New Synthetic Bones Help Army Scientists Get Closer to New ‘brain’ Defenses

Shock waves from battlefield explosions are invisible threats for U.S. Soldiers and their top-of-the-line combat helmets, but with new studies in synthetic human physiology, researchers are learning how to lessen blast wave effects on the brain.

Exactly how, and to what degree, these waves cause brain damage is what the U.S. Army Research Laboratory scientists and engineers and a group of university partners are trying to answer as part of a multi-year, multi-disciplinary research project.

In a related research project, Army researchers are investigating new material development for helmet padding systems, and from this research, they expect greater insight and innovation in addressing what is likely to be the next big development in head protection: strategies for mitigating the effects of blast.

They’re creating synthetic cranial bones that look and behave like the skulls of 20- and 30-year old Soldiers that will be tested in laboratory experiments that mimic combat-like blast events in hopes of improving military helmet pads, shells, and other protective equipment.

Dr. Thomas Plaisted, materials engineer in the Materials and Manufacturing Science Division at the ARL, said even though synthetic bones are commercially available, they’re used primarily by doctors to practice surgical procedures. But, their design prevents them from “behaving like real human bones when subjected to blast tests.”

“The mechanical properties of the human skull change with age and depend on the health of the individual. Donor skulls that may be available for testing would typically come from older people, and the properties of those skulls can be highly variable and may not have the same response as the average skull of the Army Soldier population,” said Plaisted.

He said this is among the variables that “add uncertainty when trying to evaluate head protection devices, like helmets.”

“So we are developing our own synthetic bone, [and] capturing material and architecture response, specific to the human skull.”

A simulated skull ARL researchers are developing is made of synthetic materials, with the goal of creating a uniform response that is representative of the Soldier population to use in tests to understand how to best protect the head during exposure to blast waves and blunt impact.

“The cranial bones have a highly-graded structure, from a tough outer layer, a spongy inner section, to a more brittle inner layer, which together are responsible for how it responds under impact conditions, he said.

Slice-by-slice images taken from a CT scan help researchers get the geometry and structure of the skull right. ARL composite materials, combined with these images, and 3-D printing technology, produce models of bone-like surrogates that ARL researchers will use to test new helmet padding materials in simulated blast and impact conditions. The goal is to determine how the pads and helmet shell materials protect the head from injury, Plaisted said.

“We are developing new helmet padding materials to improve the impact protection afforded by the Army’s helmets. The helmet can withstand impact at a certain velocity, while protecting the head from accelerations that would lead to injury. In the extreme case, excessive acceleration may lead to skull fracture,” he said.

“We are using computer modeling of head and helmet impacts to understand how tailoring the padding properties can reduce acceleration at various impact locations around the helmet,” Plaisted explained. “Then, those properties are engineered into materials and tested in the laboratory to validate what we are seeing in the computer models. The research is giving insight on optimal material structures and material combinations that achieve increased energy absorption while still being comfortable to wear.”

Earlier this year, ARL evaluated the base material of the synthetic bone by hitting it at a high rate, and comparing the fracture properties to human bones tested by the same technique. They’ve determined it to be a “close match” to human bones, he said.

“Our next step is in determining the limits of resolution we can achieve with the 3-D printing, and how fine the resolution needs to be to capture the properties we are looking for.”

He said he expects to start printing synthetic skulls with 3-D technology by the fall.

“Part of ARL’s mission is to take varying levels of risk in finding state of the art science and developing the technologies that could potentially provide the Soldier with more protection, more capability, or both,” said Dr. Shawn Walsh, who leads ARL’s Agile Manufacturing Technology Team. “What is equally important is that ARL strategically reduce the risk of these new technologies so that centers, such as the Natick [Soldier Research, Development and Engineering Center], can begin to think about how they would integrate into a larger Soldier “system.” Many of ARL’s material, processing, and conceptual technologies were transitioned and demonstrated in NSRDEC’s “HEaDS UP” program.”

“[Dr. Plaisted’s] efforts are unique in that he is bringing fundamental material science and modeling to the dual problem of accurately representing biological systems (for example the skull) and coupling this biological model to a materials model to provide better insight on how impulses are transmitted during an impact to the helmet and head. Such insight will lead to new and quantifiably proven methods for reducing the adverse effects of violently applied forces to the head and helmet system,” Walsh said.

The research is also the focus of the latest episode of “Inside the Lab,” an ARL-produced feature news broadcast.

