[Congressional Record Volume 142, Number 143 (Monday, October 21, 1996)]
[Extensions of Remarks]
[Pages E1942-E1943]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 CONFERENCE REPORT ON H.R. 3610, DEPARTMENT OF DEFENSE APPROPRIATIONS 
                               ACT, 1997

                                 ______
                                 

                          HON. THOMAS M. DAVIS

                              of virginia

                    in the house of representatives

                       Tuesday, October 22, 1996

  Mr. DAVIS. Mr. Speaker, I rise in support of the provision in the 
final Conference Agreement to the FY 1997 Department of Defense (DOD) 
Appropriations Bill, which encourages the Department to pay particular 
attention to pediatric patients as it explores telemedicine initiatives 
that would provide cost-effective, accessible, and high quality 
services for DoD beneficiaries.
  The Department of Defense in the past decade, has experienced many of 
the same challenges confronting the Nation's private health care 
system--increasing costs, uneven access to health care services, and 
disparate benefit and cost-sharing packages for similarly-situated 
categories of beneficiaries. As DoD responds to these challenges, there 
is a particular need to ensure that the transition to managed care for 
pediatric patients within the Military Health Services System is 
handled with a high level of professionalism and care.
  The requirements of a reformed health care delivery system and the 
emergence of new medical and information technologies have radically 
changed the manner in which health care is provided and delivered to 
pediatric patients. Therefore, it is critically important for the 
Department to develop a partnership with a pediatric hospital which has 
the proven expertise and track record in the diagnosis and treatment of 
sick children.
  Children's National Medical Center (CNMC), located in the Nation's 
capital, offers significant benefits to DoD and to countless citizens 
in Northern Virginia, Washington, DC, and Maryland. CNMC has had a 
longstanding relationship with the Department of Defense through 
collaboration with DoD facilities, and through the provision of patient 
care services to a large number of military dependents and the children 
of DoD civilian employees. CNMC currently has affiliation agreements 
with Walter

[[Page E1943]]

Reed Army Medical Center and Bethesda Naval Medical Center. Through 
these relationships, CNMC serves as a major regional source of training 
for military physicians, nurses, technologists, therapists, and other 
allied health professionals.
  In recent years, CNMC has worked closely with DoD to develop 
pediatric quality assurance criteria for emergency medical care 
services to acutely ill and injured children who are military 
dependents referred by area military medical treatment facilities. This 
pilot study involved the development and application of screening 
criteria designed to assess the process and outcome of pediatric 
emergency care for head trauma, seizures and respiratory distress due 
to upper airway construction. The criteria was applied to a sample of 
six military treatment facilities in the United States. The findings 
from the study revealed specific aspects of pediatric emergency medical 
care which would benefit from clinical and/or administrative 
educational programs.
  Given the specific expertise which Children's National Medical Center 
brings to pediatric health care, its longstanding successful 
relationship with DoD, the National Institutes of Health, and other 
Federal agencies in health policy and research matters, CNMC is 
eminently qualified to work with DoD in establishing a state-of-the-art 
telemedicine network to ensure that pediatric military dependents have 
access to the most advanced standards of American health care.
  Telepediatrics demonstration of this nature will provide DoD with 
otherwise inaccessible state-of-the-art pediatric medical advice and 
services to providers and their patients. It will also provide the 
broadest range of pediatric specialty services allowing for the phased 
integration of target specialties (trauma, radiology, psychiatry), it 
will develop broad or segmented demonstration of the utility of various 
telemedicine technologies in the field of pediatric medicine across the 
range of primary, chronic, and acute care services, and it will 
demonstrate the cost-effectiveness of telemedicine technologies in 
enhancing the quality of services and access to pediatric populations 
in urban, suburban, rural, and regionally dispersed, as well as 
transitional communities.
  Mr. Speaker, I strongly support the effort by the Department of 
Defense to explore telemedicine initiatives which will bring new 
insights and services to the care of pediatric patients.

                          ____________________