Transforming Medical Care - Modernization Directorate

Transcription

Headquarters U.S. Air Force
Integrity - Service - Excellence
Transforming
Medical Care:
Modernization
Directorate
Col Deb Niemeyer, USAF, BSC
Deputy Assistant Surgeon General
& Chief Scientist, Modernization
Commander, AF Medical Support Agency
28 February 2007
1
Purpose
Purpose:
SGR Overview
Classification: Unclassified
Type:
Informational
Length of Briefing: 2 hours
Briefer: SGR Team
2
Agenda

Modernization Vision

Organization

History, Achievements & Partnerships

Modernization Process

Inside the Divisions: Missions & Programs

Future Efforts

Questions & Discussion
3
Who We Are
Provide oversight,
direction, policy and
resources to leverage
Science &Technology,
Information Systems,
Academia & Industry;
transforming medical
capabilities to address
critical short-term and
long-term challenges in
support of the Air Force
and Joint Warfighter.
Air Force Surgeon General’s
Modernization Directorate
AFMS - CIO
4
Modernization Directorate
Asst SG,
Modernization
BGen
Theresa Casey
AFMSA/CC - SGR 2
Col
Deb Niemeyer
AFMSA/CV
Col
Andy
Stoehr
AFMSA/SGR
Superintendent
SMSgt
Chuck Alexander
Requirements
Col
Angela Washington
Management
&
Program Support
Mr. Brian McCarty
Requirements
Health Informatics
& AFMS CIO
Col
Lee Harford
Research
&
Development
Col (s)
Janet Deltuva
Information
Technology
Services
Col
Julie Hall
Programs / Projects / Special Interest Items
Integration, Test
&
Transition
Col
Dick Griffith
Research
Oversight
Compliance
Lt Col
Joe Narrigan
Material Solutions
5
SGR Sites
Madigan CIF
Travis AFB
Wright-Patterson AFB
AFRL/HE
Travis CIF
Shriever AFB
C-Stars
Chicago
C-Stars
St Louis
Falls Church
Fort Belvoir
Bolling AFB
C-Stars
Baltimore
C-Stars
Cincinnati
Fort
Detrick
Kirtland
AFB
WHMC-BAMC CIF’s
Keesler CIF
th
311 HSW
Lackland AFB
Brooks City-Base
KellyUSA
6
FHP Fellowship
AFIT Fellowship started FY04
Enhance understanding of AF and DoD
agencies & programs associated with RD&A
and Healthcare Operations
Moved to SGR – better access to a variety of
agencies
Special project participation (i.e., EOS / Avian
Influenza Surveillance)
Rotations & Site visits: AF/SG directorates,
DTRA, NMRC, USAMRIID, USAMRICD,
AMEDDC&S, AFSF Center, JPEO-CBD
Rotate through SGR
Familiarization with Modernization processes
Follow-on opportunities
AF/SGR / AFMSA
AFSF Center
7
History

Established in 2003

Grew out of Medical Readiness, Science &
Technology Directorate… Medical S&T Division

Established with SG reorganization

IM / IT realigned to SGR

Vision to mirror LAF – SGR to be “medical acquisitions”
Ensure compatibility of IM/IT systems across the Enterprise
CIO responsibility moved to SGR