Source : US Army

$7.3 million Contract By Naval Medical Logistics Command

to Provide Research and Development Services for the Behavioral Sciences and Epidemiology Department

Leidos, a national security, health and engineering solutions company, was awarded a prime contract, Behavioral Epidemiology Assessment Research (BEAR), by the Naval Medical Logistics Command to provide research services for multiple behavioral health and epidemiology projects that support the Naval Health Research Center’s (NHRC) Behavioral Sciences and Epidemiology Department. The single-award cost-plus fixed-fee (CPFF) contract has a one-year base period of performance, four one-year options and a total contract value of approximately $7.3 million, if all options are exercised. Work will be performed primarily in San Diego, Calif.

The NHRC’s Behavioral Sciences and Epidemiology Department is dedicated to the study of behavioral trends that impact warfighter readiness. The department examines operationally relevant issues affecting personnel such as combat and operational stress, posttraumatic stress, misconduct, substance use, suicide and career-span health and wellness issues. Under this contract, Leidos will conduct behavioral and epidemiological investigations that address these and other deployment-related health issues. Specific examples of these studies may include determining factors related to the onset of mental disorders in military personnel; mental health surveillance of combat-deployed personnel; assessing the effects of adverse lifestyle behaviors on health, performance, and healthcare costs; and investigating the effects of acute stress on military personnel.

“Finding ways to improve the health and wellness of our military personnel and their families is important to the Nation, which means it’s important to Leidos,” said Steve Comber, President of Leidos Health.  “We are pleased to continue our support of NHRC to help ensure our military is prepared to perform every mission.”

Source : Leidos

Published on ASDNews: Mar 10, 2014

FLIR Awarded US Army Contract Valued at up to $81 M to Support MEDEVAC Operations

FLIR Systems, Inc. (NASDAQ: FLIR) announced today that it has been awarded a two year blanket purchase agreement from the U.S. Army to support the MEDEVAC program. The blanket purchase agreement is valued at $81 million and is for the Army MEDEVAC Mission Sensor (MMS) configuration of FLIR’s commercially developed military qualified Talon product, a stabilized 9-inch multi-sensor gimbal system. The Talon MMS will be installed on the Army’s fielded and new MEDEVAC Blackhawk helicopters. An initial delivery order of $19 million was received.

Work under this award is expected to be performed out of FLIR’s facility in Billerica, MA, with shipments under the initial delivery order expected to be completed by 2014.

“To continue to be a key element of the U.S. Army’s MEDEVAC mission is an honor,” said Earl Lewis, President and CEO of FLIR. “Our highly advanced imaging systems enhance the efficient and safe location and transport of injured personnel and medics in the field. We excel at providing our products rapidly and with a very low total cost of ownership, which enables the success of customers such as the Army.”

Source : Flir Systems Inc.

Air Force challenges industry for research in laser medicine

Kristin Galbally-Kinney, Steve Davis, and Terry Rawlins, of Physical Sciences Inc., adjust the excitation source for an argon microplasma laser. Kristin Galbally-Kinney, Steve Davis, and Terry Rawlins, of Physical Sciences Inc., adjust the excitation source for an argon microplasma laser. (Contributed photo)

Kristin Galbally-Kinney, Steve Davis, and Terry Rawlins, of Physical Sciences Inc., adjust the excitation source for an argon microplasma laser.
Kristin Galbally-Kinney, Steve Davis, and Terry Rawlins, of Physical Sciences Inc., adjust the excitation source for an argon microplasma laser. (Contributed photo)

U.S. Air Force researchers are asking commercial companies and universities to join a program aimed at using lasers and other light source technology to develop applications in medicine, photobiology, surgery, and closely related materials sciences for military needs.

The Air Force Office of Scientific Research (AFOSR) in Arlington, Va., has released a broad-agency announcement (BAA-AFOSR-2013-0002) for the Military Medical Photonics Program to advance the state of the art in medical laser applications for military needs.

Medical laser applications related to combat casualty care and other military medicine are a high priority, Air Force researchers say. The program is open to university-based medical groups, scientific organizations, or commercial companies.

Proposals should describe three-year medical laser research programs to be carried out by interdisciplinary teams of physicians, biomedical scientists, physical scientists, and engineers. Those submitting winning bids may be awarded contracts or research grants.

