FleetForces Command and Com-mander, Navy InstallationsCommand, SC/CS 15 is thelargest U.S. Navy force protec-tion/anti-terrorism exerciseconducted nationwide.

The exercise will consistof an active shooter scenario

and a series of mini-drills,helping to strengthen, inform,and educate leadership andemergency response teams.All staff members are urgedto pay close attention to com-mand-wide e-mails that willbe distributed throughout theevent, informing them how torespond to the various sce-narios throughout the train-

ing. Master-at-Arms 1st ClassGeorge Sangriu, NSAB Secu-rity leading training petty of-ficer, said people should notbe alarmed and use this train-ing event as a learning experi-ence that they can pass on totheir friends and family.

“The whole base will be in-volved,” said Sangriu. “Therewill be a lot of police activity

going on. Security personnelwill be wearing colored train-ing vests and training weap-ons. You will also hear an in-crease in sirens around thebase.”

For more information onSC/CS 15, contact Master-at-Arms 1st Class George San-griu at 301-319-2558.

Solid Curtain/Citadel Shield Exercise to Test Installation, Tenant Readiness

2 Thursday, January 29, 2015 The Journal

Published by offset every Thurs-day by Comprint Military Publi-cations, 9030 Comprint Court,Gaithersburg, Md. 20877, aprivate firm in no way con-nected with the U.S. Navy,under exclusive written con-tract with Naval Support ActivityBethesda, Md. This commercialenterprise newspaper is an autho-rized publication for members of themilitary services. Contents of The Journalare not necessarily the official views of, norendorsed by, the U.S. Government, theDepartment of Defense, or the Departmentof Navy. The appearance of advertising inthis publication, including inserts or supple-ments, does not constitute endorsement bythe Department of Defense or Comprint,Inc., of the products or services advertised.Everything advertised in this publicationshall be made available for purchase, useor patronage without regard to race, color,

religion, sex, national origin,age, marital status, physicalhandicap, political affiliationor any other non-merit fac-tor of the purchaser, user,or patron. Editorial contentis edited, prepared and pro-vided by the Public AffairsOffice, Naval Support Activ-

ity Bethesda, Md. News copyshould be submitted to the Pub-

lic Affairs Office, Building 17, first floor,across from PSD, by noon one week pre-ceding the desired publication date. Newsitems are welcomed from all installationsources. Inquiries about news copy will beanswered by calling 301-295-1803. Com-mercial advertising should be placed withthe publisher by calling 301-921-2800.Publisher’s advertising offices are locatedat 9030 Comprint Court, Gaithersburg, Md.20877. Classified ads can be placed bycalling 301-670-1700.

Naval Support Activity (NSA) BethesdaCommanding Officer: Capt. David A. BitontiPublic Affairs Officer: Ronald D. InmanPublic Affairs Office: 301-295-1803

Journal StaffManaging Editor MC2BrandonWilliams-ChurchWRNMMC Editor Bernard Little

Staff Writers MC1 Christopher KruckeMC2Ashante HammonsAndrew DamstedtSarah MarshallKatrina SkinnerSharon Renee Taylor

NSABethesdaFleet And Family Support Center 301-319-4087

Walter Reed National Military Medical CenterOffice of Media Relations 301-295-5727

NSAB Emergency Information Line 301-295-6246NSAB OmbudsmanMichelle Herrera 240-370-5421

NSAB Chaplain’s Office 301-319-4443/4706

Sexual Assault ResponseCoordinator Hotline 301-442-2053

Visit us on Facebook:Naval Support Activity Bethesda page:https://www.facebook.com/NSABethesda

Walter Reed National Medical Center page:http://www.facebook.com/pages/Walter-Reed-National-Military-Medical-Center/295857217111107

Uniformed Services University of the HealthSciences page:http://www.facebook.com/pages/Uniformed-Services-University-of-the-Health-Sciences/96338890888?fref=ts

MLK Jr. ObservanceThe Walter Reed Bethesda Multi-Cultural

Committee will host a program observing thebirthday of Dr. Martin Luther King Jr., todayat 11:30 a.m. in Bldg. 19, first floor, lobby/pianoarea. Everyone is invited. For more informationcall Hospital Corpsman 2nd Class BuddhikaAbeyratne at 301-295-4265.

Nursing Grand RoundsA Nursing Grand Rounds focusing on

“Management of the Complex Patient/FamilyRelationship” is scheduled for today from 11:30a.m. to 1 p.m. in Clark Auditorium. One hour ofContinuing Nursing Education for attending theevent is available to participants.

