Hardware: Breakthroughs for the battlefield
MC4 telemedicine brings e-Health to the battlefield
Interview with Army Lieutenant Colonel William Geesey, product manager, MC4 EDITOR’S NOTE
Battlefield medicine has come a long, long way since the Civil War, and advanced many clicks beyond what was commonplace only 10 years ago in OIF. The U.S. Army’s Medical Communications for Combat Casualty Care (MC4) is integrating and deploying the best COTS technology available to further soldiers’ golden hour, aid in mental health, and even facilitate “remote” surgeries directed by off-site surgeons. Increasingly, MC4’s technological breakthroughs are rivaling those available to the general civilian population in America, as lumped under the latest “e-Health” buzzword. I had the privilege of speaking with Lieutenant Colonel William Geesey, product manager and “chief visionary” for MC4. Edited excerpts follow. – Chris A. Ciufo, Editor
MIL EMBEDDED: Let’s take it from the top: Where are you based, and what is MC4?
GEESEY: I’m based in Fort Detrick, Maryland, and MC4’s higher headquarters is the Program Executive Office Enterprise Information Systems (PEO EIS). MC4 fields, trains, and sustains a comprehensive medical IM/IT [Information Management/ Information Technology] system that has three primary capabilities: 1) an electronic medical record capability; 2) a medical logistics suite of applications; and 3) medi- cal surveillance and command and control. Additionally, there’s a suite of joint software applications developed by the military health system and employed by all of the services. We also have several other innovations in the works.
MIL EMBEDDED: Let’s dig a bit deeper. First, what does MC4 do, more specifically?
GEESEY: In addition to what I’ve men- tioned, we also have a responsibility to implement Army-unique requirements. One of those is the Joint Theater Trauma Registry [JTTR], a software application in which medics in-theater can capture all data available from point of injury through the evacuation chain to facilitate research on better ways to create material solutions for saving soldiers’ lives.
Another thing specifically mentioned in our ORD [Operational Requirements
Document] is telemedicine/telehealth. In the past 18 months, we had a successful demonstration of telesurgery capability in Iraq in which a general surgeon per- formed a very difficult, complicated surgical procedure and saved a patient’s life (Figure 1). This particular surgical procedure was not one the surgeon was familiar with, but was able to perform via telemedicine consultation with a CONUS [Continental United States] expert. We’ve also done some experimenting with TeleBurn, where a burn surgeon in Iraq wanted to provide consultation to other physicians with burn patients.
MIL EMBEDDED: You’ve described Army-unique requirements like the Joint Theater Trauma Registry, and also telemedicine – anything else for MC4?
GEESEY: Yes, we have something that’s really current: a pilot telebehavioral health project in Afghanistan and Iraq. MC4, PM Army Knowledge Online, the Office of the Surgeon General for the Army, and TATRC (the Telemedicine Advanced Technology Research Center) have collaborated on this project. The purpose is to develop new capabilities to improve the delivery of behavioral health services to deployed forces in Operation Enduring Freedom and Operation New Dawn.
There might be a situation, for example, in Afghanistan where soldiers are spread
18 March/April 2011 MILITARY EMBEDDED SYSTEMS
Figure 1 | Lt. Col. T. Sloane Guy IV received real-time consultation from providers at Brooke Army Medical Center (BAMC) in Fort Sam Houston, Texas, during a complex and rare surgical procedure while deployed with the 47th Combat Support Hospital in Mosul, Iraq. Photo courtesy of U.S. Army/MC4
throughout many different bases. A divisional unit in Afghanistan might have one psychiatrist assigned, who would review the types of medications soldiers might take for depression or related issues. We’ve been able to set up a teleconsultive environment where a soldier goes into a clinic at one site with a non-mental-health-care provider, say a family practice physician, and engages in a teleconsultation with a psychiatrist located elsewhere. Of course, that allows the psychiatrist to perform a greater num- ber of consults because they don’t have to travel everywhere.
MIL EMBEDDED: What’s involved in these teleconsultations, technically?
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