THE EXAMINER

Volume 19, No. 8 August 2011C

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Did you know?...

Robert E. Bush Naval Hospital

“Serving with Pride and Professionalism since 1993”

You have the right toexpress your concerns

about patient safety and qual-ity of care.

There are several avenuesopen to you:

* Through the ICE web-site.

* Through the NavalHospital Customer CommentCards.

* The Hospital’s CustomerRelations Officer at 760-830-2475, or any of the CustomerRelations representatives inthe hospital’s clinics.

Or Directly to the JointCommission via:

E-mail atcomplaint@jointcomission.org

Fax:Office of Quality Monitoring630-792-5636

Mail:Office of Quality MonitoringThe Joint CommissionOak Renaissance BoulevardOakbrook Terrace, IL 60181

http://www.med.navy.mil/sites/nhtp/pages/default.aspx

An Award Winning Publication

Patients seen in May -- 12,748Appointment No Shows in June -- 926

The news for our patients in June show a small up tick in ourmissed appointments. For May it was 6.6 percent, for June weare up a bit to 6.8 percent. We have to keep the appointmentswe make, or cancel in enough time for someone else to use theslot... Don’t let your neighbors down by denying them access toneeded health care.

To make an appointment call -- 760-830-2752To cancel an appointment call -- 760-830-2369

Introducing Captain Cynthia Gantt, (NC) Executive Officer

By Dan BarberPublic Affairs OfficerRobert E. Bush Naval Hospital

Captain Cynthia Gantt, is not new to the command... she is a plankowner of the Robert E. Bush Naval Hospital.

To be clear the command was officially established as NavalHospital Twentynine Palms, in 1988 under the command of thenCommander G. Russell Brown. In 1991, newly commissionedLieutenant Cynthia Gantt became the first Family Nurse Practitionerassigned to the command...it was also her first “job” as she explained,in her civilian lexicon, to then Captain Brown in her first meetingwith the CO after checking in. “I was new to the Navy and I tried toexplain to Captain Brown that I wasn’t sure what to do,” said Gantt.“Captain Brown told me, well lieutenant you better learn.”

In July 1993 the command moved into the current facility.It seems that Captain Brown set the tone for Gantt to excel in her

chosen profession... to “learn.”Fast forward 21 years and now Captain Cynthia Gantt, NC, USN,

FNP-BC, PhD, a recipient of the American Hospital Associations(AHA) “2010 Federal Health Care Executive Award for Excellence”was selected by Rear Admiral Elizabeth Niemyer, Director of theNavy Nurse Corps for the Executive Officer “job” here.

“This is a gift that I never expected to receive. I am so grateful forthis opportunity. When Rear Admiral Niemyer called me and saidCynthia, congratulations, you are the next executive officer at NavalHospital Twentynine Palms. I was thrilled. It was my first choice, andI never expected to get it.”

Gantt hails from Temple City, Calif., a suburb of Los Angeles. Thereshe attended Temple City High School and then went on to earn anAssociate Degree from Pasadena City College.

She wasn’t yet finished with her education, she then earned aBachelor of Science in Nursing from Sonoma State University, gradu-ating cum laude and was the valedictorian speaker at the commence-ment. Also at Sonoma State she also later returned and earned aMaster’s in Science degree as a Nurse Practitioner.

Gantt’s father, who still lives in Temple City, was in the U.S. Navyfor 3 years and who retired several years ago from the Postal Servicewas an inspiration to his daughter. “I was inspired by my father’sservice in the Navy, but when I was in Graduate School at Sonoma, aNavy Nurse Corps recruiter came and offered me a free lunch, whichwas my introduction to the United States Navy as a possible joboption.”

“Everyone of my past duty station’s have had a memorable experi-ence for me. This command was my first duty station when I wasassigned as the first Family Nurse Practitioner... I am a plank ownerof this facility,” said Gantt. “I met my husband, Lieutenant RobertGantt, here... so I have many memorable experiences right here,” saidGantt.

Continued on page 7

By Dan Barber Public Affairs OfficerRobert E. Bush Naval Hospital

The Robert E. Bush NavalHospital is in the processof converting to the

Medical Home Port model ofhealth care delivery to enrolledpatients.

The Medical Home Port modelwill allow patients enrolled atRobert E. Bush Naval Hospital,to see the same team ofproviders each time they call orcome in for medical appoint-ments.

The ultimate goal is to seeyour personal Primary CareManager (PCM) as often as pos-sible. However, if they are notavailable, another provider onthe same team will see you.

In addition to providers, theteam of healthcare professionals

will also be made up of nurses,clerks, and hospital corpsmenthat are dedicated to providingtheir patients with the best pos-sible care. Patients will be ableto get to know the rest of thestaff as well as they know theirprovider. According to a recentarticle in the Los Angeles Timesnewspaper, Four physiciangroups... the American Academyof Family Physicians, theAmerican Academy ofPediatrics, the AmericanCollege of Physicians and theAmerican Osteopathic Assn. ,believe this method of patientcare, known as patient-centeredmedical homes will providepatients with more access to pri-mary care and allow longerappointments.