Policy integration with IM / IA / IT Modernization
8
Achievements

SGROCC

SG’s Requirements for Operational Capabilities Council

Integration with Capabilities Review & Risk Assessment (CRRA) Process

Medical RDT&E / POM

Human Systems Integration

Support AIRPRINT Office

Telehealth

Epidemic Outbreak Surveillance ACTD & Program

Advanced Technology Demonstrations

$30M+ Congressional Adds

Assessment of Critical Medical Platforms

IT Infrastructure Upgrades (Wireless)
9
SGR Partnerships
311th
HSW
Air Force
59th MW
Surv/Diag &
T&E
AFDW
CBRN
T&E Spt
Mod Spt
AFRL, AFA,
Army
TATRC
R&D, IM/IT
Academia
AF Security Forces Center,
R&D, Field Experiments
UPMC, UIC,
UTSA etc.
AIRPRINT
HP, Systems
Engineering
DHHS
CDC LRN
Surv/Diag
JPEOCBD
Federal
Med CB
DHS
Surv/Diag
Joint / OSD
JMISO
NHRC
IM/IT
*Representative Listing
DTRA,
DARPA
DoD
GEIS
Surveillance
Surv/Diag
NMRC
Surv/Diag
Navy
10
Defense Threat Reduction
Agency (DTRA)
Medical S&T for the Joint CB Defense
Program
Coordinate with DoD labs, Joint Requirements
Office and the Joint PEO-CB Defense
Coordinate with Academia and Industry
International collaborations
Capabilities Area Management
Establish and Manage programs
Consultants to AFMS, OSD, Joint Staff, NATO
SGR DTRA Positions
Therapeutics
Diagnostics
Emerging Threats/Chem Therapeutics, NonTraditional Agents and Low Level
11
AF Security Forces Center
(AFSFC)
Protect Personnel, Facilities,
Weapons Platforms
Conglomerate of military, civil service and
contract support personnel of various
specialties / backgrounds working to
enhance FP measures quickly
Collaborate with other agencies, Academia
and Industry
Drives change in TTP’s & Doctrine
Ranges from novel research & technology
use, to new applications of off-the-shelf
solutions
SGR AFSFC Positions
Formerly AF FP Battlelab (changeover FY08)
Senior Scientist
Force Health Protection
12
The Modernization Life Cycle
13
Push Development & Speed
Acquisition

AF
AFcontributes
contributesto
toand
and
pushes
technology
pushes technology
development,
development,transfer
transfer
and
anddelivery
deliveryto
tothe
the
marketplace
marketplace

Govt
Govtbuys
buys“off-the-shelf”
“off-the-shelf”
Promotes
Promotes

D. Sharon, Frontline, Inc. 2003-4

Focused
FocusedR&D
R&D
Faster
Fasterdevelopment
development
Knowledgeable
KnowledgeableT&E
T&E
Smarter
Smarterprocurement
procurement
Enabled
Enabledtransition
transition
Robust
Robustsustainment
sustainment
“Steamlined
“SteamlinedAcquisition”
Acquisition”
14
Maj Steve Quigley
Chief, Requirements Development Division
15
Requirements
Col Washington
Mission
Establish guidelines, policies and procedures for defining, developing,
documenting, validating, and managing Air Force Medical Service operational
capability requirements
Major Program Areas

Requirements Policy

Requirements Generation

Requirements Development

Requirements Integration
16
SGRR – AFMS Capabilities
Review & Risk Assessment
AFMS CRRA Capabilities

Detect, identify, quantify and mitigate both present and future
health threats
Provide prevention, medical diagnosis, and treatment
Capture / access all health-related personnel data, cradle-tograve
Maximize Human Performance
Enhance situational awareness across the battle space to
include in-flight and ground-based elements
Provide platform to sustain / enhance medical / surgical skills
Provide medical response for on-base, off-base, and
international incidents
17
A “Capabilities-Based” Approach
Align Resources with Capability Shortfalls
5
1
Capability Gaps
Identified
(vetted through
MAJCOM/SGR)
SGRR
SGRR
Staffs
Staffs
Pre-SGROCC
Pre-SGROCC
Final
Final
Prep
Prep
Initial Capabilities
Document
submitted
Assigns
Assigns
Leader
Leader
Facilitator
Facilitator
2
HPT
completes
FSA and
Requirements
Research &
Development
Division
AF RDT&E$
Validated
Research/Development
Requirement
6
Analysis
Analysis
ofofSolutions
Solutions
SGRR
SGRR
Staffs
Staffs
4
Validated
Materiel
Solution
3
SGRS
SGRS
Staffs
Staffs
HPT
HPTReviews
Reviews
Down-select
Down-select
Solution
Solution
Line$
DHP$
Congress$
AFMS Med
Mod Panel
Prioritizes
Programming
18
Unfunded AE Requirements
Mapped to SGROCC Initiatives
Materiel Requirements
CCATT-specific equipment
Battery Life Optimization
Wireless Capability
Research Requirements
Severe Traumatic Brain Injury & CCATT
Abdominal & Extremity Compartment Syndromes

AE-specific risk factors?
Blast/Thermal mechanism risk factors for extremities?

