"HAVANA SYNDROME Better Patient Communication and Monitoring of Key DOD Tasks Needed to Better Ensure Timely Treatment

 

 

The use of sonic based or other technologies , for the moment likely primarily to access data rich devices but secondarily and i specific instance to injure targets has tended to be relegated to the forgettable by the media. The use and the threat of these technologies, however, are not dependent on press attention.  Though it appears that the response of the State to its victims--whether as targets or collateral damage--is.

It is in this light that a recent GA report may be worth reading:   HAVANA SYNDROME: Better Patient Communication and Monitoring of Key DOD Tasks Needed to Better Ensure Timely Treatment.

This report examines (1) the challenges AHI patients have faced accessing care in the MHS, (2) how DOD is facilitating AHI patients’ access to the MHS, and (3) the extent to which DOD has developed a registry to facilitate AHI research.

The highlights follow.

July 2024
HAVANA SYNDROME
Better Patient Communication and Monitoring of Key
DOD Tasks Needed to Better Ensure Timely
Treatment
What GAO Found
U.S. government employees and family members in several countries have
experienced a sudden onset of symptoms referred to as anomalous health
incidents (AHI). GAO interviewed 65 AHI patients, who reported a variety of
challenges in accessing the Military Health System (MHS). They included
inconsistent support from home agencies before seeking MHS treatment, limited
information and unclear points of contact upon entering the MHS, and difficulty
scheduling appointments when using the MHS. According to officials, civilian AHI
patients are not as familiar with the MHS as active-duty military and need
additional support to navigate the system. In addition, the Department of Defense
(DOD) lacks an official mechanism to communicate authoritative information to
AHI patients, which led some to use informal support groups to navigate the
MHS. While some patients found these groups valuable, other patients and DOD
officials noted these groups sometimes communicated inaccurate information.
For example, some officials reported misinformation in the groups about the
availability of appointments in the MHS. Without an official DOD mechanism to
communicate with AHI patients, this situation can perpetuate inaccuracies, fuel
perceptions of inequity, and lessen trust in MHS providers.
Challenges Reported by Anomalous Health Incident Patients Accessing the Military Health
System
DOD has created a plan to address some access concerns of AHI patients, but it
contains uncertain timeframes and lacks monitoring provisions. For example, the
plan produced a new approval process for AHI patients to enter the MHS and
calls for an enhanced AHI Care Coordination Cell to centralize administrative and
clinical processes. However, the timeframe for implementing the care cell has
been delayed. Moreover, the plan does not contain components for monitoring
these two key tasks, which could undercut its success.
DOD has developed a registry as required by law to include certain data on AHI
patients assessed or treated by DOD. However, the AHI Registry data fields
remain under development. Moreover, delays in obtaining individual consent for
inclusion have limited the number of patients contained in the AHI Registry. DOD
did not initially seek consent from individuals to be included in the registry when
they entered the MHS, limiting the number of participants. Of 334 AHI patients
who had qualified for care in the MHS in January 2024, only 33 had been entered
in the AHI Registry as of May 2024. According to DOD, key agencies also have
not signed memorandums of agreement with DOD, which has contributed to the
slow inclusion of AHI patients. Without a plan to gather consent from AHI patients
who have left the MHS, DOD will have a limited number of patients in the AHI
Registry to analyze, which could limit its usefulness for supporting AHI analysis
and research activities.

Page i GAO-24-106593 DOD Care for AHI Patients
Letter 1
Background 4
AHI Patients Face Several Challenges Accessing Care in the
Military Health System 13
DOD Plan for Facilitating AHI Care Contains Uncertain
Timeframes and Lacks Monitoring Provisions 26
AHI Registry Remains Under Development and Delays in
Obtaining Consent Have Limited its Usefulness 31
Conclusion 34
Recommendations for Executive Action 36
Agency Comments 36
Appendix I Objectives, Scope, and Methodology 38
Appendix II Comments from the U.S. Department of Defense 41
Appendix III GAO Contact and Staff Acknowledgments 45
Tables
Table 1: Department of Defense Secretarial Designee Processing
Times by Calendar Year 12
Table 2: Department of Defense (DOD) Plan of Action and
Milestones Tasks with Projected Completion Dates for
Anomalous Health Incidents (AHI) Care 29
Figures
Figure 1: Defense Intrepid Network for Traumatic Brain Injury and
Brain Health Locations 8
Figure 2: Anomalous Health Incident Secretarial Designees by
Agency as of April 2024 9
Figure 3: Intended Secretarial Designee Approval Timeline for
Anomalous Health Incident Patients 11
Figure 4: Secretarial Designee Package Approvals by Month 13
Figure 5: Agency Breakdown of Anomalous Health Incident
Patients Interviewed by GAO 14
Contents