[July is the month to highlight military health innovations, and Total Force Fitness (TFF) plays a strong role in military inventiveness. This article is the second in a series about the culture of military inventiveness and how it is driving the Defense Health Agency in its role as a High Reliability Organization.]

The holy grail of Total Force Fitness (TFF) is the ability to find predictive analytics about service members.

These analytics must be focused on the service member throughout the course of their careers from induction onward based on the TFF eight domains of fitness, which connect to optimize health, performance, and readiness holistically.

"Being able to have a great dataset, which we have, and being able to look longitudinally from service members' entrance into the military onto their careers, this helps us to find signals up front" about their fitness in the eight domains, said Patricia Deuster, executive director, Consortium for Health and Military Performance, (CHAMP), Defense Center of Excellence for Human Performance Optimization Translation, Bethesda, Maryland.

"Predictive data analytics are being conducted in the realm of musculoskeletal care, and we would like that in mental health," said Deuster, who holds a doctorate in nutrition science and physiology and is a master of public health with a specialty in public health and epidemiology.

"Medical data are not good enough; we need all pieces of data collected in one place from all the services," she said. Currently, data are collected individually by the services, and their measurements vary.

"We are looking at each person as a whole," she said. "We look at them from their totality."

"CHAMP has already been contacted by Walter Reed National Military Medicine Center" to gather a dataset for chronic kidney disease (CKD); such an analysis would "inform upstream health signals that could mitigate downstream effects," she said. CKD can be present in people long before there are symptoms or a crisis.

Sickle cell trait is another dataset that would be useful, she added. The Army has announced that it will now screen for sickle cell trait in inductees, as do the other services.

Said Deuster: "The possibilities are limitless."

Enhancing just one domain, or even two or three, like physical fitness, preventive care and nutrition, misses the connections that collectively lead to wellness. All the domains play a role in optimal health and performance.

CHAMP plans to present some promising results to Military Health System personnel and "show what can be done" with such a dataset, she said.

An impactful CHAMP program forthcoming is a web-based application to improve the "military nutrition environment." The military Nutrition Environmental Assessment Tool, or m-NEAT, will be deployed within the next several months, Deuster said.

CHAMP will beta test m-NEAT, which aims to evaluate access to high-quality, nutritious foods, health messaging, policies, and economics parameters of the nutrition environment on military installations, she explained. The goal is to improve the availability of healthy food choices across the enterprise, which "the nutrition community has been working on for a long time," Deuster said.

Another area of innovation that would be helpful is training of embedded Human Performance Teams (HPTs). For example, -social workers, physical fitness specialists, clinical psychologists, mental performance specialists, chaplains and dietitians all work together, Deuster said. "We need optimize their abilities to most effectively work as a team to sustain warfighter performance," she suggested.

"We need to have a good training program to work effectively as members of a team and not independently. If we want to improve cognitive function, we need the HPT working together from the Total Force Fitness perspective," she said.