Fresh Whole Blood & Systemic Inflammatory Response
– immediate / mid- / long-term outcomes
19
Lt Col Tim Wiley
AF Clinical Research Program Manager
20
Management & Program Support
Mr. McCarty
Mission
Provide program execution, resource management, operations, and
support services to the Modernization Directorate
Major Program Areas

Acquisition Services to support AFMS needs

Resource Management (O&M, R&D, and OP)

Program Management (includes Clinical Investigations,
Epidemic Outbreak Surveillance [EOS], Avian Flu Project, etc.)

Congressional Programs
21
Clinical Investigations
Research
Objectives
Improve the quality of patient care
Support Graduate Medical Education
Resident and Staff Research
Initiatives
Generate an atmosphere of inquiry

responsive to the dynamic nature of
the health sciences
Promote high professional standing
and accreditation of health education
programs
Source: DoDI 6008.8 (draft)
22
Clinical Investigations
Research Sites
Medical Centers with
CI Facilities
Wilford Hall Medical Center
59th Medical Wing
David Grant Medical Center
60th Medical Group
Keesler Medical Center
81st Medical Group
Medical Centers with
CI Programs
Malcolm Grow Medical Ctr
89th Medical Group
Wright Patterson Med Ctr
74th Medical Group
Other Sites with
Protocols
Brooks AFB, 311 HSW
United States Air Force
Academy, CO Springs,CO
Madigan Army Medical
Center, Fort Lewis, WA
23
Wilford Hall Medical Center
Clinical Investigation Facility

Staffing
Active Duty
Civilian
Contractors
9
26
5
Mission:

Surgical Residency
Flow Cytometry
ECMO
Ventilator Studies

HIV Program
Nursing Research
K-9 program
IRB fellowship
24
David Grant Medical Center

Staffing
Active Duty
Civilian
Contractors
14
8
4
Mission:

Molecular Biology Center
Surgical Residency
Immunology

EOS RPM testing and
validation
JBAIDS clinical trials
Food & Water
25
Keesler Medical Center

Staffing
Active Duty
Civilian
Contractors
8
7
0
Mission:

Surgical Residency
Genetics
Dental Residency
Recovering capabilities, post-Hurricane Katrina
26
Advanced Medical Surveillance
& Diagnostics

Perform world-wide Public Health Screening/
Surveillance and rapid diagnostics capabilities
using advanced/novel technological solutions

Incremental, Integrated “Family of Systems”
27
Lt Col Phil Livingstone
Deputy Program Manager, Epidemic Outbreak
Surveillance Program
28
Epidemic Outbreak
Surveillance (EOS) Program
Program Goals:

Improve near real time notification
of BMTs presenting to HCP with FRI
Evaluate new technologies for near
real time identification of respiratory
pathogens
Improve identification of
uncultivable respiratory pathogens
Improve surveillance for
emerging/re-emerging respiratory
pathogens
Provide surveillance for agents of
BT/BW
Integrate new data streams into
surveillance system
29
Epidemic Outbreak Surveillance
Making the Difference
Detection via
Medical
Surveillance
Delay until
Clinical
Diagnosis
100%
Day 5 – 90% casualties
80%
% Casualties
60%
40%
Day 3 - 30% casualties
20%
Source: Adapted from U.S. Army Hazard Analysis Modeling
0%
D0
D1
D2
D3
D4
D5
D6
D7
DAYS TO RECOGNITION
D8
D9
D10
D11
earlier
response
and
Save nearly 90% ofAllows
treatable
casualties
with
early
control
interventions
identification
- Contain outbreak -
30
EOS Integrated Capabilities
Real Time Medical
Surveillance Situational
Advanced
Diagnostics
Bioinformatics
Awareness
Real World
Infectious Disease
Outbreaks
Advanced
Diagnostics
Platforms
- Controlled Test
Population
- Wing/Group CC
Support
- Multiplexed Pathogens
- Host Response Array
Information
Technology
ELSI - Policy
Real World
Assessment
- Platform Independent and Scalable
- Integration of Legacy Data Sources
- Interfaces to CCs and Stakeholders
31
Disease Surveillance
Advanced Diagnostics Lab (ADL)
32
EOS Transitions
& Impacts
•Spans full operational spectrum
•Protects forces during planning, deployment, execution, & redeployment phases of joint operation
•Transformation of massive data sets to decision-quality information in real time
•Enabling CC with enhanced situational awareness and readiness assurance
Operations
Scheduling
Command and Control
Epidemic Containment
The right decisions
All data sources
United States
The right
information
COHORT
Iraq
The right data
Microarray
RTRT-PCR
33
EOS Summary

