Over the past two decades, the Army’s Role 3 hospital centers have achieved a 98% survivability rate—the highest in the history of modern warfare. The U.S. military’s ability to deliver unmatched combat health care support is underpinned by an assurance that whenever and wherever a medic, doctor, or nurse needs medical equipment, it will be there—and it will work. Even in the most austere environments, a wounded service member has access to a fully functioning pharmacy, clinical laboratory, blood bank, radiology, emergency treatment, surgery, and physical therapy. These world-class hospitals maintain their life-saving success rate because the Army delivers on a promise that we give our Soldiers the best resources to do the job and sustain those assets throughout their life cycle. That is why the Army Medical Logistics Command (AMLC) is developing into the Army’s Life Cycle Management Command (LCMC) for medical materiel. AMLC will be involved in every phase—from developing new requirements to the divestiture or modernization of fielded materiel.
Evolution of Army Medicine
AMLC activated in 2019 as part of a series of Army-wide transitions designed to better shape the force for the future fight, including large-scale combat operations and multi-domain operations. AMLC, a subordinate command under U.S. Army Communications-Electronics Command, is responsible for delivering integrated sustainment and data management to enable health services supporting the operational Army and the joint force worldwide. AMLC joins four other Army LCMCs within Army Materiel Command focused on increasing readiness by synchronizing acquisition activities through the total life cycle. LCMCs throughout the Army strategically and operationally align structures, processes, and responsibilities of a commodity, such as Class VIII, to ensure synergy while improving the effectiveness and efficiency of all organizations involved in the sustainment of programs and equipment.
Baked In, Not Bolted On
AMLC’s core LCMC functions will include monitoring life cycle sustainment costs; maintaining accountability; and providing readiness visibility of individual items and sets; and verifying suitability, supportability, and safety for items before completing acquisition and fielding processes. A key part of LCMC success is an early and frequent collaboration with capability and medical materiel developers to integrate sustainment considerations into every step of the development process from the start. Sustainment must be baked into the process, not bolted on when the item is already in the field. To ensure early coordination, AMLC sustainment experts work directly with the materiel developers at the U.S. Army Medical Materiel Development Activity, a direct reporting unit to U.S. Army Medical Research and Development Command to help them determine how much money and resources are needed to sustain different medical devices. These include devices that require expendable items, such as tubing and pads, to complex expensive items, such as CT scanners, which require expert-level maintenance. Other sustainment considerations are repair parts, technical manuals for maintenance and repair, and training for operators and maintainers. These considerations are not unique to Class VIII. But what is different for the medical commodity is that we mainly field commercial off-the-shelf products developed and used by the private health care industry. So, the Army must compete with private industry to purchase high-demand items.
A recent example would be the pandemic response where we had to work with our prime vendors to get personal protective equipment (PPE) and medical device repair parts that were in high demand and short supply. Additionally, rapid advancements in health care often leads to challenges in obsolescence management. As medical device manufacturers update models, older versions become more difficult to maintain because of limitations in hardware parts and software updates. Medical devices deemed obsolete by a manufacturer, for example, may remain accessible to operating force units in the field. When repair parts are no longer available for device servicing from the manufacturer, an immediate solution must be found to return the device to an operational state of readiness as quickly as possible. AMLC will help find those solutions to enable operational forces’ healthcare support.
Strategy to Tactics
While AMLC will execute the overall sustainment strategy for life cycle medical materiel management, the tactical implementation will be carried out by an Integrated Logistics Support Center (ILSC) that serves as the “operational” force of the command’s sustainment mission. The ILSC organization is currently also in development and will be comprised of eight integrated teams, including:
- Analysis – Provides logistics readiness, maintenance, and sustainment data visibility. Staff members perform data analysis, assist directorate data reporting needs, support data visualization, and formulate stewardship recommendations.
- Process Standardization – Designs ILSC processes, creates desktop procedures (job aids), and supports the establishment of the Logistics Assistance Directorate.
- Product Support Integration – Manages the medical materiel life cycle and medical devices transitioning to sustainment.
- Stocked Supply Support Activity (National-Level Support) – Manages PPE/Testing and Consumable/Vaccination missions in partnership with Sierra Army Depot.
- Additive Manufacturing for Medical Devices and Repair Parts – Develops policies and procedures for identifying, managing, and controlling additive manufacturing (3D printing) device/part candidates and monitors compliance with regulatory guidelines.
- Class VIII Repair Parts Center of Technical Excellence –Develops repair-parts requirement forecast models in support of U.S. Army Medical Materiel Agency Medical Maintenance Operations Divisions (MMODs) and integrates repair parts into Global Combat Support System-Army.
- Medical Maintenance – Formalizes demand/supply planning processes and develops MMOD workload models.
- Technical Writing – Assists all ILSC workstreams to create, edit, and format documentation products, as needed, per Army regulations and guidelines.
As Army medicine continues to evolve, AMLC will bridge the gap between former operational practices and the current medical materiel support required to achieve readiness across the force. As the medical LCMC no later than 2025, AMLC will assume responsibility for all devices that Transition 2 Sustainment (T2S). Streamlined T2S processes will ensure every medical product fielded to the force can be maintained and sustained throughout its life cycle and eventually be divested. By executing the Army’s T2S plan, we will ensure that sustainment operations for medical materiel are carried out successfully, governed, and enforced. We will increase the visibility of devices across the force, boost accountability, identify obsolete items, and, ultimately, see issues coming before they pose threats to readiness. Rapid delivery of high-quality medical materiel to operating forces in the field is essential. But these solutions must be sustainable. As the LCMC for medical materiel, AMLC will synchronize with key medical materiel stakeholders and provide a foundation for sustainable medical readiness.
Col. Anthony “Tony” Nesbitt currently serves as the commander of the Army Medical Logistics Command. Nesbitt also currently serves as the Army Surgeon General Consultant for medical logistics. Academic achievements include a Bachelor of Arts in Healthcare Administration, a Master of Science in Management, and a Master of Science in Strategic Studies. He is also a graduate of the Combat Casualty Care Course, the Combined Arms Service Staff School, the Command and General Staff Course, the Medical Logistics Management Internship Program, the Joint Staff Internship, Training with Industry Fellow with the Logistics Management Institute. He is also a graduate of the U.S. Army War College.
This article was published in the Winter 2022 issue of Army Sustainment.