Committee of the Chiefs of Military Medical Services in NATO

The Committee of the Chiefs of Military Medical Services in NATO (COMEDS) is the senior committee for medical care within the Organization. It acts as the central point for the development and coordination of military medical matters and for providing medical advice to the NATO Military Committee.

The military medical community plays a key enabling role within NATO and, more specifically, within NATO’s defence planning process. The military medical community not only provides medical care, but also preventive health care, veterinary support and psychological support for deployed troops. It provides essential combat service support, making it one of the key planning domains for operations, along with armaments, logistics, air traffic management and other areas of specialization.
COMEDS makes recommendations concerning the development and assessment of NATO military medical policy and procedures for medical support. It seeks to improve existing arrangements between member countries in the fields of co-ordination, standardization and interoperability. It also helps to improve the exchange of information between countries so, for instance, advances made by one member state are available to all. Additionally, COMEDS undertakes studies of general and particular interest such as preventive medicine, dental service, food hygiene and military psychiatry. For this purpose, it has several subordinate working groups and expert panels to which subject matter experts contribute.
The meetings of the chiefs of Military Medical Services are conducted bi-annually and include participants from member and partner countries.

Roles and responsibilities
COMEDS
As explained above, COMEDS advises the Military Committee on military medical matters affecting NATO. It also acts as the coordinating body for the Military Committee regarding all military medical policies, procedures and techniques within NATO. In recent years, COMEDS has come to represent the medical community at NATO HQ, in the NATO Standardization Organization, as well as in specific areas such as defence planning and the chemical, biological, radiological and nuclear (CBRN) field.
COMEDS’ objectives include improving and expanding arrangements between member countries for coordination, standardization and interoperability in the medical field and improving the exchange of information relating to organizational, operational and procedural aspects of military medical services in NATO and Partner countries.

The military medical support system
COMEDS is a key component of the Alliance’s military medical support system, principally in the preparation phase of an operation. It facilitates the development of medical capabilities in individual countries and helps to improve the quality and interoperability of capabilities between them.
Generally speaking, the military medical support system contributes to preserving the “fighting strength” and meeting the increasing public expectation of an individual’s right to health and high quality treatment outcomes. Medical services make a major contribution to force protection and sustainability. Effectively, health is a key force multiplier of fighting power.
Countries that allocate forces to NATO retain responsibility for the provision of medical support to their own forces. However, upon Transfer of Authority, the NATO commander shares the responsibility for their health and will determine the medical support requirements. Multinational arrangements usually require more responsibility of the NATO commander.

Working mechanisms

  1. Frequency of meetings –  COMEDS meets biannually in plenary session and reports annually to the Military Committee.
  2. Composition –  The chairman is elected by the committee in plenary session for a three year term. The country of origin of the chairman is also responsible for providing a Liaison Officer to NATO HQ. He/she is the point of contact for military medical matters for NATO HQ and individual countries. For practical reasons, this Liaison Officer cooperates closely with the medical branch of the International Military Staff, which also supports his/her work. COMEDS also cooperates closely with the medical branch of Allied Command Operations (ACO) and Allied Command Transformation (ACT) in developments regarding defence planning, capability development, standardization needs, training and education and certification.
    In December 2009, the chairmanship of COMEDS was transferred from Germany to the Netherlands.
  3. COMEDS is composed of:
    • the Chiefs of the military medical services of all member countries;
    • the International Military Staff medical staff officer; and
    • the medical advisors of the two strategic commands – ACO and ACT.
    Its meetings in plenary session, as well as its activities benefit from the participation of the following observers:
    • the Chiefs of the military medical services from all Partnership for Peace, Mediterranean Dialogue and Istanbul Cooperation Initiative countries;
    • the Chairman of the Joint Medical Committee;
    • a representative of the NATO Standardization Agency, the Military Committee, the Senior NATO Logisticians Committee, the NATO Military Medical Centre of Excellence, the Human Factors and Medicine Panel of the NATO Research and Technology Agency, the Health and Societal Dimensions Panel of the NATO Science for Peace and Security Committee, and the CIOMR, the organization of military medical reserve officers.
    COMEDS can also invite partners from “Contact countries”, non-NATO troop-contributing countries and organizations.
  4. Subordinate working groups
    To assist in carrying out its tasks and in addition to the bodies referred to above, COMEDS has a number of subordinate working groups which meet at least annually and address the following topics: military medical structures, operations and procedures (including planning and capability development); military preventive medicine (force health protection); military healthcare; standardization; CBRN issues; emergency medicine; military psychiatry; dental services; medical materiel and military pharmacy; food and water hygiene and veterinary medicine; medical training; mental healthcare; medical naval issues; and medical information management systems.
  5. Evolution
    Historically, medical matters within NATO were regarded strictly as a national responsibility. Consequently, for the greatest part of the Alliance’s existence, there was not a high-level military medical authority within NATO.
    New NATO missions and concepts of operations have placed increased emphasis on joint military operations, enhancing the importance of coordination of medical support in peacekeeping, disaster relief and humanitarian operations.
    COMEDS was established in 1994 for that purpose.
    Today, COMEDS is very active in developing new concepts of medical support for operations, with emphasis on multinational health care, modularity of medical treatment facilities, and partnerships. Increasingly, the developed doctrines are open to non-NATO countries and are sometimes released on the internet.
    In 2011, COMEDS established the Dominique-Jean Larrey Award in recognition of a significant and lasting contribution to NATO multinationality and/ or interoperability within military medical support or healthcare developments in NATO operations and missions ¹. The award is named after the French surgeon general of the Napoleanic imperial forces, who invented amongst other things the field ambulance, which helped to significantly improve medical care in the field.