To develop a testbed at Lackland Air Force Base to improve
national bio surveillance capability to prevent or mitigate the
outbreak of natural occurring endemic diseases and/or
eliminate the threat of a covert or overt release of biological
agents.

Improve situational awareness by integrating innovative
technologies for rapid pathogen identification with relevant
information systems currently in operations at LAFB.

Provide a unique opportunity to identify, define and validate
capabilities using a real life local outbreak model prior to
deploying the bio surveillance system on a national level.

Demonstrate how a host of technologies can be integrated to
provide an effective homeland security and public health bio
surveillance system.
34
Advanced Development
Center (ADC; Skyline)

Build, Modify,
Assess &
Demonstrate
Advanced
Informatics

“Next Generation”
IM / IT to improve
the health &
welfare of our
military force and
beneficiary
population
35
Applied Technology Center
AFIOH, Brooks City-Base

Evaluate, identify, minimize, prevent
personnel exposure to, and improve
patient treatment resulting from
exposure to environmental hazards and
CBRN agents

Supports Demonstrations, Test & Eval

Advanced Surveillance & Diagnostics
Demos, MEFPAK Assessments
JBPDS, JBAIDS Blocks I & II
“Next Generation”

ART-Fever (Non-invasive fever
determination)

Handheld Radiac Devices
Handheld Diagnostic Systems
Aptamers; Nanotechnology
36
Maj Mike Dempsey
Chief, Bioinformatics
37
Avian Flu Surveillance Project
Silent Guardian II
Family of Systems
Pathogen Detection
Kiosk
Vital Signs &
Data Collection
Advanced RT-PCR
COHORT
…MI
LP
D
S
Goal
Institute worldwide real-time
Public Health Screening/
Surveillance for H5 (Avian
Influenza) at 6 sites initially, up
to 20 if desired, using
advanced real-time PCR
- Develop near real-time C2 with
bidirectional information flow
- Partnered with CDC LRN; Increase
number of “avian designated” sites
C
C
D
B
M
2
COHORT
Data
Extract
Transfer
& Load
DB
IM/IT Backbone
Timeline / Accomplishments
- Ops Demo at LAFB (25-27 Sep 06); 2 clinics live
- AFIOH Stood up, Oct 06
- Senior AFMS Briefing, 21 Nov 06
- AFDW hosting JFCOM Demo, Mar 07
- Stand up 5 -9 MTFs this FY
38
Silent Guardian II
CONOPS
DB
Nurse/Tech requests “PHS”
Test in CHCS and sends
sample to lab
PHO/PHEO
Others Feedback Loop
Role
Defined
•GUI data
feedback
Lab Technician
Lab
MTF Commander
ID: 12345-6789
ID: 12345-6789
Lab receives pt
specimen
COHORT
Aliquots/labels samples
PCR Test Result (complete data
Schema) + Patient
Questionnaire and demographics
+ Algorithms applied =
decision quality
information at end users
fingertips
Patient
continues
SOC
exam/
treatment
ID: 12345-6789
ID: 12345-6789
Patient
If pt meets criteria- to tx room
to collect nasal wash / throat
swab
ID: 123-456789
Patient checksin with ILI
symptoms and
is taken to Vital
signs screening
room
Kiosk for vital signs
and questionnaire
Cold/flu symptoms
cough or sore
throat < 72 hrs and
fever > 100.5
Advanced RT-PCR
Simultaneously testing
30 patient samples for H5
1. Flu A/B rapid test at MTF
2. AFIOH / DoD Influenza
Surveillance (Gold Stnd
days to weeks)
3. RT-PCR at MTF( if meets
LRN criteria)
39
Laboratory

