FORT SHAFTER, Hawaii - As medical planners strategize for future large scale combat operations, the reoccurring question is, “how to increase medical capacity at point of injury?” As Army Medicine looks for new ways to expand expeditionary medical capabilities, a new paradigm involving a multidisciplinary support system may be the key to modernizing and prolonging battlefield care.
18th Medical Command (Deployment Support) Fort Shafter, Hawaii is one such unit which is addressing this challenge now by promoting the Joint Tele-Critical Care Network (JTCCN) through a proof of concept test.
JTCCN is a Department of Defense/Defense Health Agency asset that provides the joint force a virtual two way monitoring system for medical teams in deployed and contingency operations. The network is managed by Virtual Medical Center U.S. Indo-Pacific Command (INDOPACOM (VMC-IP)) located in San Diego and additional assets located at Brook Army Medical Center (BAMC) in San Antonio, Texas and Madigan Army Medical Center (MAMC) in Tacoma, WA.
The JTCCN proof of concept’s goal is to demonstrate the connections between the different care locations and demonstrate how current technologies can enable this capability. It will test the deployable Critical Care monitoring platforms and software that can be accessed virtually.
Mr. Mark Griffith, a JTCCN Nursing Supervisor explained the importance of the system, “In a conflict of the future with a peer or near peer, we may experience distributed lethality, lack of air superiority and the need for prolonged care with limited resources. Both physicians and nurses providing that critical care in an austere environment can benefit from being virtually supported by experts located just a few kilometers from Point of Injury (POI) or by subject matter experts or specialists far removed from the battle space in areas such as the JTCCN.”
One JTCCN concept design illustrates that a nurse at the VMC-IP can monitor a wounded service member over a JTCCN connection to a Tempus Pro monitor, and a neurosurgeon at MAMC can virtually walk a bedside general surgeon through a craniotomy, thus correcting the issue of not having enough staff on site.
“The concept of providing VCC support to deployed assets applies to care delivered in a multi-domain battle space including care for casualties found both at sea and ashore,” Griffith said, “In a time of limited resources and dire need, the JTCCN Team is not just an integral part of the care team, we are the ultimate critical care ‘phone-a-friend’.”
Col. Tanya Wahlberg, 18 MEDCOM (DS) Chief of Clinical Operations said, "There is a capacity lack out there for critical care in the future battle. JTCCN has the capability to mitigate this gap at Role 2 or Role 3 to care for patients and keep them alive.”
Griffith said, “The lessons learned and feedback that JTCCN/MEDCOM receives on the deployed platforms and software will ‘guide-the-change’ on how critical care support for the warfighter will be accessed and delivered during the next large scale conflict.“
Col. Wahlberg added, “Clinical Operations is working to get the right people connected to coordinate the training and testing at the tactical level. After the proof of concept, we will use that data to support requesting this capability far forward on the battlefield.”
Facilitating this type of innovative test is just one way that the 18 MEDCOM (DS) team is increasing medical capacity by innovating and experimenting with urgency and focus.
The proof of concept was tested at exercises GARUDA SHIELD in Indonesia and COBRA GOLD in Thailand in August 2021.
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18th MEDCOM’s mission: 18th MEDCOM (DS) postures and prepares Army Health System support to the Joint Force, medically sets the theater, improves medical system outcomes with allies and partners, and executes theater medical command and control to synchronize Health Systems support to Joint and Combined operations throughout the Indo-Pacific.
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