Medical Home Ports add con-tinuity of care for patients evenwhen the active duty providerdeploys.

The combination of both civil-ian and military team memberscultivates stability for the teamsand patients when militarymembers are transferred or

deployed.The hospital’s Facilities

Management Department is inthe process of arranging the

clinics spaces so team memberswill all be co-located.

In addition to assigningpatients to one of three teamshere, Naval HospitalTwentynine Palms has estab-lished “Naval Hospital 29Online” which is powered as asecure messaging program byRelay Health... contractedthrough Navy Medicine. NavalHospital 29 Online is a securecomputer based program whichprovides a more convenientmethod of communications withthe healthcare teams, allowingpatients to securely communi-cate, via e-mail. Naval Hospital29 Online will allow patients torequest their lab results; requesta medication refill; access healthcare information and allow themto create their own health carerecord to help manage their owncare, all from the comfort ofhome.

A feature of this new commu-nications concept that shouldprove very popular, is patientswill be able to request appoint-ments through the NavalHospital 29 Online link on thehospital’s web site. The hospi-tal’s Information Managementteam has been working on thisproject to make it easy foreveryone to use in a secureforum to protect patient toprovider communications.

According to the ExecutiveOfficer of the hospital, Capt.Cynthia Gantt, “I truly believethat the Medical Home Port willimprove the health of all ourbeneficaries. The changes weare making will help foster thepatient-provider partnershipsthat will increase a person’ssense of control over theirhealth care and will lead topatient satisfaction.”

2 -- The Examiner -- August 2011

Published by Hi-Desert Publishing, a private firm in no way connected with the Department of Defense, the UnitedStates Marine Corps, United States Navy or Naval Hospital, Twentynine Palms under exclusive written contract withthe Marine Air Ground Task Force Training Command. The appearance of advertising in this publication, includinginserts or supplements, does not constitute endorsement by the Department of Defense, the United States MarineCorps, the United States Navy or Hi-Desert Publishing of the products or services advertised. Everything advertisedin this publication shall be made available for purchase, use, or patronage without regard to race, color, religion, sex,national origin, age, marital status, physical handicap, political affiliation, or any other non-merit factor of the pur-chaser, user or patron. If a violation or rejection of this equal opportunity policy by an advertiser is confirmed, thepublisher shall refuse to print advertising from that source until the violation is corrected. Editorial content is preparedby the Public Affairs Office, Naval Hospital, Twentynine Palms, Calif.

Commanding OfficerCaptain Ann Bobeck, MSC, USN

Executive OfficerCaptain Cynthia Gantt, NC, USN

Command Master ChiefHMCM (SW/FMF) Rodney Ruth, USN

Public Affairs Officer/EditorDan Barber

Command OmbudsmanValatina Ruth

Care Line 830-2716Cell Phone (760) 910-2050

The Examiner welcomes your comments and suggestions concerning the publication. Deadline for submission ofarticles is the 15th of each month for the following month’s edition. Any format is welcome, however, the preferredmethod of submission is by e-mail or by computer disk.

How to reach us...Commanding Officer Naval HospitalPublic Affairs OfficeBox 788250 MAGTFTCTwentynine Palms, CA 92278-8250Com: (760) 830-2362DSN: 230-2362FAX: (760) 830-2385E-mail: dan.barber@med.navy.milHi-Desert Publishing Company56445 Twentynine Palms HighwayYucca Valley, CA 92284Com: (760) 365-3315FAX: (760) 365-8686

New Model of Health Care Delivery and Communications Coming Soon

...Medical HomePorts add continuityof care for patientseven when the activeduty providerdeploys...

Africanized honey bees...How dangerous are they?

By Martha Hunt, MA CAMFHealth Promotion and WellnessRobert E. Bush Naval Hospital

Morongo Basin has a resident population of Africanized HoneyBees (AHB). AHBs are not native to the U.S.; they camefrom Africa to South America and then crossed over to the

US across the Texas border. Just like regular honey bees that we are used to, they pollinate plants

and can only sting once before dying. The problem is that AHBs arevery aggressive and will swarm in huge numbers to protect theirhives. You cannot tell a regular honey bee from an AHB as they lookidentical. Therefore it is always best to be careful around all bees anddo not anger them or otherwise annoy them so that they sting.

The best safety advice is to avoid an encounter with unfriendlyAfricanized bees. Remember that AHBs sting to defend their colony,so watch for honey bee swarms and colonies. AHBs don’t always livein the typical beehive we are familiar with... rather they sometimesnest in cracks of houses and junk left in your yard. For that reason, bealert for bees coming in and out of an opening such as a crack in awall, or the hole in a utility box. Also listen for the hum of bees tolead you to where the colony may be nested.

