The warrant officers are the Army's subject matter experts in technical areas. In Army Medicine, the warrant officer handles the role of the Health Services Maintenance Officer (670A) with professionalism and a commitment to saving lives. This week marks the observance of 100 years of honorable duty since the warrant officer was established in the Army.

The Army is currently the only service with warrant officers, and Army Medicine has about 75 handling critical medical maintenance leadership roles.

Chief Warrant Officer 3 Vladimir A. Sequera, an instructor at the Army Medical Department Center and School Health Readiness Center of Excellence, explained the approach the 670A warrant officers take with management of medical devices and medical device systems. It's more than an occupation; it's "an idealism" that goes beyond the skill of repairing or maintaining medical equipment in a strategic, tactical or operational level. "We understand," he said, "that a failure of a medical device can represent the loss of life for one of our Soldiers in the battlefield, and we take this responsibility very seriously and with honor."

How does the 670A do this? Chief Warrant Officer 4 Deanna Hughes, most recently at the 6th Medical Logistics Management Center, had the answer. The warrant officers in Army Medicine integrate medical technology into the operational environment, she said, and "they do this where it is most critical--the deployed medical units and the areas of the hospital where lives are on the line."

Hughes has personally been integrating clinical engineering capabilities--and the only person doing this--into every operations plan for every combatant command and operational command across the globe. Hughes has worked with Africa Command (AFRICOM), Central Command (CENTCOM), where she deployed for 6 months last year, Pacific Command (PACOM), and Northern Command (NORTHCOM).

The warrant officers who make up the technical foundation of the Army are called "technical warrant officers." They specialize in areas such as intelligence, aviation, or military police. There are more than 40 technical areas where warrant officers skills and experience are required; Areas of Concentration (AOCs) range from construction engineering (120A) to counterintelligence (351L), from bandmaster (420C) to signals collection (352N). Although they make up less than three percent of total Army strength, warrant officers have responsibilities that includes training and professional development of Soldiers and organizing and advising on missions.

Warrant officers are not limited to being technical experts; Army aircraft are generally piloted by warrant officers who start their training at Warrant Officer Flight Training school and then go on to more specialized flight schools. Army aircraft include rotary wing aircraft such as UH-60 Blackhawk helicopter, fixed wing aircraft such as the C-12 Huron, and unmanned aircraft.

The origins of the Army Warrant Officer Corps date to July 9, 1918, when Congress established the Army Mine Planter Service as part of the Coast Artillery Corps.

The roots of the Health Services Maintenance Officer begin in 1919 when the Army first recognized the need for a central medical repair facility. Even then, leaders in Army Medicine saw that medical equipment for both the fixed and deployable facilities was complex enough to require specialized maintainers. By 1922, the St. Louis Medical Depot under the control of the Army Surgeon General became the first Medical Maintenance Shop.
In 1943, the Army Surgeon General authorized the creation of the Medical Equipment Repairer and specialists from various maintenance-related fields made up the original staff.

The first medical maintenance repairers' course in 1947 consisted of Army, Navy, and Air Force biomedical technicians; this was one of the first programs that offered a single training platform to standardize skills across all three service branches. Cross-service cooperation remains a key focus of the 670A today.

In 1956, the Surgeon General requested that medical supply officers for Specialty Fields, such as clinical laboratory, dental, medical equipment repair, optical, and sanitation, be converted to warrant officers. From that request, the 202A Medical Equipment Repair Warrant Officer emerged.

Biomedical technician and repairer schools would be developed and expanded, and by 1982, health services maintenance technicians became designated as 670A.

Today, the 670A is responsible for managing medical maintenance requirements and execution for both the deployable and fixed medical activities. They supervise the technical and tactical performance of biomedical equipment and medical supply specialists. They lead, coach and train staff in the proper care, use, and operator maintenance of medical equipment and medical systems. If that isn't enough, the 670A also provides guidance and technical expertise to commanders and staff on all issues concerning the medical equipment lifecycle.

Once the warrant officers were just repairers; now they do entire life cycle management of medical equipment--cradle to grave. They warehouse and handle excess or obsolete equipment; administer contracts for repair of equipment; and manage maintenance shops.

Hughes discussed critical issues with medical equipment in the deployed environment. She explained that every Combatant Command is interconnected; interoperable equipment is a requirement for seamless medical transition when a patient moves from one Combatant Command to another.

"There is no time," she said, "and it is medically dangerous to be removing and changing life-supporting equipment such as ventilators and physiological monitors on an intubated patient." The patient movement equipment used by Transportation Command (TRANSCOM), for example, must be identical as that used by PACOM or any other command to maximize patient care and safety.

The level of responsibility is high. At Hughes' next assignment at Brooke Army Medical Center, she'll have team of 120 of maintainers, repairers, and other staff.

Sequera explained the approach to training begins with taking classroom skills into the field where they are honed further. "There are many experiences we gather in the organization that mature the way we think," he said. He explained that these experiences are the fundamental pillars in the curriculum for Warrant Officers Basic, Warrant Officer Advanced, and the soon to be implemented the Warrant Officer Intermediate levels of education, which he is helping to develop.

"The new curriculum explores one of the most significant challenges for our field," Sequera said, which is "implementing the network connectivity and design of the medical devices near the point of injury." The goal is to guarantee success in the operational environment and prepare future Warrant Officers to effectively provide the correct on-time advice to the Commanders.

The warrant officer has been at the spear point of change and transition as technical experts, and they have been doing it for 100 years. The role the 670A fills will continue to be important in the future, but it may be on the cusp of changes. For example, Army Medicine is addressing how to provide technical support for medics remote from any close medical support. Warrant officers will be key advisors for this sort of technical advice for the maintenance of medical equipment used by the medic far from a repair facility. Service on equipment to guarantee optimal functioning is most critical where the warfighter is most vulnerable.

The fixed facility is the location where the 670A hones his or her skills as a repairer, leader, and technical advisor. Those skills are invaluable in the deployed environment where lives are on the line. Without that additional experience to take to the deployed environment, the cost could be paid by injured or wounded Soldiers.