Equipment / supply package
ready
Hardware &
consumables provided
Site-specific items as
required
Training plan underway
On-site; documentation;
includes QA/QC pkg.
Approx. 5 days; all
equipment and
protocols
Labs upgrading to CDC /
LRN “Avian” status
Critical in order to
obtain the CDC H5
assay and protocol
40
Silent Guardian II Reporting

Real time
alerting on H5
User-defined
views
Event filtering
41
Tier 1 Sites: Avian Flu
2. Travis,AFB, CA
3. Andrews AFB, MD
1. Lackland AFB. TX
4. Incirlik, Turkey
5. Osan AB, Korea
** AFIOH **
Results Validation
Reach- back Capability
Tier 1 Sites
Regions with H5N1 cases
42
What We Have Right Now
SG II Package
AB 7000
Roche MagNA Pure Compact
Operational
Vital signs kiosk
AFIOH reference lab
COHORT
LAFB: 2 clinics
Web application
DITSCAP in process
Contract vehicles in place
Upgrade sites to LRN /
Avian designated status
COHORT
Web Application
Result: Real-time influenza
surveillance allowing
Commanders and PHOs
the opportunity to be
proactive with infection
prevention and control
measures
Pre-Operational
Andrews AFB, MD
(- go active by 16 Mar)
Travis AFB, CA
Incirlik AB Turkey
No other real-time influenza
A/H5 surveillance capability
in DoD or US Government
Osan AB Korea
43
Research & Development
Col(s) Deltuva
Mission
Identify medical research solutions to address capability gaps in
Air Force medical care
Major Program Areas

Medical Research (includes CIin Research Program)

Bioeffects Medical Research

Environmental & Occ Health Research

Medical Technology
44
Trauma Registry
AFTTR / JTTR
Description of the project: Data
collection system designed for patient
information to include demographics,
mechanism of injury, associated
circumstances, documentation of
physical exams (injuries, tests/
procedures, disposition); improve
outcome
Demonstration: Air Force Medical
Evaluation Support Activity
(AFMESA).
Fielding: In coordination with Pilot
Unit, CENTAF & CENTCOM;
EMEDS & Theater Hospitals;
Eventual tie-in with JTTR/S / TMIP
Funding: Congressional
Sponsor: AF/SGR, ACC/SG
Estimated Deployment Date:
Summer 2007
45
Brain Acoustic Monitor
BAM
Description of the project: Small,
portable, non-invasive monitor of
cerebral perfusion pressure, to be
used at all echelons of care
Demonstration: R. Adams Cowley
Shock Trauma Center, Baltimore,
Maryland, and the Maryland
Institute for Emergency Medical
Systems (MIEMS)
Funding: WRAP
Sponsor: AF/SGR, AF/SG3
Fielding: Plan in progress - From
field to CONUS Tertiary Care
MTFs
June 2008
46
Directed Energy
NLW / DE
Description of the project: Small
group of projects centered on laser
eye protection and detection of laser
injury. Includes laser detection, flash
protection, nonlinear optical
coatings, and biomarker injury
detection.
Research Sites: University of
Illinois (Chicago) and AFRL
(Brooks City-Base & Wright –
Patterson AFB)
Funding: Congressional
Sponsor: AF/SGR
47
Food & Water Assays
Description of the project:
Development of Real-time PCR probes
for food and water pathogens. Assay
Information transferred to the JPEOCBD Critical Reagents Program
repository for JBAIDS use
Research Sites: AFIOH Applied
Technology Center, Travis CIF
Funding: RDT&E
Sponsor: AFMOA, ACC/SG, JPEOCBD (JBAIDS Office)
FY 2008
48
Microarray
Description of the project:
Assessment of advanced microarray
system for multiple marker, multiple
pathogen identification
Research Sites: AFIOH Applied
Technology Center
Funding: RDT&E
Sponsor: AF/SGR (EOS)
49
BREAK/QUESTIONS?
50
Healthcare Informatics
Col Harford
Mission
Develop and coordinate AFMS information management strategic planning
and tactical execution to support business intelligence
Major Program Areas