There have been reports of AHBs in the Joshua Tree National Parkand the open desert here so be aware of your surroundings and keepan eye out for bees the way you would watch out for snakes and othernatural dangers. Don’t panic at the sight of a few bees foraging in theflowers. Bees are generally very docile as they go about their normalactivities.

Here are some precautions that you can take so that you don’t attractAHBs -- or any dangerous creature -- in the first place. Wear light-col-ored clothing as bees tend to attack dark things. Dark clothing, darkhair, or anything dark in color could provoke the AHB. Also, bees aresensitive to odors, both pleasant and unpleasant. The smell of newlycut grass has been shown to disturb these bees. Also avoid wearingfloral or citrus after shaves or perfume.

Continued on page 7

By Brian P. SmithTriWest Healthcare Alliance

There is a logon that allowsmilitary families access tocertain Department of

Defense (DoD) benefit websiteswith one username and pass-word: it’s the DS Logon.Having a DoD Self-ServiceLogon (DS Logon) can meanremembering just one usernameand password for some DoDand Veterans Affairs (VA) web-sites.

How to request yoursingle logon:

* Sponsors with a CommonAccess Card (CAC) or DFASmyPay Login ID may request aDS Logon atmyaccess.dmdc.osd.mil/dsac-cess.

* Eligible beneficiaries can

request a DS Logon at TRI-CARE Service Centers (TSC).

* Sponsors and family mem-bers can also request a DSLogon through the VA eBenefitsportal.

It’s safe and secureIf the sponsor does not use the

CAC or DFAS method torequest a DS Logon, beneficiar-ies must finish a verificationprocess known as in-personproofing to be granted full DSlogon access. To help protectyour identity, users need full, orLevel 2, access to view orchange personal informationthrough the websites below. Youcan complete the verificationprocess at a TSC. NationalGuard and Reserve memberswho can’t go to a TSC for vali-dation may be eligible to com-plete a remote proofing process(more information at www.tri-

care.mil/reserve). After in-person (or remote)

proofing, your DS Logon can beused to access these DoD andVA sites:

* Beneficiary Web Enrollment(www.dmdc.osd.mil/appj/bwe):Manage TRICARE Primeenrollments and update contactinformation.

* Reserve ComponentPurchased TRICAREApplication(www.dmdc.osd.mil/appj/reservetricare): Purchase TRICAREReserve Select and TRICARERetired Reserve coverage.

* TRICARE Online (www.tri-careonline.com): Set appoint-ments and refill prescriptions atcertain military treatment facili-ty locations.

* myDoDbenefits (mydodben-efits.dmdc.osd.mil): Access andupdate information that goes

directly into the DefenseEnrollment Eligibility ReportingSystem (DEERS).

* VA eBenefits (www.ebene-fits.va.gov): Apply for VeteransAffairs (VA) benefits, downloadyour Certificate of Release orDischarge from Active Duty(DD Form 214) and view bene-fits status.

* DS Logon Self-Service(myaccess.dmdc.osd.mil/dsac-cess): Activate and manage yourDS Logon account.

What kind of identification do I needfor in-person proofing?Beneficiaries need two current

forms of approved ID; at leastone must be a government-issued photo ID. DMDC’s list ofapproved IDs:www.dmdc.osd.mil/appj/dsac-cess/pub/FAQ.do.

What about my securewww.triwest.com

account?Your triwest.com account does

not use the DS Logon option. Atriwest.com username and pass-word are required to manageyour health care through a tri-west.com account. Go towww.triwest.com/Register tolearn more.

By Martha Hunt, MA Health Promotions CoordinatorRobert E. Bush Naval Hospital

Postpartum Depression isused to describe a range ofphysical and emotional

changes that new moms experi-ence around the time of the birthof their babies. Symptoms ofpostpartum depression or “thebaby blues” can range frommild to severe. Sometimes newmoms need medications to helpwith these symptoms, whileother moms may only need totalk to someone they trust sothat they can get help workingthrough their symptoms.

Postpartum Depression symp-toms can include: persistent sador empty moods; sudden moodswings; loss of interest in usualactivities; restlessness; irritabili-ty; excessive crying; feelings ofguilt for no reason; feelings ofworthlessness, helplessness, orhopelessness; or fear of hurtingthe baby or yourself.

Postpartum Depression symp-toms can also include: sleepingtoo much or too little; eating toomuch or too little; feelingfatigued and drained; thoughtsof death or suicide; difficultyconcentrating or making deci-sions; excessive forgetfulness;or vague physical complaints.

