Army Medical Research and Development Infrastructure Planning Proceedings of a Workshop (2021) / Chapter Skim
Currently Skimming:
Setting the Stage for Improving Army Medical Infrastructure Planning
Setting the Stage for Improving Army Medical Infrastructure Planning
Pages 5-17
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Noting the importance of aligning medical care with threats and the need to treat as close to the front as possible, he highlighted the global reach of the threat environment (Figure 1) and noted that the "information environment respects no borders." Friedrichs observed that future casualty-generating threats encompass an array of domains and capabilities, such as cyber; artificial intelligence (AI)
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6 UNCLASSIFIED FIGURE 1 A globally integrated threat environment. SOURCE: Brigadier General Paul Friedrichs, U.S.
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Mayhew focused on World War I (WWI) lessons, particularly serious limb injuries and their relation to the Thomas splint, a device used for stabilizing limb fractures.
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could be preventable. Referring to the National Academies of Sciences, Engineering, and Medicine Army Combat Trauma Care in 2035 workshop,1 he noted that many of the same issues will be present in 2035 as now, including technical development, who is responsible, training, and military versus civilian trauma outcomes.
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Holcomb asserted that benefits to military personnel at these trauma centers would include routinely caring for very sick patients at those centers and establishing an ongoing research network focused on military-relevant clinical research. Holcomb referred to the Air Force concept of military trauma teams assigned to a large number of academic civilian trauma centers with high volume and high capacity, thus producing a national trauma care system as outlined in the 2016 National Academies report A National Trauma Care System: Integrating Military and Civilian Trauma Systems to Achieve Zero 2 R.L.
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The 2017 report was 3 National Academies of Sciences, Engineering, and Medicine, 2016, A National Trauma Care System: Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths After Injury, Washington, DC: The National Academies Press, https://doi.org/10.17226/23511. 4 Defense Health Board, 2017, Improving Defense Health Program Medical Research Processes, Defense Health Headquarters, Falls Church, VA, https://health.mil/Reference-Center/ Reports/2017/08/08/Improving-Defense-Health-Program-Medical-Research-Process.
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Responses DHB Report Findings and Set Recommendations DHA Responses 1 Findings: • oD medical research enterprise is fragmented across the Services. D • nvestment in the Clinical Investigations Program is inadequate.
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NOTE: DoD = Department of Defense; IRB = Institutional Review Board; SOP = standard operating procedure. SOURCE: Clifford Lane, National Institute of Allergy and Infectious Diseases, Defense Health Board, and DHB Public Health Subcommittee, presentation to the workshop.
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; further, DHB believed this DoD research element to be severely compromised by a lack of infrastructure and core funding, absence of a career track for officers, and noncompetitive pay for civilians. Lane then highlighted DoD medical-research contributions, such as tourniquets and blood products.
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He believed the Army is a valued partner implementing parts of the NIAID research mission, which has been facilitated by overarching agreements that resolve issues like intellectual property and data sharing; however, frequent staff turnover is a challenge. PERSPECTIVES FROM THE ARMY MEDICAL MATERIEL AND MEDICAL RESEARCH COMMANDS Kenneth Bertram, Clinical Product Development Officer for the Wake Forest Institute for Regenerative Medicine, described a range of advancements beyond body armor to save lives, such as blood component therapy and whole blood, tourniquets, buddy aid and training, and rapid evacuation.
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Bertram showed the typical medical acquisition life cycle (Figure 2) from discovery to prototyping, to production and fielding, and sustainment and improvements.
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SOURCE: Kenneth Bertram, Wake Forest Institute for Regenerative Medicine, presentation to the workshop.
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SOURCE: Kenneth Bertram, Wake Forest Institute for Regenerative Medicine, 17 presentation to the workshop.
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