Air Force Medical Service CIO

Data Modeling and Analysis (includes Bioinformatics)

Knowledge Management

Enterprise Architecture and Integration

Population Health Support
51
Maj Letitia McGee
Clinical Systems Consultant
52
IT Systems
Col Hall
Mission
Integrate information technology (IT) initiatives across the AFMS to provide
requirements-driven technological solutions. Transition Military Health
System (MHS) and Air Force systems to the AFMS user
Major Program Areas

Expeditionary and Business

Information Assurance

Information Technology Support

Medical Systems Integration
53
Medical Systems Infrastructure
Modernization - MISM

Started in 1994
Flexible, robust, resilient network
Comprehensive, scalable telecommunications and
networking infrastructure
Support emerging technology and requirements, e.g.
digital radiology, telehealth & AHLTA (“Electronic
Health Record”)
54
MSIM Wireless Update
Opportunities

Timely access to patient data
Multi-user workstation
Medical record documentation at
the end of day
Wireless Benefits

Mobility and real-time access to
patient data
Improved productivity
Faster care and more RVUs
Higher accuracy of records
Multi-user logon
Provider satisfaction
Align with AF Line 2nd Generation Wireless Local Area Network implementations
55
ITS / Clinical Services
Col Ibanez-Pabon
Mission
Serve as primary AF liaison among MHS program offices, AF leadership,
contractors, and end-users to optimize development of new clinical systems
and their interface with existing systems. Ensure that soundly applied
information systems support optimum healthcare through orchestrated, AFspecific implementation, deployment, and transition support.
Major Program Areas

AHLTA

DoD/VA Sharing

EWS-R

Cache’

Telehealth

ICDB
56
AHLTA Update

Block 1 (Outpatient) deployment completed 2 Nov 06

All 83 “brick & mortar” Air Force MTFs trained
Percent of total encounters documented per Service

AFMS = 90% Army = 86% Navy = 81%

AHLTA is meeting operational requirements threshold for
speed/reliability
Performance enhancements & new functionality continue
to be developed and fielded

Block 2 (Dental) Operational Test & Evaluation, May 07

AF Dental Test sites: Tinker AFB & Sheppard AFB
Anticipate full deployment decision for Block 2 Sep 07

Block 3 (Ancillary) acquisition strategy under revision
57
Telehealth

Move electrons instead of people

Bring care to where the patient is rather than
bringing the patient to the provider

Maximize limited resources

Improve care
58
Telehealth
Near-term
Dermatology
Radiology
Expeditionary Telehealth
Pathology
Ophthalmology
59
Telehealth
Way Forward
Air Force Enterprise-Wide Telehealth
RadNet
2009
Imaging
Provider-Patient Live
Tele-Consultation
Teleconsultation
2010
2012
“To Be”
“As Is”
Existing Digital
Infrastructure
(PACS)
Doctors just
Electrons
away
Telehealth
Radiology
Regional
Teleradiology
Cardiology
Some
Tele-Dermatology
Gastroenterology
Mental Health
Home Health Monitoring
Surgery
Pathology
Ocular Medicine
Dermatology
Audiology
60
Lt Col Sue Harmon
Deputy Director, Integration, Test, and Transition
Maj(s) Dave Hagerty
Chief, Training and Transition Branch
61
Integration, Test & Transition
Col Griffith
Mission
Integrate and transition technology solutions to the AFMS end
user through provision of testing, training assessment and
coordinating the smooth transition and sustainment
Example Programs & Projects

Joint Capability for Airborne Networking System (JCAN)

Patient Controlled Analgesia pumps (PCA)

EDOCS-120B - O2 concentrator for deployed med facilities

Joint Biological Agent Id & Diagnostic System (JBAIDS)