Research Submission DeadlineSubmission deadline for all research abstracts

in the 7th Annual National Capital RegionResearch Competition is tomorrow at midnight.The competitions will be in May. For more infor-mation, call Lt. Ryan Kim at 301-295-8338, oremail [email protected].

Prostate Cancer Health IssuesProstate cancer survivor and urologist Dr.

Robert Dean, will discuss “Sexual Health Issuesand Prostate Cancer” on Feb. 5 from 7 to 8:30p.m. in the America Building, Rm. 2525, atWalter Reed Bethesda. Family and friends (mili-tary and civilian) are invited. No registration isrequired. Military ID is required for base access.For those without a military ID, call the ProstateCenter at 301-319-2900 at least four businessdays prior to the event for base access. For moreinformation, contact retired Col. Jane Hudak at301-319-2918 or [email protected].

DHA Town HallAir Force Lt. Gen. Douglas Robb, director of

the Defense Health Agency (DHA), will host atown hall, “DHA – One Year in Review,” on Feb.23 at 7 a.m. in Memorial Auditorium. All WalterReed Bethesda staff members are encouraged toattend.

Bethesda Notebook

In 2008, the NationalQuality Forum identified“patient and family engage-ment” as one of the fiveNational Health Prioritiesthat would guide and shapehealthcare transformation.Since then, there has beena growing amount of dataavailable that demonstratespatients who are active par-ticipants in their care aremore inclined and motivat-ed to assume responsibilityfor managing their own health.When thathappens, the results are better outcomesfor the patient and better performance forthe health system.

Implementation of Patient CenteredMedical Homes as primary care accesspoints to the National Capital Region(NCR) healthcare system has placed agreater emphasis on patient engagement,care continuity and understanding theentirety of the patient experience by rec-ognizing that each individual’s interac-tion with the healthcare system is unique,complex and influenced by multiple fac-tors and touch points. Transforming thecare experience requires addressing themedical needs of the patient, as well asthe full continuum of care.

Within the NCR, we are employingdesign thinking to evaluate patients’ in-teractions with the health system, usingqualitative data from a sample of patientsto shape adjustments to the care con-tinuum. Understanding the full patientexperience enables greater collaborationbetween patients and their providers,potentially identifies redundancies, newopportunities for improvement, and ulti-mately leads to increased patient engage-ment.

Our goal is to shape quality throughthe patients’ eyes and their experiencesand then design our NCR Market envi-ronment, systems and processes to deliverquality as seen from the patients’ perspec-

tive. Our ability to do thisis dependent on an engage-ment strategy that includesimmersive interviews withour patients and staff mem-bers.

Last year, Fort Bel-voir Community Hospital(FBCH) achieved Baby-Friendly Hospital Initiativeaccreditation – a four-year,four-step, hospital-wideperformance improvementprocess. This evidence-

based program is designed to give moth-ers accurate and consistent information,confidence, and the skills necessary tosuccessfully breastfeed their babies orfeed formula safely. Those skills providefamilies with a strong foundation in theearly days of a baby’s life by ensuring pa-tients receive the same information onbreastfeeding, infant feeding, and caringfor their baby regardless of where theyreceive care in the hospital. FBCH is onlythe second medical facility in Virginiaand third in the National Capital Area toachieve this accreditation. Walter ReedNational Military Medical Center is in thethird phase of the accreditation process tobecome a Baby-Friendly Hospital.

This is one of other examples of howwe are striving to improve your militaryhealth system and patient experience inthe National Capital Region. I am alwaysinterested in hearing from our patients.Please let me hear from you on challengesyou may be experiencing with timely ac-cess to care. I can be contacted at DefenseHealth Agency, National Capital RegionMedical Directorate, Building 1, Floor 9,Room 9121, 8955 Wood Road, Bethesda,MD 20889.

Thank you for your service and sup-port,

Rear Adm. Raquel BonoDirector, National CapitalRegion Medical Directorate

Commander’s Column

The Journal Thursday, January 29, 2015 3

By Andrew DamstedtNSAB Public Affairs

staff writer

Instead of the basketballcourts full of players, Naval Sup-port Activity Bethesda’s (NSAB)gymnasium was full of job seek-ers Friday; while just outsidethe gym, Building 17’s atriumhad plenty of schools seekingnew students.

Approximately 250 peopleattended the NSAB Employ-ment and Education Fair Fri-day, which featured a varietyof employment and educationopportunities represented by 60employers and 45 schools.

“I’ve been seeing non-stopconversations,” said LindseyRoss, Fleet and Family Serviceswork and family life consultant.

Jasmine Pearson, veteranand military spouse, had someof those conversations withprospective employers. Pearsoncame to the job fair becauseshe was looking to re-enter theworkforce after taking time offto care for her newborn child.

