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May 15, 2006

Medical Communications for Combat Casualty Care

APL's information technology and systems engineering expertise is helping the Army implement an electronic medical record-keeping system.

A Critical Challenge

When a national television news correspondent was seriously injured in Iraq, his medical data followed him electronically from in-theater emergency treatment, to an Army hospital in Germany, to a stateside hospital. Like the troops, he and a colleague were beneficiaries of an advanced information technology/management system in use by the Army. Paper-based recordkeeping systems still predominate in America's healthcare system. For military personnel injured in combat operations, ensuring that medical records follow an individual's movement is an enormous challenge. And effective treatment of illness or injury depends on the information that these records provide. To prevent the loss of vital medical data (as in the 1990 Gulf War) and ensure continuous reach-back from the field, the military services need a reliable, effective process.

APL Systems Engineering Supporting MC4 Program

To implement a Department of Defense directive, the Army developed Medical Communications for Combat Casualty Care (MC4), an electronic medical tracking system. MC4 is an automated, digitized framework for soldier care that captures pre- and post-deployment medical histories and treatments received during deployments. The system ensures that casualty information is available, secure, and authentic—whenever and wherever needed.

APL is providing systems analysis and engineering to the Army Medical Command to address the interrelated technical requirements for operational effectiveness. The work focuses on test and evaluation for MC4 applications, interfaces, and hardware.

MC4 is a true "system of systems," combining existing and emerging functions for military and commercial off-the-shelf hardware and software. APL helped MC4 personnel identify the requirements for software applications—creating a system that flows seamlessly on a variety of hardware configurations. Using MC4 laptop computers and handheld devices, medics in the field can pass patient information to an interim theater database and beyond. APL helped transition the advanced prototype from demonstration to deployment in Operation Iraqi Freedom and in Southeast Asia.

The Army credits APL's team with providing "understandable answers to complex engineering questions."

APL tests all software updates in its Systems Evaluation Laboratory before implementation. Laboratory staff develop evaluation criteria, test plans, and procedures and make recommendations based on test results. A core element in APL's approach is a hands-on process—talking to soldiers who use the handheld computers, rugged laptops, and deployable servers that make up MC4 in the field, and translating their concerns and comments into system requirements.

MC4's suite of software, hardware, and protocols has ensured joint interface through the Theater Medical Information Program (TMIP). The Army asked APL to develop the technical requirements for an interface between MC4 and the Global Combat Support System-Army, the service's next-generation logistics tracking and management program. The success of that effort brought APL into the end-to-end systems engineering process, not only to prepare MC4 for the current operational environment but also to shape it for seamless transition into future combat systems. In addition, APL is beginning a similar program to develop the Navy's capability.

APL's Technical Direction Agent (TDA) Role

APL's early work with the MC4 project office grew into an expanded role. As the Army Medical Command's TDA for integrating MC4's capabilities, APL acts as the Army's honest broker for working with commercial developers for all of the MC4 subsystems in spiral development. APL serves as MC4's representative for commercial upgrades. APL has provided end-to-end continuity for an expanded, interconnected system that's growing exponentially. APL is totally embedded in MC4, acting as a "technical guru" to MC4 staff. That role includes serving as keeper of the project's technical history, including various configurations, and as the documentation repository for interface and engineering documentation. The Laboratory performs hands-on testing and evaluation of new products, ensuring that they work effectively and add value. Another aspect of APL's role is anticipating program needs and providing essential capabilities to meet those needs.

The TDA role originated with APL's Navy work, when the Laboratory provided critical leadership that bridged the multiplicity of organizations involved in early guided missile development. APL staff serve as advisors and consultants to government program managers, providing objective, independent recommendations to assist a sponsor's engineering and management decision-making. For MC4, that role includes systems engineering, configuration management, and developmental testing. APL has also been appointed TDA for Future Combat Systems medical recordkeeping capabilities.

Continuing Contributions

The Army's MC4 system gives physicians immediate, digital access to soldiers' medical records, not only affording better care but improving operational commanders' medical situational awareness and helping medical logisticians to resupply combat support hospitals. The complex MC4 mission requires the knowledge and skills of experts in a variety of fields. APL's systems engineering and development support is part of the Army's team effort to reach a common goal: enhance the operational viability of the MC4 system and ensure that it supports troops no matter where they serve.