Mobile Molecular Technology Laboratory (MMTL)
62
Test & Evaluation
Fort Detrick & LAFB
Key Responsibilities
Operate AF Medical Evaluation
Support Activity (AFMESA) and
Experimentation, Technology &
Integration (XTI) Test Bed
Systems integration, testing, & utility
assessments
Formal technology insertion into
MEFPAK process
Modeling & Simulation
Key Partners
AFOTEC, MAJCOMs, 311 HSW,
Defense Medical Standardization
Board (DMSB), Telemedicine &
Technology Research Center (TATRC),
AF Medical Logistics Office (AFMLO)
63
Mobile Molecular Technology
Laboratory (MMTL)

Congressional plus-up 2004 ($1M RDT&E funds)

Vital Probes awarded contract from AFRL, WPAFB

Briefed Nov 04 (SGR, AT&L, JPEO-CBD, DTRA)
Purpose: Construct a vehicle that contains
equipment & facilities found in fully-operational
stationary lab which could be deployed to offroad or urban locations & operate near hot zone

Prototype delivered to AFIOH – 2005

MMTL can use external water & power in addition
to the internal water supply and power generator
Two technical assessments accomplished over
the last 6 months

Certified as BSL 2 and 3 lab
Operational assessment in the near future
64
Training & Transition Branch
Key Responsibilities
Transition of Medical Modernization projects to the field
Liaison between SGR project team and sustainment entity
Ensure project team is incorporating effective and
accessible training into acquisition strategies
Key Partners
DoD MHS, HQ AF/SG1, HQ AF/SG3, AFMOA, MAJCOMs,
MEFPAKs, AETC, USAFSAM, UTC Pilot Units, AFMLO
65
Patient Controlled Analgesia
(PCA)

PCA pumps for multi-Service en
route care

Assessed performance of four
candidate PCA’s in Army, Navy
and Air Force Treatment facilities,
exercises and aircraft
Results endorsed by
DMSB/Service SGs as the Joint
solution
Coordinating quick transition to
field for today’s pain management
needs
66
Joint Bio Agent Identification &
Diagnostic System (JBAIDS)

Validated JBAIDS sensitivity and usability with new
DNA/RNA extraction kit

Boosted sensitivity while eliminating 150-lb centrifuge
permitting shipboard operations
Recently completed JBAIDS EC/IC assessment
Updating AF training documents for HLD LRT & BAT
67
Research Oversight & Compliance
Lt Col Narrigan
Mission
Provides regulatory oversight and ethical guidance for all research
conducted or supported by the USAF involving both humans and/or animals
Major Program Areas

AF review of sister Service NLW / DE protocols

1st Research Reviewer certification training

Site visits: Focus on ed / training / communication

SG the accountability point for Subjects Protection
68
New Initiatives
Col Deb Niemeyer
69
The Texas Biomedical Science
Consortium - TBSC
Meeting
MeetingaaVital
VitalNational
NationalInterest:
Interest:
Reducing
ReducingCost
Costand
andTime
Timeto
toEquip
EquipMedical
MedicalForces
Forces

Public/private partnership

To U.S. Air Force = a technology accelerator

To San Antonio and Texas = an economic generator

Technology Strategic Planning

Proponency & Network Development

Peer Reviews

Systems Engineering & Requirements Analyses

Market & Technology Reviews

Commercial Assessments and Cost/Benefits Analyses
70
The Texas Biomedical Science
Consortium - TBSC
71
S&T Transformation
AFMS S&T Transformation Contributor

SGR Addresses
Near-term “urgent & compelling” needs

Mid-term capability gaps

Longer-term solutions (“R&D”)
AFMS Transformation

A “multi-disciplinary” & -agency approach
Modernize Medical capabilities
Areas:

VX Vapor Detection Baseline* Analysis
*Does not address HAPSITE capabilities
Roles
WOC CE BEE
CAM/ICAM
(.1 mg/m3)
Agent Concentration (mg/m3)