Job recruiters at NSAB’s fair

were honest about her employ-ment prospects, she said, withsome even pointing her to othertables where she might be a bet-ter fit. She believed her militarybackground could be a benefitto employers, but also acknowl-edged how some might see it asa challenge.

“I think it is a challengewhen you have to move fre-quently to build a career, butit is important to continue tonetwork,” Pearson said. “Havingevents like this makes it easier.”

Army Capt. DantefordLavoisier was just starting hissearch when the fair opened at10 a.m. He was on leave fromthe U.S. Army’s Yongsan Garri-son in Seoul, South Korea anddecided to stop by the employ-ment fair because he transitionsout of the military in June. Hewas looking for a job in informa-tion technology - a skill he ac-quired during his eight years ofmilitary service.

Not planning far enough inadvance and not having a clear

NSAB Employment, Education Fair Helps Hundreds Seeking Opportunities

A participating university representative provides advice to a service memberduring the event.

Photos by Andrew Damstedt

Attendees navigate some of the 45 schools which took part in the Employment and Education Fair on Naval Support Activity Bethesda,Jan. 23.

See FAIR page 7


(Top left) Naval Support Activity Bethesda’s (NSAB) Child Development Center ribbon cutting ceremony - photo by Mass Commu-nication Specialist 2nd Class Brandon Williams-Church, (Middle left) First Lady Michelle Obama’s visit to the Fisher Houses onboardNSAB - photo by Mass Communication Specialist 2nd Class Brandon Williams-Church, (bottom left) Gary Sinise and Chef RobertIrvine entertain the crowd at the Invincible Spirit Festival at Walter Reed National Military Medical Center onboard NSAB, (topmiddle) WWE Stars with NSAB Commanding Officer Capt. David A. Bitonti - Photo by Mass Communication Specialist 2nd ClassBrandon Williams-Church, (middle) Army-Navy Flag Football Game - Photo by Mass Communication Specialist 2nd Class BrandonWilliams-Church, (bottom middle) Morale, Welfare and Recreation’s (MWR) Character Brunch - Photo by Mass CommunicationSpecialist 2nd Class Brandon Williams-Church, (top right) Former President George W. Bush at the USO Dedication - Mass Com-munication Specialist 2nd Class Brandon Williams-Church, (middle right) Color Me 5K Run sponsored by MWR - courtesy photo,(bottom right) USO ribbon cutting ceremony - Mass Communication Specialist 2nd Class Brandon Williams-Church

2014 YEAR IN REVIEW


By Sharon ReneeTaylor,

WRNMMC PublicAffairs staff writer

Public Health officialsat Walter Reed NationalMilitary Medical Center(WRNMMC) on NavalSupport Activity Bethesda(NSAB) continue to urgemeasures against the in-fluenza or flu virus.Deaths due to the flu

and pneumonia exceededthe epidemic threshold forweek 53 of the 2014-2015flu season, according to theCenters for Disease Con-trol and Prevention (CDC).“The 2014-2015 flu

season is in full swing,”explained Army Lt. Col.Tina Streker, chief ofPublic Health Nursingand Preventive Medicineat (WRNMMC). “We atWRNMMC have seen asubstantial increase inthe rate of influenza-likeillnesses and influenzaassociated hospitaliza-tions compared to previ-ous years. Maryland andour local communities alsohave increased levels offlu as widespread influ-enza activity is reportedthroughout the UnitedStates.”Streker reports the

number of influenza-asso-ciated WRNMMC hospi-talizations in the currentflu season (as of Decem-ber 2014) has alreadyexceeded the previous2013-2014 season throughJune. Comparing the sametime periods for Influenza‘A’ — associated hospital-izations, the 2014-2015season nearly doublesthe previous flu season.Streker indicated a totalof 33 positive Influenza ‘A’specimens identified dur-ing the current flu seasonat WRNMMC.Walter Reed Bethesda

has provided more than28,000 flu vaccinations atthe medical center to date,according to Army Lt. Col.(Dr.) Casey Geaney, chief,Allergy Immunology Ser-vice. He said an additional8,000 were administeredat the Pentagon duringthe initial flu drive ear-lier in the season, with

approximately 800 moregiven at the Departmentof Defense’s Mark CenterBuilding in Alexandria,Va.Army Col. (Dr.) Kevin

Michaels, chief of the De-partment of Public Health,named three importantsteps everyone should fol-low in this season’s battlewith the flu. “Get the flushot. If you’re sick, stay athome. Wash your handsand use good cough eti-quette,” the physician said.Experts also recom-

mend flu vaccinationeven though the seasonis nearly at the halfway

point. The CDC continuesto endorse flu vaccina-tion because the vaccinecan prevent infection andalso averts serious flu-related complications inmany people, according toStreker.“Anyone who has not

gotten vaccinated yet thisseason should do so now,”she urged. “This includespeople who may alreadyhave gotten the flu thisseason because flu vac-cines protect against threeor four different viruses,and other viruses may cir-culate later in the season.”Army Reservist Col.

