Army Lt. Gen. (Dr.) Ron Place, the Director of the Defense Health Agency, spoke recently about the vital role that communications and data systems can play in supporting the Military Health System.
Speaking at the annual Healthcare Information and Management Systems Society conference in Orlando, Florida, Place outlined his views on the connections between medicine, national security, and technology-driven solutions for better patient treatment.
His speech highlighted military medical education and training and ways to improve it in the future. He emphasized the essential role of unit-level medical teams across the force.
“The lives of America’s sons and daughters are saved by medics and by corpsmen,” Place affirmed.
Supporting those medical teams is a key component of medical readiness, he said.
“Readiness means you never let your guard down. You think about it. You’re prepared for the worst-case scenario so you can better prevent it from ever happening. And to do that, you demand agility from your people, from your equipment, and from your systems – and in particular your information systems from which your people rely on to make decisions.”
Place said the title of his presentation, “Clear and Present Danger: Lessons from the Military Healthcare System,” was “willfully borrowed,” from Tom Clancy’s best-selling political thriller novel.
“First, what are the clear and present dangers facing the Department of Defense, at least from my present vision within the Military Health System?” he asked. “And second, what are the solutions that I, and my colleagues, are looking for to help us best prepare to meet those challenges?”
Place drew an analogy from aviation, describing a scenario that pilots might experience while flying through a storm. He pointed to the important distinction between dangers that are present versus those that are clear.
Place pointed to the different techniques that pilots rely on to navigate their aircraft, including “Visual Flight Rules,” or VFR, which pilots use in good weather when they can clearly see the ground and other obstacles. He compared VFR to “Instrument Flight Rules,” or IFR, which is the technique pilots use in bad weather when they cannot see clearly from the cockpit and have to rely on data provided by instruments on their control panels to navigate the aircraft.
“Given a choice, most pilots will avoid that storm and choose to veer off to the right, into the clear, where they will follow the Visual Flight Rules, or VFR. Better weather, safer, more comfortable,” he said.
But sometimes that’s not an option, Place explained, and aviators might have to turn into the storm and rely on instrument flight rules. The systems and instrumentation on the aircraft help pilots when they must fly blind.
In medicine and the military, we may not always have the option to choose the safe route, he said.
“We don’t always get to choose an easier path,” Place said.
In these scenarios, mission control plays a critical role by providing a perspective that may include vital information that the flight crew cannot immediately access.
“While the air crew is performing its assessment, there may be other risk factors that would lead mission control to have them go left into that storm,” Place said.
“Mission control centers almost always have a larger view of the operating environment,” which can include key intelligence or other issues the flight crew is unaware of, he explained.
“Supervisors, leaders in the mission control center are making their own risk calculations. Of course, they factor in all the information that they are getting from the aircrew. But they are also considering all the other details that I just mentioned that the aircrew is blissfully unaware of. Mission control is connected to numerous data systems. They are, in many ways, an example of the IFR system,” he said.
Place stressed that the tools used to detect problems in the system are important but so are the people using those tools. “Individual defenders have been and will be the lynch pin to our success,” he stated.
Place explained that medical personnel must have the tools and the training needed to detect the problems in the system. “Will they know the threat when they see it? And have they been properly trained to react? Have we provided them the training, simulators, the ‘settings and repetitions’ to be ready? Have we resourced them with what they need to be a success?” he said.
“Did we give them IFR-like data coupled with VFR skills that they need? In retrospect, I think the answer is largely yes,” he said.
The solution is to be more detailed, he said. Great health care requires timely and reliable patient data. “And what we need to do better in the future is customize care recommendations for individual patients.”
Place recalled the period in 2020, early in the pandemic, when customization was not possible due to a lack of information and scientific data. Now, however, there is enough data to offer evolving treatment programs.
And to be effective, the information needs to be shared with the front-line teams. The information – and the treatments – must move at lightning speed, he said.
While good, rapid and reliable data is a key component of modern health care, Place also emphasized the human aspects of the MHS mission.
“And the other element to outstanding outcomes, is a ready medical force. This gets to the skills of our medical teams that operate alongside our line counterparts to support in unfamiliar environments.”
“We are a military health care system. And our goal is to produce medics and corpsmen who can think on their feet, take what they have learned and apply it in non-traditional settings,” he said. Good training and proper preparation will help medical teams recognize the dangers and adjust to the circumstances that they may find themselves in.
“We utilize technology to train our medical teams and to outfit our home station, and deployed hospital and clinics. That technology must be modern, secure, and connected. But the most important tool is the medic, the corpsman, stepping out into the element unafraid, with their aid bag, and the skills gained through training, and experience—the sets and reps needed to hone those skills, to fly VFR, even in the storm.”
“The moment is now to invest smartly on items that can keep soldiers, sailors, Marines, and airmen healthy and able to deploy,” he concluded.