Footnote:
1. Any individual belonging to the military medical service may be nominated to receive the COMEDS Dominique-Jean Larrey Award. In exceptional circumstances, the award may be given to more than one individual where it is clearly demonstrated that the nominees have individually and collectively met the selection criteria. This includes a military medical organisation and/ or structure. The Award is granted no more than once a year.

From NATO Website

Cassidian to Support Medical Evacuation Missions in Afghanistan

  • Mobile Support System enables sucessful operation of German Army MedEvac NH90s
  • Standardized operations support of all German helicopter types

Cassidian will support the Forward Air Medical Evacuation (FwdAirMedEvac) mission carried out with NH90 helicopters of the German Army in the evacuation of ill and injured persons. For this purpose, the German Federal Office of Defence Technology and Procurement (BWB) ordered a total of eight units of Cassidian’s mobile EUA (= Einsatz-Unterstützungsanlage) operations support system for mission control, preparation and planning.
From the end of 2012, German Army Aviation will be in charge of providing forward air medical evacuation in Afghanistan using their NH90 helicopters. The FwdAirMedEvac helicopters will provide a solid base for emergency medical care for German soldiers in crisis areas.
The EUA operations support system combines operational command and control with technical logistic support. Its current adaptation complements its extension ordered in May last year for the support helicopter Tiger ASGARD (Afghanistan Stabilisation German Army Rapid Deployment) which, from October 2012, will also be used to support the German mission in Afghanistan. The EUA operations support system, developed by Cassidian, integrates the capabilities of the German helicopters into the integrated military command, which is ensured via the German Army C3I System (FüInfoSys H), for both MedEvac and armed support missions.
The new generation of the EUA with an updated software configuration allows the system to be used for all helicopter types of the German Army and Air Force: the support helicopter (UH) Tiger, the tactical transport helicopter (TTH), the light transport helicopter (LTH) NH90 and the transport helicopter CH-53GA. In future, the German Armed Forces will operate their helicopter fleet using a standardised operations support system which not only enables operational readiness to be increased, but also permits operating costs to be reduced.
From the end of 2012, the EUA will also be used to support the missions of the HAD and HAP variants of the Spanish Tiger helicopters.

Source : Cassidian

Electronic medical assets and records reduce delays in treatment and enhance healing.

