Moderator:
LTC Sharon L. Rosser, DScPA, PA-C Chair, DHA Pain Management Clinical Support Service
Bio: LTC Sharon L. Rosser is a 2001 graduate of the Inter-service Physician Assistant Program at Fort Sam Houston, Texas and has served as an active duty PA since. From 2001 to 2006, she practiced troop medicine in Germany and Internal Medicine in Missouri. LTC Rosser has deployed to Kosovo, Iraq and Afghanistan. She earned a Doctor of Clinical Science focusing in Emergency Medicine from Baylor University in 2007 and completed a one-year Emergency Medicine and Critical Care Ultrasound Fellowship from 2012 to 2013 at San Antonio Military Medical Center. She is currently assigned to the Defense Health Headquarters in Falls Church, Virginia as the Chair of the DHA Pain Management Clinical Support Service and the Director of the Army Comprehensive Pain Program.  Previously, she served as the Army Post-Graduate Education Manager and Hospital Based Programs Director and Executive Office to the Dean, Graduate School, Army Medical Department Center. From August 2013 to August 2016, LTC Rosser was the lead Emergency Medicine and Point of Care Ultrasound faculty for the Inter-service Physician Assistant Program. She has held Associate Professor status with Baylor University and Adjunct Faculty status with University of Nebraska Medical Center.
Abstract Summary:This presentation provides an overview of the DHA policy and efforts MHS Stepped Care Model for Pain implementation training to include provider and and patient education efforts.
Learning Objectives: At the conclusion of this activity, the participant will be able to discuss the following:
1. Describe the MHS Stepped Care Model for Pain.
2. Describe the purpose of the Primary Care Pain Champion as it relates to the MHS Stepped Care Model for Pain.
3. Describe key elements to consider in developing training for the MHS Stepped Care Model for Pain.

Presenters:
Mr. Joseph Phillips, MHA, Navy Comprehensive Pain Management Program
Abstract Summary:The DOD/VA has developed a team-based, multidisciplinary model for pain management that leverages the concept of “stepped” care. It is a system of delivering and monitoring treatment so that the most effective and least resource intensive treatment is delivered to patients first. Clinicians only 'step up' patients to intensive and specialty services as clinically required. Primary Care Clinicians (PCCs) play a critical role in the management of the majority of patients whose pain advances and becomes more complex. The Stepped Care Model aims to provide these patients with effective pain management guided by clinical practice guidelines (CPGs) to avoid chronic-pain, implement non-pharmaceutical interventions, reduce opioid use, and minimize complications for the minority of patients that do require opioids as part of their care plan. The model calls for diverse health resources to offer comprehensive, multi-modal, and interdisciplinary care as needed. Further, it emphasizes the goal of appropriate referring/escalation and de-escalation of patients between all levels of care. The ultimate goal is to improve function and encourage self-management by the patient. Clinical resources and education initiatives are crucial to the success of this model.
Learning Objectives:  At the conclusion of this activity, the participant will be able to:
1.Understand Navy’s Stepped Care Model implementation approach and progress
2.Understand how Navy has integrated the SCM into the Primary Care setting
3.Understand current NCPMP efforts to provide support and additional clinical resources to the deckplate to successfully implement the SCM

COL Matthew ‎Garber, SP, USA, Director Rehab and Reintegration Division, Office of the Surgeon General
Bio: Colonel Matt Garber is the Director, Rehabilitation and Reintegration Division at OTSG where he oversees the Physical Performance Service Line, the Traumatic Brain Injury Program, and the Comprehensive Pain Management Program for Army Medicine. His military career has included a variety of clinical, teaching, staff officer and leadership positions including chairing the Department of Orthopedics and Rehabilitation at Fort Belvoir Community Hospital; Director, Military Health System Governance at OTSG, and assisting in the development and implementation of the USASOC THOR3 Human Performance Program.  He also serves as the physical therapy consultant to the Army Surgeon General and chairs the Neuromusculoskeletal Clinical Community for the Military Health System. Colonel Garber is a board certified specialist in orthopedic physical therapy and a fellow in the American Academy of Orthopedic Manual Physical Therapists. 
Abstract Summary: Physical therapists play an important role in managing musculoskeletal conditions, with considerable evidence supporting early access to physical therapy to improve patient outcomes and decrease downstream medical costs. This discussion will focus on the role of physical therapists in assisting patients understand pain and learn strategies to effectively manage pain to decrease its impact on their functional performance. A framework of how physical therapists, as an integral member of a collaborative patient management team, can provide treatment alternatives to assist in improving patient outcomes and facilitate patient independence.
Learning Objectives:  At the completion of the lecture, attendees will be able to:
1. Discuss the impact of early access to physical therapy as it relates to utilization of additional healthcare resources, patient outcomes, and cost.
2. Distinguish normal pain responses from abnormal pain responses and list strategies to assist patients in understanding the source of these differences.
3. Describe a framework where physical therapists, working as part of a collaborative care team, can improve patient outcomes and improve patient independence.

Mr. Kevin T Galloway, BSN, MHA, Deputy Director Strategic Communications and Policy, Defense & Veterans Center for Integrative Pain Management (DVCIPM)
Bio: Mr. Kevin T. Galloway is currently the Deputy Director, Strategic Communications and Policy at the Defense and Veterans Center for Integrative Pain Management (DVCIPM), the Military Health System’s designated pain management Center of Excellence and advisory organization.  Prior to joining DVCIPM in 2014, Kevin completed a 27 year career in the U.S. Army, retiring at the rank of Colonel.  His last assignment was in the Office of The Army Surgeon General where he served as the Director of the Army Pain Management Program after serving as Chief of Staff for the Department of Defense’s Pain Management Task Force.  He is a graduate of The Catholic University of America with a Bachelors of Science in Nursing, and Baylor University with a Masters in Health Care Administration. Kevin is an active contributor and leader on many federal medicine and national pain management initiatives.
Abstract Summary: This section will provide an overview of the continued evolution of pain measurement, treatment and education that has been occurring during the last 18 years of military conflict and in the midst of a national epidemic of opioid overuse, abuse, and overdoses.  DoD efforts to improve the methodology for assessing pain and the effectiveness of pain treatment.  Available DoD sources for information and tools for health care providers, patients and families that include a new paradigm of pain care, risks of opioid medications for use in the management of pain (acute and chronic) will be provided.
Learning Objectives:  At the completion of the lecture, attendees will be able to:
1. Demonstrate knowledge of the changing paradigm of pain management that has occurred over the last 18 years of military conflict
2. Explain the unintended consequences related to the historical reliance on numeric rating scale (NRS) for pain assessment and treatment; to include relationship with the nation’s epidemic of opioid overuse, abuse, and overdoses 
3. Demonstrate knowledge of the DoD’s rationale for developing the Defense and Veterans Pain Rating Scale (DVPRS) and the Pain Assessment Screening Tool and Outcomes Registry (PASTOR)
4.  Demonstrate knowledge of the DoD and VA pain management resources and tools that are available for patients and providers

Presenters may be subject to substitution or addition