(Dr.) Cynthia L. Perry,Preventive Medicine andPublic Health, explainedwhat viruses this season’svaccines protect against.“Flu vaccines are de-

signed to protect againstthe main flu viruses thatresearch suggests will bethe most common duringthe upcoming season,” shesaid. According to Perry,the 2014-2015 influenzavaccine is made to protectagainst either three orfour viruses: two type ‘A’viruses (H1N1 and H3N2),along with one or two In-fluenza ‘B’ viruses. The

WRNMMC Immuniza-tion Clinic offers the four-component vaccine, Perryindicated.According to the CDC,

injectable flu vaccinesare currently made intwo ways: either with fluvaccine viruses that havebeen inactivated (killed)and are therefore not in-fectious; or, with no fluvaccine viruses at all. Thenasal spray flu vaccinedoes contain live viruses,but they are attenuated(weakened), and thereforecannot cause flu illness.Is this season’s vaccine

a good match for circulat-ing viruses? Perry saidthe overall match betweenvaccines’ type ‘A’ H3N2components is approxi-mately 42 percent.So why doesn’t this sea-

son’s vaccine contain theright H3N2 virus?Echoing the response

of CDC Director Dr. TomFrieden, Perry said, “The‘drifted’ (slightly mutated)H3N2 viruses now circu-lating were first noticed inMarch of 2014, too late toinclude in this year’s vac-cine.”The H3 component of

the vaccine was still by farthe most common of theH3N2 viruses at the time,according to the CDC Di-rector, who added it wasn’tuntil September that thenew strain became com-mon. Flu experts havesuggested that H3N2-dominated flu seasonstend to be more severe.Perry explained re-

searchers are currentlyworking on vaccines intime for the 2015-2016 fluseason. Vaccine develop-ment is a lengthy process,and begins far ahead ofthe season in which it isadministered.

“The vaccine was ourbest available, however itwas slightly off,” Michaelssaid, adding that it willstill provide protection.“We get vaccines to

protect ourselves but alsothose we love, coworkers,classmates, the very old,the very young and ourpatients here, as health-care providers,” she said.According to the CDC, ev-eryone six months of ageand older should get a fluvaccine every season.Immunization officials

indicated plenty of vaccineis still available for thoseseeking influenza vac-cinations at WRNMMC.Eligible individuals seek-ing a flu shot can receivevaccination weekdays,from 7:30 a.m. to 4 p.m., atthe Immunization Clinicin Bldg. 19. Call 301-295-5798 for more information.

Flu Season Nearing Peak

Health Officials Continue to Recommend Vaccination

U.S. Navy photo

Health-care officialsencourage peopleto get the influenzavaccination as the fluseason is nearing itspeak.

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She said the model built by the two and their teamserves as a model for similar tools being used by orunder development at the Hearing Center of Excel-lence, the Vision Center of Excellence and the AmputeeCenter of Excellence. In partnership with the DefenseHealth Agency, the developers of the project expect tosoon provide other DOD organizations with tools andsystems for their registries.

“We are now advocating this as a model for otherwould-be registry managers across the Military HealthSystem,” stated Army Col. (Dr.) John S. Scott, directorof Clinical Informatics Policy, Health Affairs, in his Oct.16, 2014 correspondence with the Office of the AssistantSecretary of Defense, Health Affairs.

Caban led the NICoE team to develop the powerfultool that standardizes data collection across clinical

specialties at the NICoE. According to the informati-cian, researchers and clinicians don’t translate data thesame way — a huge challenge for the project.

Researchers want forms where detailed clinical infor-mation could be captured, and clinicians prefer free textto better describe the patient’s condition, Caban said.The NCMT meshed together both clinical informationand research so that both can maximize benefit fromthis data, “for collecting information, particularly bothon clinical and research elements, to allow us to betterunderstand the complex patients that we have comingthrough,” explained Dr. Joseph Bleiberg, NICoE’s seniorscientific advisor.

Bleiberg said the NCMT project helps to develop aseries of subgroups by analyzing data it provides andhelps provide an understanding of those patients. Thesuccessful project generates data into queries for re-search, dashboards providing visual analytics, and al-lows data sharing.