Battlefield medicine has advanced significantly since the days when surgeons used whiskey as an anesthetic, and in the last year several new technologies have rolled out to deployed soldiers facing physical or psychological disorders. The U.S. Army program responsible for fielding software and the hardware on which it resides is pushing the cutting edge of diagnostics and treatment to the tip of the spear. Personnel hope the effort will save lives and limbs not only by treating injury or illness, but also by keeping troops off the road in war zones.
The Army’s Medical Communications for Combat Casualty Care (MC4) has the service’s Title 10 responsibility to field, sustain and maintain a joint software applications suite for combat medicine. The MC4 is the far-forward Army system used to capture health care information. Applications are developed by the Military Health System and provided to the various military services, which are responsible for placing them into their individual systems. The MC4 integrates the apps into hardware, adding Army-unique systems and apps, and then fields the packages to operational forces. “Army medical units don’t have hardware unless we provide it,” explains Lt. Col. William Geesey, USA, the MC4 product manager.
Since beginning field operations in 2003, the MC4 has enabled the capture of more than 16.5 million electronic patient encounters in combat zones. The system-of-systems also has trained 61,000 medical staff and commanders and fielded 49,000 systems to 750 units with medical personnel. This includes Army National Guard and Reserve units as well as active components in 19 countries.
One of the systems fielded by the MC4 in the last year centers on tele-behavioral health. It leverages commercial technologies available in theater to create a videoteleconference capability that enables mental health providers to conduct private consultations with soldiers at far forward operating bases who otherwise might go untreated. An Army division with as many as 10,000 to 15,000 troops spread over multiple locations may have only one psychiatrist assigned to it, meaning that either that single physician has to travel to all those places to provide treatment, or soldiers have to travel to the doctor’s location. Either way, troops traverse treacherous terrain. Through the videoteleconferences, care can be provided more quickly and safely.
Col. Geesey says that information coming in from the field reports that 70 percent of the doctor-patient interactions resulting from the new technology would never have occurred without it. “When you’re at a forward operating base, you’re not going to get onto a road that’s dangerous or get on an aircraft to go see a psychiatrist who’s far away,” he states. With the system, soldiers can visit their local medical facility and have a consult with a mental health provider in another place.
Also completed in 2011, the MC4 fielded a mild traumatic brain injury (mTBI) documentation capability and assessment tool. When a solider is exposed to an improvised explosive device (IED), a medical provider can administer a battery of tests to determine injuries. The results are documented in the electronic record that is at the heart of the MC4. Through this digital trail, all the medical care soldiers receive from the time they enter service through the rest of their lives is captured in one database accessible by military and Veterans Affairs Department (VA) health care providers. The result is faster diagnosis and treatment as well as an elimination of repeated tests or procedures. With the mTBI information recorded, medical practitioners can access the data if a soldier affected by a blast develops problems in the future.
In addition to its immediate application, the mTBI tool also helps feed research and development efforts by providing data on thousands of soldiers affected by IEDs. “You can use that for developing treatments and also materiel solutions,” Col. Geesey says. Overall, he explains, MC4 systems are designed to focus comprehensively on the entire soldier. The mTBI and telehealth initiatives have a focus on the effects of IEDs on the human body, responding to a number of studies showing a correlation between higher incidences of IED exposure and elevated depression rates.
Another recent MC4 update involved the fielding of a medical logistics capability to Army combat support hospitals for the first time. A hospital at Camp Dwyer, Afghanistan, became the premier facility in Southwest Asia to employ this Defense Medical Logistics Standard Support system, which serves as an automated medical logistics inventory management and property accountability tool. The fielding team consisted of MC4 and 6th Medical Logistics Management Center personnel.
The MC4 is interested in taking advantage of the many Army and personal technologies available in the field and is in the midst of an initiative to make online training courses available on smart devices. The content includes interactive video and constantly updated documentation. Though the Army is still in the process of officially acquiring and fielding smart devices to soldiers, Col. Geesey explains that by his estimation based on personal observations and the observations of others who have deployed, the vast majority of soldiers carry their own laptops and smartphones in theater. Through these, they can access the latest MC4 resources. The initial version of the MC4 guide was available only in a PDF format accessible on computers via Army Knowledge Online.