The Baby Blues are felt by asmany as 75 percent of allwomen who have either recentlygiven birth or recently experi-ence the loss of a pregnancy.Symptoms of the baby blues areusually felt 3-4 days after deliv-ery. However, baby blues mayalso be felt while you are stillpregnant. If PostpartumDepression is left untreated,symptoms may worsen and maylast for up to a year after deliv-ery.

It’s not known exactly whatcauses the Baby Blues. Theymay be caused by changes inhormones in your body, stressover being pregnant or thedelivery, feeling isolated fromfamily and friends, and feelingsimply overwhelmed by theresponsibility of being a newparent.

A new mom can experienceBaby Blues after the birth ofany child, not just the first one.Also, she may feel them for onepregnancy, but not another.There is no way to predictwhich pregnancy will result inpostpartum depression. Anywoman is at risk of postpartumdepression regardless of thenumber of children she has hador her age.

Postpartum Depression is morelikely to occur if a woman hashad any of the following: previ-

ous postpartum depression;depression not related to preg-nancy; severe premenstrual syn-drome (PMS); a non-supportivepartner; or stress related to fami-ly, marriage, occupation, hous-ing or other events in her life.

Self care for new moms shouldinclude getting enough rest!Take time for yourself and try tonap when the baby naps so youdo not become exhausted. Askfor help when you need it. Askyour partner for help withchores and get emotional sup-port from your partner, familyand friends. Make an effort toget out of the house every day,even if it’s only for a short walkin your neighborhood. Maketime for just you and your part-ner. Ask your primary careprovider for help. Join a newparent support group so you canmeet other new moms who aregoing through the same experi-ences as you.

Remember that you don’t haveto suffer with Post PartumDepression. There are peopleand groups in the communitythat can help. You can calleither the Perinatal CaseManagement Program at 830-2822, the Behavioral HealthDepartment at 830-2724 if youare active duty or Military OneSource at 1-800-342-9647 formore information.

The Examiner -- August 2011-- 3

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Got the New Baby Blues?

Convenient Access to Online Accounts with One Password

Six Tips to Save a Child from DrowningBy Shari LopatinTriWest Healthcare Alliance

Three children die every day from drowning.

It’s the leading cause of death from an injury for children ages 1-4years old, according to the Centers for Disease Control andPrevention (CDC). Mid-summer is prime time for water fun, but it

can also be deadly, if parents aren’t careful.The Red Cross Summer Water Safety Guide states more than 90 per-cent of families with young children will spend time in the water thissummer. And almost half of them plan to swim in places with no life-guard.

What does this mean? You need to take responsibility for your children’s safety around

water. Here are six tips from the Red Cross and the CDC to keep yourchildren safe:

1. Learn CPR. Seconds count if your child falls into the water. Youcould be the life-saving support until paramedics arrive. Contact yourlocal Red Cross chapter or your local fire department to learn whenCPR classes are available.

2. Supervise your children constantly around water. Never leave thesupervision to an older child, and avoid distractions yourself whenwatching your kids. This includes around bathtubs, swimming poolsand natural bodies of water...such as the ocean or a lake.

3. Secure pools with proper barriers. Install a four-sided fence Continued on page 6

4 -- The Examiner -- August 2011

Super Stars...

HM1 Eduardo Pamatz, Radiology, takes the oath of reenlistment recently for a period of six years.

HM2 Mary Wagner, Radiology, takesthe oath of reenlistment for a period ofthree years. The reenlisting officer for

both Pamatz and Wagner, was theRadiologist for the Naval Hospital,

Lieutenant Commander ChristopherDelbridge (not shown in photos).

Lieutenant Rebecca Ensley, a physician in the InternalMedicine Dept., receives a Navy and Marine CorpsAchievement Medal for her work while assigned to the RobertE. Bush Naval Hospital.

The Examiner -- August 2011 -- 5

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Full Color

Beneficiaries Can Battle Blemishes with TRICARE

By Kristin ShivesTRICARE Management Activity

Acne is a common problem among people of all ages, but someface chronic, severe breakouts that may require medical treat-ment. Beneficiaries can rest assured knowing TRICARE cov-

ers treatment for acne.The National Institute of Arthritis and Musculoskeletal and Skin

Diseases (NIAMS) estimates 80 percent of all people between theages of 11 and 30 have acne outbreaks at some point. It’s unclear whycertain people get acne, but according to NIAMS there are two impor-tant factors: an increase in hormones called androgens and heredity.

Androgens increase in both boys and girls during puberty, causingoil glands to enlarge and produce more oil. Hormonal changes likepregnancy and starting or stopping birth control pills can also lead toacne. Although going through puberty and heredity can't be changed,there are effective preventive actions and treatments available.