“By using the NCMT, we can leverage info that’s cap-tured by all our providers here on the clinical side and

be able to understand their clinical condition in that el-emental form,” explained Dr. Thomas J. DeGraba, dep-uty director and chief of medical operations at NICoE.“In other words, we can get the information about thepatients in a much more detailed form that goes intothe database that allows us to understand the patientsbetter than we were ever able to do before.”

“We’re doing things that were impossible to do oth-erwise,” Bleiberg added. “This is transformative, it’s notjust [efficient].

“We’re allowing the process of taking care of patients[to] produce research [data] as we’re taking care of pa-tients,” Bleiberg said. “We’re using a clinical model thathas been used at the National Institutes of Health inthe past [and that] we’ve incorporated here as part of aclinical research institute that allows us to change theface of clinical research,” he said. “It’s a pilot-capabilitytest case as it were: can this be done utilizing/incorpo-rating the advances that are being made by Dr. Cabanand his team but still utilize the legacy system? We’restill leveraging the ALTHA system, we’re just using itin a better way.”

The NCMT taps into the existing medical systems:Armed Forces Health Longitudinal Technology Appli-cation (ALTHA) and Composite Health Care System(CHCS).

Dr. Greg Morgan, a neurologist and sleep special-ist who serves as director of the sleep medicine lab atNICoE, has used the new system for a little over a year,and explained how it is helping providers.

“I like it because it organizes the data that we ac-quire, which is a lot, in a systematic way so it’s repro-ducible from patient to patient, rather than typicallywhen you take a history, [as] you may stray in one di-rection or another. When you try to do research, youneed reproducibility data points from patient to patient.Structurally, I like the organization of it,” Morgan said.“It helps me take what I thought at first was a veryunwieldy note when I first got here, and consolidateit into chunks that are more organized and digestible.I’ve gotten comments from some outside providers thatthey like the format of our notes — they think they’reeasier to navigate than the old, long paragraph afterparagraph, after paragraph. Having it in sections, andlabeled, they know what they can jump to, to get thenuggets that they think are interesting.”

Morgan said he liked the way NCMT collects self-reports from the patients. “I reference that before I evengo and see the patient, populating my notes. It gives mea framework on how to aim the discussion,” he said. “Ithink it adds efficiency with the patient because I’malready primed with good information that they filledout. It sort of extends the history beyond the time youhave [with them during the appointment] … you canefficiently focus on what they’ve already written down.I like that aspect of it.” Caban said the challenge was todevelop something that physicians were already usingin their clinical practice—not adding to the tasks theyalready have. He added, “We don’t want to interrupt orinterfere with that, that’s why we’ve been letting theprovider do what they do best, taking care of patients.”

NICOEContinued from pg. 1

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plan can be a stumbling block for someservice members as they transition out ofthe military, said Anne Bloesl, Fleet andFamily Services transition and employ-ment manager.

“They can do anything they want to donow,” Bloesl said. “They need to make thedecision based on personal and familygoals, such as where they want to live.”

Katie Mancusi, a nurse recruiter ata Washington, D.C.-based hospital, saidher company has stepped up efforts torecruit veterans.

“A lot of veterans have skill sets di-rectly related to health care,” Mancusisaid.

Plus, she said military values oftenmatch what employers are searchingfor in an employee: hard-working, up fornew challenges and with a desire to ad-vance, among others. She said she was“impressed right off the bat” with poten-tial candidates she met at NSAB’s Edu-cation and Employment Fair and saidshe was already planning to re-contacta few individuals who stopped by hertable.Willie Woolford, school recruiter fora national university, its assistant direc-tor of military programs and a veteranhimself, said three things stop peoplefrom going to college: Time, money andfear. One of his main goals is to alleviate

prospective students’ fear of going to col-lege after serving in the military, and asa “former military guy,” he said he looksto find the best educational fit for servicemembers.

“I work for my university and my jobis to get students to my school, but it’salso making sure military members un-derstand all of their education opportu-nities,” Woolford said.

The fair was a first step for many at-tendees, and Navy College Bethesda Di-rector Elizabeth Baker hopes they willfollow-up with schools they had conver-sations with at the fair.

Bloesl echoed that sentiment.“It’s up to them to follow-up with the

contacts they’ve made within the next48 hours,” Bloesl said. “[The fair] is justa first step; they might not have had aninterview here.The onus is on the servicemember or individual to follow-up.”

FAIRContinued from pg. 3

Photo by Andrew Damstedt

More than 250 people attendedNaval Support Activity Bethes-da’s Employment and EducationFair, which featured 60 employ-ers and 45 schools.

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2014 Mercedes-Benz ML 350 Sport Utility

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Journal 012915