Lt. Col. T. Sloane Guy IV, USA (right), chief of surgery with the 47th Combat Support Hospital, Mosul, Iraq, reviews an image of a patient’s chest with specialists located at Brooke Army Medical Center at Fort Sam Houston, Texas. The operation showcased technology that connects deployed medics with experts back in the United States to provide the best possible medical care in the field.
Moving forward, the MC4 plans to take the Army’s tele-behavioral health program and expand it to demonstrate a broader telehealth capability. During the next several Network Integration Evaluation events—the Army’s new method for evaluating and more rapidly fielding necessary technology assets into the field—MC4 personnel are scheduled to demonstrate that the concept can help medical specialists address the concerns of forward-deployed soldiers who lack access to such expertise at their locations. “The idea is to reduce the amount of time soldiers have to travel or take to be evaluated,” Col. Geesey explains.
Already, the MC4 system was instrumental in a one-in-a-million surgery that helped an Iraqi receive the medical assistance he required. The surgeon in theater was able to consult via a videoteleconference with a specialist at Brooke Army Medical Center in Texas to conduct the procedure and save the man’s life. This telesurgery mentor initiative was led by the U.S. Army Medical Research and Materiel Command’s Telemedicine and Advanced Technical Research Center.
Col. Geesey says the MC4’s telehealth efforts eventually could have applications across the Army, but for now the work is focused on units that have the fewest medical providers and specialists assigned to them. “MC4 really offers a tool that enables a provider to deliver better health care,” he explains. “It’s not a clinically invasive device that heals soldiers. What we primarily do is leverage emerging commercial technologies to support the deployed service member.” This support includes laboratory results, pharmaceuticals and X-rays. Keeping all the information collected electronically means that in emergency situations, personnel do not have to worry about sending the right paperwork with patients, and it eliminates situations where information may arrive too late or not at all.
Having information stored and available electronically throughout soldiers’ lifetimes creates advantages in non-emergency situations as well in immediate life-or-death incidents. For example, a soldier who breaks his ankle while in service may require VA compensation for problems the injury causes later in life. With the captured information, everyone can validate a claim more easily. Access to the information also helps protect troops from overexposure to radiation because of unnecessary X-rays and informs doctors about how often patients have been seen for certain complaints regardless of where in the military they sought care or who provided it.
In addition, the technology can capture what vaccines and medicines soldiers received in theater and how those could be affecting them now. With enough statistics like those, researchers could make links between exposures and conditions. “For uniformed troops, it helps increase continuity of care,” Col. Geesey explains. “It allows [medical providers] to see all of soldiers’ prior medical history and have a better picture of what potentially is impacting them.”
The MC4 soon could have even more pieces of data to manage if MRI devices are fielded in theater. Though the office is not responsible for moving the devices to forward locations, it would serve as the information technology enabler for synching the medical images from the machines with soldiers’ electronic medical records.
The medical systems program has an initiative underway to integrate its technology into signal networks in theater. “The bottom line is we rely on the signal community to provide the communications for us to move the information around the battlefield and to [the continental United States] CONUS,” Col. Geesey says. “Sometimes what we find in theater is that the medical guy will go to the signal guy, and the signal guy says ‘That’s medical. I don’t touch that.’ We’ve been working with signal leadership to resolve these issues.”
Another important player in MC4 efforts is industry. Col. Geesey explains that his organization looks to partner with the private sector to leverage current and emerging technologies. His message for industry is similar to many in the military, but the officer emphasizes that he requires solutions that are “commercial standards, open source, open architecture and nonproprietary. Sell me a solution; don’t sell me hardware. Don’t tell me this is the device I need to do something. Give me the capability that supports the mission I’m trying to meet.”

WEB RESOURCES
MC4: www.mc4.army.mil
Military Health System: www.health.mil
Telemedicine and Advanced Technical Research Center: www.tatrc.org

NATO Coalition Warrior Interoperability Event Held In Poland For First Time

For the first time in its history, the NATO Coalition Warrior Interoperability exploration, experimentation and examination exercise (CWIX) was held at the Joint Forces Training Centre (JFTC) in Bydgoszcz, Poland from 30 May to 16 June 2011.
CWIX 2011 is the largest event JFTC has hosted to date and the intense coordination between the ACT CWIX Team, JFTC, the local NCSA team and Host Nation Poland led to a flawless execution.

During the execution period, about 900 participants representing seventeen NATO nations, three Partnership for Peace Nations, one contact nation, seven NATO Agencies and one Centre of Excellence (CoE) worked on improving the interoperability of NATO and National Command AND Control (C2) Systems. During peak days, about 650 people were present at JFTC to participate in or observe interoperability testing.
NATO CWIX 2011 attracted 104 C2 systems (an increase from 96 systems in 2010) and conducted 4316 tests over a two week period. The Coalition Information Assurance Team (CIAT) noted that there were more than 900 network hosts on the exercise network.

NATO CWIX broke ground in several areas this year. A few accomplishments in these areas are mentioned below:

  • Afghan Mission Network (AMN) related testing: One of the current AMN testing objectives is to make it possible for forces in Afghanistan to plan and do the targeting of missions without delays caused by manual transfer of data between systems. While further testing is still required, NATO CWIX successfully demonstrated that it is technically possible to exchange data between complex systems and disparate databases. The Joint Fires Focus Area significantly improved the capability to automate the one-way exchange of target data from USA systems to NATO systems. In addition to targeting, 23 AMN-related systems were tested for battle space management interoperability. All of the results will be forwarded to the appropriate working group in order to be certified and validated.
  • Cross Component Interactions: For the first time Cross Component interactions (e.g. Air Task Orders, Close Air Support etc.) were conducted to avoid the traditional Air/Land/Maritime stove piped focus.
  • Geospatial: NATO CWIX Geospatial testing continues to expand. The goal for this year was to have a single source location for all geospatial data using an enterprise service bus. This capability allows all users to access all geospatial data without having to query different national systems. This capability proved to be a big success and it showed that technically this can be done.
  • Logistics / Movement & Transportation (M&T) / Medical: For the first time, Logistics, M&T and Medical interoperability was tested at NATO CWIX from an Information/data exchange point of view. HQ SACT sponsored the involvement of NC3A developed logistics and medical prototype software tools and their availability acted as a hub around Nations and NATO could construct test cases for the exchange of data. At CIWC 2011 it was proven that automatic data transfer from 3 National Systems to the NATO Operational Logistic Chain Management prototype and then to the Joint Common Operational Picture was possible.

    NATO CWIX is crucial for NATO and Nations to test systems before deploying them in real operations and to get ready for NRF certification

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http://www.act.nato.int/multimedia/archive/42-news-stories/662-act-conducts-nato-cwix-2011-at-jftc

Services split over push for unified medical command

The military’s top medical officers are divided over a House-passed plan to re-organize the health care system under a unified medical command. The plan, in effect, would merge commands that the Army, Navy and Air Force have run with separate staffs and resources for decades.

Two of three surgeons general oppose the move and hope senators will reject it when preparing their own version of the fiscal 2012 Defense Authorization Bill.

The plan to restructure military medicine, which the Army and Navy embraced five years ago, assumes cost savings of $460 million a year by ending duplication of effort and staff redundancies across the services.

But Lt. Gen. Charles B. Green, Air Force surgeon general, said his service opposes a unified command, in part because it doesn’t believe the restructuring will save money.

“We believe a more effective and efficient joint medical solution can be attained without the expense of establishing a unified medical command,” Green said.

The Navy no longer supports medical command consolidation, at least not now. Vice Adm. Adam M. Robinson Jr., Navy surgeon general, warned “there is currently no joint construct or doctrine to permit the seamless and safe care for our servicemembers and their families” under a unified command.

But Lt. Gen. Eric Schoomaker, Army surgeon general and commanding general of Army Medical Command, finds “merit in considering the most effective and efficient command structures to support the strategic goals of the military health system, the services and the combatant commanders.”

Under the House bill, the unified medical command would be a major combatant command similar to Special Operations Forces Command, and reporting directly to the secretary of defense. The four-star officer selected to run it would be given authority over medical staffing, training, purchasing, operations and readiness, just as SOCOM is responsible for all aspects of combined special forces.

Medical personnel still would be trained for service-unique missions in the culture of parent services. But overall medical training, assignments, procurement and operational support would be centrally controlled.

The unified command would oversee three subordinate commands led by three-star officers. One would be responsible for all fixed military treatment facilities. A second would run all medical training and education plus research and development. The plan is silent on functions such as logistics and information technology, allowing the department to organize those as it deems fit.

A third subordinate command, called the Defense Health Agency, would assume all functions now performed by the Tricare Management Activity including the multi-billion dollar Tricare support contracts that support vast networks of civilian health care providers to deliver a triple health care option to family members and retirees.

The House directs the secretary of defense to present details for implementing these changes to defense committees by July 1, 2012.

Military Update asked each current surgeon general his views on the unified command plan the House passed.

Green said the Air Force recognizes that service and joint medical doctrine “must be improved to assure service capabilities are fully interoperable and interdependent to bolster unity of effort. The services should continue integrating common medical platforms to reduce redundancy and lower costs.”

But a unified medical command might “not achieve the intended synergy or unity of effort,” Green said.

Robinson argued the medical community “is already highly integrated” with Army, Navy and Air Force working “seamlessly to care for patients from battlefield to bedside. If we were to create a new unified command, it would require extensive study on how it would be best implemented so that we don’t jeopardize our current capability or add excessive cost to the system.”

But Schoomaker noted that “numerous” past studies have endorsed a unified medical command to improve the health of the force and to reduce redundancies. “Like all major organizational transformation efforts, however, the devil resides in the details,” he said.

“Army Medicine recognizes the merit inherent in these efforts, providing that the continuum of care remains fully integrated,” he said.

ByTom Philpott http://www.stripes.com