The Centers for Disease Control and Prevention offers a few ways tohelp reduce breakouts:

* Wash the face morning and evening with warm water and mildcleanser

* Keep hands away from the face* Don’t pick or try to pop pimples...it can lead to scarring* Wash hair regularly to help minimize oils from hair touching the

faceAcne or pimples occur when the skin makes excess oil and dead

skin cells get trapped in the pores of oil glands. When these pores getclogged, a pimple forms. Bacteria can get trapped in the cloggedpores and cause the pore to become inflamed and appear red andswollen. The face, neck, back, chest and shoulders are common placesto find pimples.

TRICARE covers medically appropriate treatment for acne. Acnecan initially be treated with over-the-counter medications, creams,washes or soaps. These over-the-counter products are not covered byTRICARE. Depending on response to treatment or severity of acne, aprovider may issue a referral to a dermatologist.

Beneficiaries who are concerned about their skin can get medicallyappropriate treatment for acne with TRICARE Prime, Standard andExtra. For TRICARE Prime, beneficiaries must first contact their pri-mary care manager for a referral. For TRICARE Standard and Extra,beneficiaries may visit any TRICARE-authorized provider for care.Referrals are not required, but some services may need authorization.

By Sharon FosterTRICARE Management Activity

The coordination of bene-fits between TRICAREand other health insurance

(OHI) can be confusing. If a beneficiary has health care

coverage through an employer,public or private insurance pro-gram, including governmentprograms such as Medicare, heor she is considered to haveOHI. Even health care throughan automobile insurance plan isconsidered OHI when servicesare related to an auto accident.

If a beneficiary has OHI, he orshe should tell his or herprovider and regional health

care contractor. Beneficiariesshould also fill out the OHIform located on their regionalhealth care contractor’s website(www.tricare.mil/contactus).Keeping the regional health carecontractor informed about theOHI will allow TRICARE tobetter coordinate benefits andwill help ensure that there is nodelay in payment of claims.

TRICARE is the secondarypayer when a beneficiary hasOHI. Before TRICARE consid-ers the claim, the beneficiary’sOHI must pay first. The excep-tions are Medicaid and TRI-CARE supplemental plans.Please go to TRICARE’s web-site to learn more www.tri-care.mil/mybenefit/home/Medic

al/OHI. After the other insurer pays,

TRICARE will pay what is leftup to the TRICARE allowablecharge, which is the maximumamount TRICARE will author-ize for medical and other servic-es furnished in an inpatient oroutpatient setting. There is nochange in benefit limits whenTRICARE is the secondarypayer.

Beneficiaries need to be sureto submit all claims to TRI-CARE because deductibles maybe applied to their annual cata-strophic cap. The beneficiary'sprovider may submit secondaryclaims as well.

To reduce pharmacy costs, abeneficiary's best option is to

use a TRICARE retail networkpharmacy that is also coveredby their OHI. After the OHIpays, TRICARE may reimbursethe beneficiary for part or all oftheir out-of-pocket costs, includ-ing copayments. Beneficiariesare not eligible to fill prescrip-tions via home delivery if theyhave OHI with a prescriptionplan, including a Medicare PartD prescription program, unlessthey meet one of the followingrequirements

* The medication they need isnot covered by their OHI.

* They have met their OHI'sbenefit cap.

If the OHI provides only med-ical coverage, not pharmacycoverage, he or she still may beeligible to use home delivery(www.tricare.mil/homedelivery)as their prescription benefit.

By Kristin ShivesTRICARE Management Activity

Ultrasound images are an exciting partof an expectant mother’s pregnancyand are often used to assess the pro-

gression of the pregnancy.TRICARE covers medically necessary

ultrasounds for expectant moms, but doesnot cover ‘routine’ ultrasounds. So, what’sthe difference?

A medically necessary ultrasound is onedoctors perform when they have a concernabout the progression of a pregnancy.Doctors often perform medically necessarymaternity ultrasounds at different times dur-ing pregnancy. TRICARE covers the follow-ing reasons:

* Confirming gestational age when date ofconception is uncertain

* Evaluating a fetus’ growth or well being* Evaluating a fetus or uterus for abnor-

malities * Diagnosing and monitoring multiples

(twins or greater)Doctors may offer expectant mothers ‘rou-

tine’ ultrasounds 16 to 20 weeks into theirpregnancy. An ultrasound performed withoutmedical necessity is not covered by TRI-CARE. It’s important for expectant parentsto remember ultrasounds aren’t to reveal ababy’s gender. Instead, the procedure isdone to take an early look at the fetus tomake sure it’s developing properly.

Ultrasounds are commonly given beforeweek 12 based on clinical circumstanceswhere the mother is having bleeding, pain oris at risk for an ectopic pregnancy (anectopic pregnancy is when a fertilized egghas implanted outside the uterus). Additionalscans can be administered for medical prob-lems such as high blood pressure, diabetes,obesity or when a physical exam suggestscause for concern.

