The Army’s response to the COVID-19 pandemic has demonstrated a very real shortfall in the Army’s ability to track medical supply visibility and readiness. The lack of end-to-end capability for Class VIII (medical) supply requisition, materiel management, distribution, and medical maintenance poses an unmitigated risk to the Army’s ability to meet the demand of large-scale combat operations (LSCO). Additionally, our inability to see, anticipate, and understand Class VIII requirements across formations masks critical vulnerabilities, choke points, and shortfalls that cause us to be reactive rather than responsive. We must address these challenges to enable future success during LSCO and in future disaster response events in our nation.Over the past few decades, medical logistics (MEDLOG) has operated from a just-in-time demand planning model in which medical professionals had access to the national catalog of medical supplies and equipment at all levels. This model worked extremely well in counterinsurgency operations that had semi-permissive environments with mature operating bases, steady operational tempo, and established contracts that enabled customized Soldier treatment. The demands of LSCO with a near-peer competitor in a multi-domain environment will fundamentally change the way we conduct decisive action tasks. This change will also test the Army’s ability to synchronize and integrate sustainment to keep pace with corps and division formations. While we have previously been able to rely on a top-down enterprise approach, the depth, breadth, lethality, and tempo of the battlefield will necessitate empowering commanders at echelon to synchronize all warfighting capabilities to position themselves to win against our adversaries. Embracing the changes required for LSCO will also improve the Army’s ability to respond to our humanitarian and homeland defense missions.What is changing? Synchronization and integration are key aspects of Army doctrine and concepts, to include the Army’s Field Manual 3-0, Operations; Army Doctrine Publication 4-0, Sustainment; and U.S. Army Training and Doctrine Command Pamphlet 525-3-1, The U.S. Army Multi-Domain Operations 2028 concept. The Army must move from stove-piped functional commodity management systems to ones that integrate, manage, and share critical information from the tactical unit to the industrial base and from the medical professional to the logistics personnel charged with distributing the critical supplies on the battlefield. This shift requires a holistic approach to supply chain management which includes developing readiness drivers for tactical medical equipment sets, implementing demand-planning factors, tracking and maintaining Class VIII in the standard sustainment resource management system, Global Combat Support System-Army (GCSS- Army). As some medical supplies have unique characteristics and special handling requirements, institutions will need to train personnel with the agility to manage specific medical supplies while also being able to harness the materiel and distribution management cap-abilities that reside in sustainment systems. This approach will give strategic planners, combat medics, and leaders a common operating picture and a shared ability to anticipate, track, and deliver critical medical supplies to enable the Army Health System to save lives, support lethality, and prevent fewer deaths on the battlefield.In late 2019, Army senior leaders made the decision to move tactical medical logistics management, including Class VIII and medical maintenance management, into GCSS-Army. This will be implemented through a phased approach. This will prepare the medical logistics community to deliver a health service capability that is responsive, capable, and efficient in meeting patient needs in LSCO. Moving to GCSS-Army will set the conditions to conduct medical supply chain management, medical asset management, medical readiness, and medical property accountability within the operating force environment.While the integration of Class VIII into GCSS-Army may simply seem like a way to improve the ‘business’ of medical logistics, in reality, this move will enable outsized battlefield effects. It will provide a single system to enable leaders on the battlefield to anticipate, allocate, and synchronize the flow of resources in support of commanders’ requirements thereby allowing leaders to quickly make better decisions. It will simplify information requirements and co-ordination lines to bring a clear and rapid understanding of what is required, when it is required, where it is required, and why it is required. It sets the stage for future improvements under the enterprise umbrella to keep combatant commanders and subordinate leaders at every echelon set for mission success. Ultimately, integration of MEDLOG into GCSS-Army ensures Class VIII is effectively delivered on the battlefield and enables providers to deliver life saving care to Soldiers in combat.As we modernize the Army, we must deliver an integrated MEDLOG supply chain from fort to foxhole that enables freedom of action and endurance. It must be responsive to a broad spectrum of missions, from strategic to tactical and humanitarian to LSCO. Integrating MEDLOG into GCSS-Army is the first step to modernizing our supply chain.--------------------Maj. Gen. Rodney Fogg, commanding general of Combined Arms Support Command, is a graduate of Quartermaster Basic and Advanced Officer Leadership Courses, Command and General Staff College, and the Army War College. He has a master's degree in logistics management from Florida Institute of Technology and a master's degree in strategic studies from the U.S. Army War College.Col. Sydney Smith currently serves as director of Fielded Forces Integration Directorate, U.S. Army Combined Arms Support Command. Smith is a graduate of Quartermaster Officer Basic Course, Combined Logistics Officer Advanced Course, Command and General Staff College, School for Advanced Military Studies, and Senior Service College. She holds a Master in Military Arts and Science from the Command and General Staff College and a Master in Resource Strategy from The Eisenhower School (formerly the Industrial College of the Armed Forces).--------------------This article was published in the October-December 2020 issue of Army Sustainment.RELATED LINKSArmy Sustainment homepageThe Current issue of Army Sustainment in pdf formatCurrent Army Sustainment Online ArticlesConnect with Army Sustainment on LinkedInConnect with Army Sustainment on Facebook