.1-
Ect50 (Miosis)
M256A1
(.02 mg/m3)
.04.02-
M22 ACADA
(.04 mg/m3)
Field
Detection
Capability
Baseline
Risk
Develop Residual Risk estimates by
using the AFMOA Chemical Warfare
Agent Health Risk Assessments Interim
Guidance Document, the AF/XONP
Vapor Hazard Tables, and the Chemical
Hazard Estimation Method and Risk
Assessment Tool (CHEMRAT).
Occupational Toxicology
What We
Know
What We
Think
Residual
Risk
OPERATIONAL IMPACT AND DECISION

0

Care in the Air

Advanced Diagnostics

Directed Energy

Service Unique Needs
Time (Minutes)
Lead
Support
72
“Big Science”

Multi-disciplinary

Biomedicine… Moving towards
“Big & Digital”
Knowledge + Science +
Computing
Knowledge-Sharing across
Basic Science & Clinical
Communities

Connected, Networked Data:
Investigators & Clinicians

“Translational Science”
SGR brings People, Platforms, & Data together … Poised to
Exploit “Big Science”
73
Medical Innovations
“The
“Theworld
worldrequires
requiresat
atleast
leastten
tenyears
yearsto
tounderstand
understandaanew
newidea,
idea,
however
howeverimportant
importantor
orsimple
simpleititmay
maybe.”
be.”Sir
SirRonald
RonaldRoss
Ross

System-Level Experimentation (SLE)

Discovery Experiments to Drive Disruptive Innovation

Employment of Novel Technology / Novel Use of Technology

Changes how we “Fly & Flight” Before the Fight

Forces Adversary to React to our Innovations
Medical Innovations Office; Parallel LAF
AFInnovations
Innovations
AF
AF
AFMedical
MedicalInnovations
Innovations
74
On the Horizon
Col Deb Niemeyer
75
Human Performance Wing

Restore “Iron Triangle” of Research, Training + Operations

Co-locate & align AFRL & 311th HSW

USAFSAM

AFIOH + Applied Tech Center

Support activities
Assets
Assets&&infrastructure
infrastructure“LEANED”
“LEANED”
and
andConsolidated
Consolidatedunder
undernew
newWing
Wing
SGR interface – Enhance not duplicate

Requirements, R&D, Compliance, T&E

Policy & Program oversight
Compliment Unified Medical Command
76
Unified Medical Command

Mandated to stand up UMC

“Combined Medical R&D Command” under USAMRMC

TSG Work Group charted & convened 26 Jan 07

Aggressive timeline: IOC Jan-Mar 08
Opportunities

Address Total Lifecycle Management

Fix Requirements Process

Push AFMS as lead Medical Tester

Delineate what each Service is “good at” -- Reduce redundancy

Human Performance Optimization (HPO) a core focus
Strategy

Place Senior Personnel in key positions

Maximize Virtual alignment & Retain personnel (TACON)
77
Key Message

SGR Role: Lead AFMS Transformation
Requirements will drive the Process
Personnel are Key to making it Happen
We are a service Staff

Serve those in the field
Serve other Air Staff functions (Ops, Plans, etc.)
Serve the Joint Community & Beneficiary Population
Pushing the Envelope… to Support the Warfighter!
78
Questions?
79
Back Up Slides
80
Real World Testbed
Lackland AFB
Clinical
Medicine
Operational
AF Benefits
¾ Advanced Epidemiology
¾ Advanced Technologies
¾ Genomes & Gene Expression
¾ Proactive ELSI Support
¾ IM / IT Test Site
81
Silent Guardian I
Advanced Technology Demo
•10,000 microarray chips
• Up to 300 Assays per Day
• Surge to 450 if Required
Collection 24/7
LAB (NRL)
•
New Standard for Bio-surveillance
•
Cut Diagnosis Time From Weeks to
Hours
•
Combined With Near Real Time Q5
Minute From AF Medical Treatment
Facilities
•
“Pushed” & Evaluated the Science
•
IOC: 6 Dec 04
•
FOC: 20 Dec 04
•
Goal: 1 Mar 05
PROCESS
Reporting
NRL
NRL
Q5 Min
MDW C2 System
82