Mothers-to-be should seek appropriate pre-

natal care as soon as their pregnancy is con-firmed. Prenatal care helps ensure the healthof the mother and baby. TRICARE Primecovers all necessary maternity care, from thefirst obstetric visit through six weeks after ababy is born. TRICARE Standard and Extrabeneficiaries pay their normal deductiblesand cost shares for office visits and inpatientmaternity care.

Beneficiaries are responsible for paymentwhen ultrasounds are performed without avalid medical reason i.e., just to find out thesex of the baby.

For more information on updates on mater-nity ultrasound coverage, prenatal care andmaternity services, beneficiaries can go tothe ‘Life Events’ tab ofwww.tricare.mil/mybenefit and select‘Having a Baby or Adopting’ or contact theirregional contractor. The regional contractors’phone numbers and Web sites are listed atwww.tricare.mil/contactus.

6 -- The Examiner -- August 2011

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Drowning...Continued from page 3around your pool. It should have self-closing and self-latching gates.

4. Always wear life jackets. Even if your kids know how to swim,they should always wear life jackets around natural bodies of water,such as the ocean or lake. For younger or inexperienced swimmers,they should wear life jackets around all water, even pools.

5. Make sure everyone in your home knows how to swim. Enrollthem in age-appropriate swim courses. And if you still need to learn,sign up for classes immediately.

6. Have lifesaving equipment available nearby. This includes reach-ing or throwing equipment (such as a lifesaver and rope), a cellphone, lifejackets and a first aid kit.

For more important water safety tips, visit www.triwest.com/water-safety.

TRICARE Tracks Progress of Pregnancy

How TRICARE Works with Other Health Insurance

TRICARE PharmacyBenefits There’s an App for That

FALLS CHURCH, Va. -- TRI-CARE and Express Scripts, Inc.(ESI) are pleased to announcethe launch of the TRICAREExpress Rx mobile app andmobile-optimized website.

These tools allow TRICAREbeneficiaries to manage theirprescriptions and access impor-tant health information safelyand securely from anywhereusing their smart phone.

The Express Rx app andmobile-optimized website willallow beneficiaries to registerfor TRICARE pharmacy homedelivery and switch current pre-scriptions over to home deliv-ery. Beneficiaries can alsoorder home delivery refills andcheck order status. Another fea-ture allows beneficiaries to lookup information on their currentprescriptions. On GPS-enabledsmart phones, the app can directbeneficiaries to the closest retailpharmacy in their network.

“Improving convenience forour beneficiaries and broaden-ing access to necessary serviceslike prescription information isa key focus for TRICARE,” saidRear Adm. Thomas J.McGinnis, chief of TRICAREPharmacy Operations. “ExpressRx is yet another way for bene-ficiaries to use their benefitwisely and conveniently, any-time and anywhere.”

To ensure security and dataprotection, beneficiaries mustregister through the memberportal at www.express-scripts.com/TRICARE beforelogging in to the Express Rxapp or mobile-optimized site.Once registered, the same user-name and password allowaccess to the Express Rx appand mobile-optimized website.

Continued on page 7

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Continued from page 1“Probably one of the high-

lights of my career was thework I did while stationed at thePentagon working for the for-mer Secretary of Defense Gateson his senior oversight commit-tee on the care and case man-agement of wounded warriorsfrom 2006 to 2008.” Accordingto the AHA citation for her 2010award, “She (Gantt) producedlandmark case management pol-icy, information sharing, anddata capture strategies thatresulted in new abilities to track,analyze and evaluate case man-agement services, including newworkload modeling capabilitiesfor all types of case manage-ment patients.”

En route to Twentynine Palms,Gantt was surprised with anaward from The AmericanAcademy of Nurse PractitionersU.S. Pacific Territory Region asthe 2011 AANP NursePractitioner State Award forExcellence. The award stated inpart, “In recognition of contir-butions to improve the healthcare delivery in Guam throughexemplary vision, transforma-tive leadership application ofresearch and excellence inadvanced practice nursing.Gantt stated that this award isvery dear to her because herheart is in patient care as aNurse Practioner.

Gantt wants to make it clearthat she is eternally grateful forthe inspiration and opportunitiesthat she has received from herfamily, the United States Navy,military leaders and the mentorsthat she has learned from overthe years. “I started at a commu-nity college, now I’m sittinghere as the XO with a PhD.,I’ve told folks more than once,

if I can do it, you can do it,”said Gantt. “Truly the value ofan education, no matter howlong they are in the Navy,whether they become a MasterChief Petty Officer, or if theyare interest in becoming an offi-cer, is very valuable,” saidGantt.

“I feel that the most importantadvice that I have for anyonehere, especially the enlisted staffis for them to work with theirchain of command and in partic-ular with the Chief’s Mess,”said Gantt.

“I also would tell everyonethat an education is an absolute-ly valuable thing to have...andeducation is a life-longprocess,” said Gantt.

