Skip Navigation Link

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Improving the understanding, detection, and management of kidney disease.

Department of Defense (DoD) Activities

Department of Defense (DoD)

This section describes current quality improvement and evidence of therapy programs of the Federal government related to chronic kidney disease.

Department of Defense (DoD)

The DoD and Veteran's Administration (VA) work collaboratively to develop evidence-based clinical practice guidelines. The VA/DoD Clinical Practice Guideline (CPG) for the Management of Chronic Kidney Disease was updated and published in 2008. The VA/DoD guideline development process follows a rigorous evidence review and grading process. Guideline champions are selected in both VA and DoD who are subject matter experts, specialists and consultants or who are doing research in the field. Guideline working group members are selected across the VA and DoD and are part of interdisciplinary teams caring for patients with chronic kidney disease. The guideline working group members develop researchable questions based on the PICO format (problem, intervention, comparison, and outcome) and review the evidence presented in some of the national and international guidelines. There is a contract with an Evidence-Based organization to do a systematic review of the literature and present evidence synthesis to the working group members to minimize bias. Guideline recommendations are developed based on the evidence and graded by the working group members using the same grading process spelled out by the US Preventive Services Task Force. Recommendations for care of patients with chronic kidney disease are outlined in the VA/DoD Clinical Practice Guideline for the Management of Chronic Kidney Disease.

After the guideline is approved and published by the VA/DoD Evidence-Based Working Group, consisting of members from the VA, Army, Air Force and Navy, the VA and DoD collaborate to develop implementation tools, clinical documentation, and quality improvement procedures into the electronic medical information systems. VA and DoD are in the process of developing several CKD encounter form templates as well as referral forms for nephrology consultation, renal nutrition, and vascular access placement to better treat patients.

Contact Information
James Ellzy, CDR, US Navy
Director of Clinical Quality
Phone: 703-681-0064
Email: James.ellzy@amedd.army.mil
Web: www.tricare.mil

Back to Top

Public Education & Outreach

Department of Defense (DoD)

The DoD has been actively collaborating with NKDEP in the review of patient education materials pertaining to chronic kidney disease (CKD). These materials will be widely available to DoD providers for patient dissemination within the clinic and will be available directly to patients via DoD's CPG shopping cart at https://www.qmo.amedd.army.mil.

Contact Information
James Ellzy, CDR, US Navy
Director of Clinical Quality
Phone: 703-681-0064
Email: James.ellzy@amedd.army.mil
Web: www.tricare.mil

Back to Top

Delivery & Payment of CKD Care

This section describes activities related to the delivery and payment of chronic kidney disease care supported or sponsored by the Federal government.

Department of Defense (DoD)

Eligible beneficiaries who qualify for care in the DoD Health Care System receive care for diabetes and hypertension, two leading causes of kidney failure, in their medical treatment facilities across the United States. Those who progress to kidney failure may be treated in the military treatment facilities if services are available, or covered by the Medicare ESRD program and TRICARE contract health services.

Under Federal law, if you're a TRICARE beneficiary eligible for premium-free Medicare Part A because of end-stage renal disease (ESRD), you must have Medicare Part B coverage to remain TRICARE-eligible (there are exceptions for those enrolled to US Family Health Plan, enrolled to TRICARE Reserve Select, or with an active duty sponsor).

Contact Information
James Ellzy, CDR, US Navy
Director of Clinical Quality
Phone: 703-681-0064
Email: James.ellzy@amedd.army.mil
Web: www.tricare.mil

Back to Top

Professional Education & Outreach

This section describes education and outreach to health professionals of the Federal government related to chronic kidney disease.

Department of Defense (DoD)

The DoD, in collaboration with the Veteran's Administration (VA), created the first evidenced based clinical practice guideline pertaining to the management of chronic kidney disease within the primary care setting in the US. The VA/DoD chronic kidney disease (CKD) guideline, initially issued in 2001, was recently revised and reissued in 2008 to reflect current research.

DoD has been actively collaborating with NKDEP since 2009 in the development of healthcare provider education materials pertaining to CKD. The purpose of such efforts is to promote provider understanding of CKD and its treatment, and foster adoption and implementation of the VA/DoD CKD clinical practice guideline. These materials will be widely available to DoD primary care and specialty care providers via the Army Medical Department CPG shopping cart and website at https://www.qmo.amedd.army.mil. Continuing education programs for physicians, advanced practice nurses, physician assistants, nutrition professionals, pharmacists, and laboratory professionals are available. The VA/DoD Clinical Practice Guideline for the Management of Chronic Kidney Disease has also developed a concise summary of evidence-based recommendations on treatment of CKD and complications.

DoD also promotes case management of CKD within their systems. An annual Case Management Society of America meeting is available and open to any health professional who is interested and has the support of his/her supervisor to implement change.

Contact Information
James Ellzy, CDR, US Navy
Director of Clinical Quality
Phone: 703-681-0064
Email: James.ellzy@amedd.army.mil
Web: www.tricare.mil

Back to Top

Surveillance

This section describes surveillance activities and programs of the Federal government related to chronic kidney disease.

Department of Defense (DoD)

The VA/DoD Clinical Practice Guideline for Diabetes Mellitus recommends monitoring the percentage of diabetics with at least one test for microalbumin or who had evidence of medical attention for existing nephropathy. This is the same metric recommended by the National Diabetes Quality Improvement Alliance. Currently, it is up to each clinic or military treatment facility to monitor this metric. The VA/DoD Clinical Practice Guideline for the Management of Chronic Kidney Disease has several additional recommended metrics that are currently monitored at the local level.

Contact Information
James Ellzy, CDR, US Navy
Director of Clinical Quality
Phone: 703-681-0064
Email: James.ellzy@amedd.army.mil
Web: www.tricare.mil

Back to Top

This information was reviewed by KICC agency representatives. It may not reflect new or future agency activities. For more information, please contact the listed representatives.

Page last updated: March 1, 2012