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

Unified Military Medical Command could save $460m a year

The Defense Department could save as much as $460 million a year by consolidating its fragmented military health system into a single joint medical command, a new government report says.

That idea is No. 2 on a list of 34 recommendations for eliminating duplicative functions and saving money across the federal government, compiled by the Government Accountability Office in a report released Tuesday.

If the idea to streamline the military health system sounds familiar, that’s because it is: Since the 1940s, at least 15 studies have addressed the structure of the military health care system, and all but three favored a unified system or at least a stronger central authority to improve management and coordination among the services. The most recent study was done in 2005 by the GAO itself.

But calls for a joint medical command have never gone anywhere because whenever the proposal surfaces, the individual services put up strong resistance.

In its new report, the GAO said the basic concept remains sound and has gained new importance in light of the deepening federal budget crisis and the military medical system’s soaring costs, which have shot up from $19 billion a decade ago to more than $50 billion today.

The GAO noted that the military health system — serving 9.6 million beneficiaries through more than 130,000 military and government medical professionals, a large network of private health care providers, 59 military hospitals, and hundreds of clinics worldwide — has multiple, and often overlapping, layers of authority.

Those layers start with the Office of the Assistant Secretary of Defense for Health Affairs. Then the Army, Navy and Air Force each has its own medical headquarters and associated support functions, such as information technology, human capital management, financial activities, and contracting. Each branch also has its own surgeon general to oversee deployable medical forces and operate its own health care systems.

“The responsibilities and authorities for DoD’s military health system are distributed among several organizations … with no central command authority or single entity accountable for minimizing costs and achieving efficiencies,” the GAO said.

The GAO noted that in the wake of its 2005 report, the Pentagon formed a working group to examine “several reorganization alternatives.” A year later, the group outlined three possible options: establish a unified medical command similar to DoD’s unified transportation command; establish two separate commands — one to provide operational and deployable medicine and another to provide beneficiary care through military hospitals and contracted providers; or designate one of the military services to provide all health care services across the force.

The effort stalled “because of an inability to obtain a consensus among the services on which alternative to implement,” the new GAO report said.

Instead, top Pentagon personnel and health care officials opted for a different approach that involved “seven smaller-scale, incremental reorganization efforts” designed to minimize duplicative layers of command and control; reduce redundancies in personnel and expenses; and squeeze efficiencies from combining common service support functions within each service, such as finance, information management and technology, human capital management, support, and logistics.

But the concept left the existing command structures of the three services’ medical departments over all military treatment facilities essentially unchanged — and five years later, the DoD officials have made only fitful progress in implementing four of the seven incremental steps approved in 2006, and have offered no guidance on “how and when to accomplish the three remaining steps,” the GAO said.

Had DoD and the services chosen to move forward on one of the three other alternatives studied by the working group in 2006, the GAO report said, projected savings would have ranged from $281 million to $460 million annually, “depending on the alternative chosen and numbers of military, civilian, and contractor positions eliminated.”

A number of the other 33 recommendations in the report touched on other possible redundancies:

  • Urgent warfighter needs. The GAO said there are opportunities to consolidate and make more efficient the processes that the Pentagon has put in place to rapidly develop, modify and field new urgent capabilities for field forces in Iraq and Afghanistan, such as intelligence, surveillance, and reconnaissance technology, and systems to counter improvised explosive devices. GAO identified at least 31 entities that play a role in DoD’s urgent needs processes, which have consumed about $77 billion since 2005.
  • Counter-IED efforts. The Pentagon created the Joint Improvised Explosive Defeat Organization in 2006 to lead and coordinate all military counter-IED efforts. But the GAO said many of the organizations engaged in the counter-IED effort prior to JIEDDO’s creation have continued to develop, maintain, and expand their own IED-defeat capabilities. Some of these entities have operated independently “and may have developed duplicate capabilities,” the GAO said.
  • Intelligence, surveillance and reconnaissance. No single entity at the DoD level has responsibility, authority, and control over resources to meet joint priority requirements in the ISR realm that has been critical to counterinsurgency efforts in Iraq and Afghanistan, the GAO said. The ISR community has “extensive, structural fragmentation,” with numerous separate organizations sharing the same roles. Further clouding the picture is the fact that ISR funding comes from a variety of sources, some of which are classified.
  • Tactical wheeled vehicles. The Pentagon lacks a coherent, unified strategy for developing and purchasing tactical wheeled vehicles that transport people, weapons and cargo, the GAO said, noting that “DoD could save both acquisition and support costs through a departmentwide tactical wheeled vehicle strategy that considers costs and benefits of the Joint Light Tactical Vehicle compared to other tactical wheeled vehicle options.”
  • Prepositioned equipment. The Defense Department prepositions equipment and supplies worth billions of dollars, including major items such as combat vehicles, rations, medical supplies, and repair parts, at strategic locations around the world, both afloat and ashore to quickly support combat-ready forces. “Although the services are expected to operate in a joint environment, some prepositioning activities are fragmented among the services, with the potential for unnecessary duplication,” the GAO report said.
  • • Business systems. The Defense Department’s business systems, which cost $10 billion a year, have “little standardization, multiple systems performing the same tasks, the same data stored in multiple systems, and manual data entry into multiple systems,” the GAO said.
  • By Chuck Vinch – Staff writer www.armytimes.com

Data Security and Interoperability Are Key to Transforming U.S. Health Care System

The lack of common interoperability standards and inconsistent approaches to security, privacy and trust are perpetuating an antiquated U.S. health care delivery system that has been largely unable to benefit from the widespread adoption of IT, according to Verizon’s top security and health care executive.
The executive, Dr. Peter Tippett, vice president of security and industry solutions for Verizon, called for the development of “simple, common-sense approaches to data security and interoperability” to help expand access to quality care, control costs and improve patient outcomes. He spoke at the 2011 Health Information Management Systems Society annual conference.
In a “Views from the Top” address titled “Prescription for Health IT: What’s Holding Us Back,” Tippett said: “The U.S. health care system is the envy of many countries around the world. However, there is much that needs to be done to bring the industry into the 21st century. Working together to tackle acknowledged industrywide challenges, we can foster an environment of change and through the pragmatic use of IT create a stronger and more viable health care system.”
Tippett outlined four key areas that he said will serve as the foundation for the future transformation of the health care system. The areas are:

  • Built-in Security – The ability to share information in a secure and trusted manner is a vital cornerstone in health care. To be effective, security compliance programs should be intuitive, easy-to-use and uniform across the industry.
  • Support for Structured and Unstructured Data – Due to a lack of common standards for its use and storage, data often remains in separate files rather than being combined to provide a holistic patient view. By redoubling efforts to tackle this issue, health care data can be easily shared among providers to help reduce medical errors and enable informatics and analytics to help improve treatment plans and patient outcomes.
  • High-IQ Networks – Pervasive and interconnected IP and wireless networks are the essential platforms to connect providers to foster innovation. Secure, high-performance networks will serve as the underlying foundational platforms to help drive productivity and efficiency enhancements.
  • Simplification – The U.S. health care system is diverse, ranging from large urban providers with thousands of physicians to small rural practices. Solutions must be affordable, consistent and, ultimately, simple. Leveraging current systems and data is an important first step and is essential for promoting usability and driving benefits to provide a solid foundation for future enhancements.

source: Verizon Connected Healthcare Solutions