“I believe in positive leader-ship, I believe in trust... I trustthe folks that I lead and I wantto be trusted by them. I firmlybelieve that leaders should bementors and particularly that amentor or a leader is generouswith their knowledge, and asmuch as possible, and with theirtime,” said Gantt.

“If I had just a couple ofwords to describe what my lead-ership philosophy is it would bepositive collaboration... every-thing can be rolled up into thosetwo words. Trust is fundamentalto collaboration,” said Gantt.

Gantt’s family is very impor-tant to her. The Gantts are theproud parents of an older son,Justin, who lives just outside ofPhoenix, Arizona and is the par-ent of the XO’s two younggranddaughters. The Gantts alsohave two daughters, Jessica whojust turned 12 and will be goinginto the seventh grade atTwentynine Palms Junior High,and Melissa who also just had abirthday and is now 10, who

will be going into the fifth gradeat Twentynine PalmsElementary. ”My husband, I’mproud to report, is right now afull-time stay at home parent.He is a retired Medical ServiceCorps Officer -- Health CareAdministrator. He was first aUnited States Navy HospitalCorpsman. He got out of theNavy then came back in as anactive duty Medical ServiceCorps Officer and then he wentinto the reserve componentwhere he retired as a command-er on the 31st of July 2009.Then on the 1st of August 2009I was promoted to Captain, so itwas a very special time for us,”said Gantt.

“Our daughters have a lot ofinterests, right now they are inthe bowling camp on base. Theyare also competitive swimmersand are fine musicians. We planon getting involved in localyouth sports like swimming andwe also plan on getting involvedin Girl Scouts. In Guam, myhusband and I held leadershiproles in Guam Girl Scouts.And when the weather getscooler we hope to be able toexplore the Joshua TreeNational Park. Our daughterJessica wants to get into rockclimbing. Now that we are backon the mainland we will have anopportunity to take some roadtrips and drive faster than35mph! We will be able toreconnect with my family here.It’s great to be home inCalifornia after six years,” saidGantt.

“My goals for this commandare to be the best possibleExecutive Officer that I can, andto continue learning.”

Introducing Captain Cynthia Gantt...

Check your house and yard atleast once a month to see ifthere are any signs of bees tak-ing up residence. If you do finda swarm or colony, leave it beand keep family and pets away.Find a local beekeeper toremove the colony or as a lastresort call a pest control compa-ny to solve the problem. To helpprevent honey bees from build-ing a colony in your house oryard, fill all cracks and crevicesin walls with steel wool andcaulk. Remove piles of refuse,

honey bees will nest in an oldsoda can or an overturnedflower pot as well as in cracksand crevices.

Obviously, it is best to avoidcontact with Africanized HoneyBees in the first place but ifcontact becomes unavoidable, itis important to know what to do.

The most dangerous stings areon the head and face. Use atowel, jacket, blanket, anythingto prevent stings

The best method of escaping abee attack is to cover your head

and run for shelter. Do not jump into water... bees

will wait for you to come up forair. Once you are away from thebees, evaluate the situation. Ifyou are allergic to bees, seekmedical attention immediately.If you see someone else beingstung or think others are in dan-ger, call 911 immediately.Remove stingers as soon as pos-sible to lessen the amount ofvenom entering the body.Scrape stingers off the skin witha blunt instrument or plasticcard.

Africanized honey bees... Continued from page 2

ESI is the TRICARE Pharmacy contractor.Smartphone users can download the app for free by going to

www.express-scripts.com/mobile or by using services like the AppleApp Store or Android Marketplace. The mobile-optimized pharmacywebsite can be accessed at http://m.esrx.com. TRICARE beneficiar-ies in the South Region can also make use of the mobile HumanaMilitary website, https://m.humana-military.com/.

For more information about TRICARE pharmacy, visit www.tri-care.mil/pharmacy. To learn about the TRICARE pharmacy homedelivery, go to www.tricare.mil/homedelivery.

TRICARE Pharmacy...Continued from page 6

8 -- The Examiner -- August 2011

On Vacation with TRICARE: Urgent or Emergency Care? By Sharon FosterTRICARE Management Activity

Two days into summervacation, a beneficiarysprains his ankle while jet

skiing. Even the best plannedvacations can be disrupted withinjury or sickness.

While TRICARE follows ben-eficiaries when they travel,understanding when somethingconstitutes an emergency roomor urgent care visit can help thebeneficiary save money andtime.

TRICARE defines an emer-gency as a medical, maternity orpsychiatric condition that wouldlead a ‘prudent layperson’(someone with an averageknowledge of health and medi-cine) to believe that a seriousmedical condition exists; thatthe absence of immediate med-ical attention would result in athreat to life, limb or sight;when a person has severe,painful symptoms requiringimmediate attention to relievesuffering or when a person is atimmediate risk to self or others.

