A Resource on Post Deployment Health for Veterans and their Providers
The War Related Illness and Injury Study Center (WRIISC) is a national program dedicated to Veterans’ post deployment health concerns and unique health care needs. The WRIISC develops and provides post deployment health expertise to Veterans and their health care providers through clinical care, research, education, and risk communication. As part of a stepped care approach at the Veterans Health Administration (VHA), the WRIISC partners with referring providers and their health care teams to support the care of Veterans. The WRIISC is part of VA’s Post Deployment Health Services, and is a VA Delivered Core Service. This means WRIISC work is fundamental to VA’s mission and is rarely found outside of VA.
Clinical Services
The WRIISC has clinical services for deployed Veterans of any era with difficult to diagnose or treat medical concerns that have been thoroughly worked up. A Veteran’s VA primary care provider submits a consult request to the WRIISC. Every consult request undergoes a thorough interdisciplinary medical record review addressing both provider questions and Veteran top concerns which results in an E-Consult. The E-Consult response summarizes the Veteran’s medical concerns, diagnostic tests and treatment to date, detailed recommendations for further assessment, and resources for additional information. The E-Consult also includes suggestions on next management steps for the provider and Veteran to follow. The recommendations to a provider may include further clinical services offered by the WRIISC.
The WRIISC is working to maximize the use of telehealth to avoid unnecessary travel for Veterans for comprehensive evaluations, standalone exposure evaluations and education classes as a way of serving more Veterans, especially given the COVID-19 pandemic.
One of these additional services is the Comprehensive Interdisciplinary Evaluation designed for post deployment Veterans with complex health conditions with no known cause (medically unexplained symptoms) that have been thoroughly worked up. The comprehensive evaluation consists of an evaluation by the WRIISC team of experts in various medical specialties and includes everything from a close look at medical history and current physical health to psychological and neuropsychological assessments to consults about environmental exposure, a social work assessment and a health education session. At the end of the evaluation, the findings are integrated into recommendations geared toward enhancing a Veteran’s day to day living. WRIISC comprehensive clinical evaluations take a multi-disciplinary approach focused on addressing the health issues of top concern to the Veteran. The recommendations made by the WRIISC team are shared with each Veteran and their referring provider care team. The team education specialist spends time discussing the recommendations and how the Veteran will implement the recommendations moving forward. To ensure appropriate follow up care, the findings from the WRIISC clinical evaluation are shared with the Veteran’s doctor and home care team who work closely with the Veteran to address health concerns and serve as a guide for best healthcare practices.
“WRIISC staff members were friendly and helpful. I felt very comfortable and am confident in the care I received.” Gulf War Veteran
Deployment Exposure Assessment
One unique WRIISC clinical service is a standalone environmental exposure assessment by a doctor who specializes in occupational medicine that looks at the potential contribution of exposures to Veteran health concerns or symptoms. The Exposure Assessment is part of the Comprehensive Interdisciplinary Evaluation or may be offered as a standalone telehealth service.
The WRIISC also has expertise in the evaluation of airborne hazard concerns and some Veterans who are referred may receive advanced diagnostic workup for their respiratory concerns such as a cardiopulmonary evaluation if needed. The Airborne Hazards Center of Excellence at the NJ WRIISC, established in 2013, was officially recognized by Congress and the President in Public Law 115-929 as a VA Center of Excellence. It was formally designated as the Airborne Hazards and Burn Pits Center of Excellence (AHBPCE) in May 2019.
Education Services for Vets & their Providers
An important mission of the WRIISC is to provide education to Veterans, their caregivers and providers. In addition to one-on-one health education to support those who have comprehensive clinical evaluations and for some Veterans health coaching, the WRIISC conducts education classes for Veterans with the most up to date knowledge, information and practices. Current WRIISC classes address environmental exposures such as agent orange and airborne hazards as well as Gulf War Illness. The WRIISC also offers wellness education such as mindful meditation weekly classes offered by telephone to yoga.
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WRIISCs newest means of educating both educating Veterans, providers and members of the Veteran community is a podcast series titles “Veterans Health Matters”. The WRIISC’s subject matter experts provide up to date information ranging from effective communication, to information on nutrition, and much more, that can impact a Veteran’s health.
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In the past close to 20 years of the WRIISCs existence, Veteran provider education has been implemented through in person trainings across the country; including national conferences, Our current provider curriculum consists of a monthly webinar services and online learning courses in post deployment health and exposure topics. Both are offered ON Demand to VA and community providers to reach as many Veteran providers as possible. Providing up- to- date information to providers on best practices can positively impact Veteran care and health outcomes!
WRIISC Research
The WRIISC research program focuses on improving the health of Veterans with post deployment health concerns. WRIISC researchers and clinicians work together to identify new problems in returning Veterans and respond to their health concerns. We use the knowledge generated by research to identify promising treatments and the most current evidence-based care for Veterans. WRIISC research interests cover a wide range of topics including environmental exposures and post deployment health, long-term health effects of combat, memory and mood difficulties, traumatic brain injuries, neurological diseases, treatments for Gulf War Illness, Airborne hazards research, integrative health and wellness approaches, Veterans’ health, among others.
WRIISC At the Core
The WRIISC mission areas of clinical, research, education and risk communication work together and this synergy promotes cutting edge research, evaluation and treatment as well as the dissemination of best practices in post deployment health. Regardless of the area of focus, everything WRIISC does is toward providing the best care to Veterans served – because Veterans are truly the heart and soul of the WRIISC!
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