“Some examples of emergencysituations may include: headinjuries, broken bones, chestpains and the inability tobreath,” said Kathleen Larkin,director, Health Plan PolicyDivision of Health Affair/TRI-CARE Management Activity.“If you or a family member

requires emergency care whileon vacation, call 911 immediate-ly or go to the nearest ER. Ifyou are admitted, you must noti-fy your primary care manager(PCM) or regional health carecontractor within 24 hours or onthe next business day to coordi-nate ongoing care.”

Authorization is not requiredfor emergency care beforereceiving treatment.

If a beneficiary is vacationingoverseas with family, they canget assistance with locating anemergency facility or emer-gency number for the countrythey are visiting by calling theTRICARE Overseas Program(TOP) contractor. This contactinformation can be located atwww.tricare.mil/contactus.

When seeking care from a hostnation (overseas) provider, ben-eficiaries should be prepared topay up front for services andthen file a claim with the appro-priate claims processor. Activeduty service members (ADSMs)and Prime enrolled active dutyfamily members should contactthe TOP regional call center inthe area prior to seeking carewhen possible or prior to mak-ing payment.

“TRICARE defines urgentcare as a medical service neededwithin 24 hours when an illnessor injury would not result in fur-ther disability or death if nottreated immediately,” saidLarkin. “Some examples of

urgent care situations mayinclude: earache, toothache,sprain or urinary tract infec-tion.”

If urgent care treatment cannotwait until the beneficiary returnshome to see a PCM, he or shemust contact their PCM for areferral or call their regionalhealth care contractor for assis-tance before receiving care.Failure to obtain a referral maycause care to be covered underthe point-of-service (POS)option and will incur highercosts. The POS option does notapply to ADSMs, newborn or

adopted children in their first 60days, emergency care or if thebeneficiary has other healthinsurance. Beneficiaries canvisit www.tricare.mil/cost forPOS details.

ADSMs should seek urgentcare at a military treatmentfacility (MTF). If away fromhome, ADSMs should contacttheir regional health care con-tractor for assistance in obtain-ing urgent care. ADSMs livingoverseas who are unable to seekurgent care at an MTF shouldcontact the TOP regional callcenter.

Beneficiaries may use anyTRICARE pharmacy optionwhen vacationing, but should besure their DEERS information iscurrent. At overseas host nationpharmacies, beneficiaries willpay up front and file for reim-bursement of covered chargeswith the overseas claims proces-sor.

If beneficiaries require emer-gency dental care, they can con-tact the dental care programthey are enrolled in for furtherassistance.

By Sharon FosterTRICARE Management Activity

Community barbeques,family camping trips andstate fairs -- Ah, summer

is finally here. However, with-out proper precautions, bees,mosquitoes, fire ants and tickscan turn a fun outing into a mis-erable day of itching andscratching.

Dealing with biting and sting-ing insects during the summer isno laughing matter and can bedown-right annoying, even dan-gerous. With the best bug repel-lents in use, a few lucky bugsare bound to get through anybarrier and leave itchy bites andstings.

“Taking proper precautions toprotect yourself and your familyagainst insect bites, not onlywill make your outings moreenjoyable, but can also protectyou from a number of diseasescarried by insects, such as WestNile virus and Lyme disease,”said U.S. Public Health ServiceCmdr. Aileen Buckler, TRI-CARE population health physi-cian.

What can TRICARE benefici-aries do to keep insects away?The Department of Health andHuman Services (HHS) list sev-eral suggestions:

* Use an EPA-registered insectrepellant (such as DEET) andwear protective clothing whenoutdoors from dusk to dawn --peak biting times for many

insects * Don’t wear heavily scented

soaps, perfumes or bright colorswhich attract bugs

* Don’t leave drinks andgarbage cans uncovered; get ridof containers with standingwater that attract mosquitoes

* After outdoor activities, ben-eficiaries should check them-selves, family members and petsfor ticks.

While bug bites and stingsusually are just nuisances thatcan be treated with over-the-counter oral and topical antihist-amines, others can transmit dis-ease or cause serious reactions.Beneficiaries should seek imme-diate medical attention if theyexperience the following:

Signs of allergic reaction:Some people are allergic toinsect bites or stings and canexperience anaphylaxis, asevere, life-threatening allergicreaction. Signs of an allergicreaction, which may occur with-in seconds to minutes, include:sneezing, wheezing, hives, vom-iting, diarrhea, sudden anxiety,difficulty breathing, chest tight-ness and itching or swelling ofthe eyes, lips, or other areas ofthe face.

Signs of infection: It is normalfor a bite or sting to result inredness of the affected area andminor swelling. Sometimes,however, a bite or stingbecomes infected and a fevermay develop or the redness orsoreness may worsen.

TRICARE beneficiaries whotake protective precautions canenjoy all the outdoor activitiesthat come with summer.

Huck Fin4X4750

TRICARE Tips to Avoid Bug Bites and Stings this Summer