The U.S. Department of Defense is embarking on an initiative to create a more agile and adaptable medical force. Healthcare depends on medical logistics, and military medical logistics needs to change and adapt to handle a future environment characterized by volatility, uncertainty and complexity. The intent of this initiative is to make better use of military medical facilities and assets, to deliver better treatment for service personnel, and to reduce operating costs.
In a video titled Life Saving Logistics (shown below), the Army presents ideas for transforming its medical logistics capabilities. Lieutenant General Patricia Horoho, Surgeon General and Commander, U.S. Army Medical Command, shares her vision and describes the goals of this initiative. This initiative will place urgent new demands and expectations on military medical logistics (MEDLOG) personnel, and the Army has set “an audacious goal for medical simulation and training” to develop the skill sets that will be needed.
To support this initiative SCM Globe participated as a subcontractor to IVIR Inc on a proof of concept project to develop the “Point of Injury Training System” (POINTS) for the U.S. Defense Health Agency.
A Federation of Simulations
To add a logistics dimension to other medical training simulations we connected SCM Globe with those simulations using software from Pitch Technologies. Their integration software enabled us to link into a “federation of simulations”. In this federation SCM Globe simulations provided medical logistics training, and other simulations provided training in different medical activities occurring at different locations in a unified training scenario.
Imagine a unified training scenario set in Afghanistan. Let’s begin with a scenario that covers medical activities in a surgical hospital located at Bagram Airbase just north of Kabul. And then let’s assume Bagram Airbase is the logistics hub supporting medical activities in surrounding locations that are also part of the scenario. Those locations could be a mobile field hospital and several points of injury located in a mountainous area, an open field, an urban setting, etc. A supply chain model and some of the products needed to support such a scenario are shown in the screenshot below. Facilities and vehicles in the supply chain represent other simulations in the federation. Facilities are located on the map in actual locations where different medical activities take place. Vehicles are defined with their speed and cargo characteristics, and the routes they travel to move products and patients between facilities are shown in blue (click on screenshots for larger images).
Medical logistics planners have to create supply chains that can deliver the products needed to support all the activities going on at each facility and in each vehicle. To do this they define the vehicles, the delivery routes, and delivery frequencies that bring in the types and amounts of products needed by each facility, and bring back patients to the appropriate care facility.
At the start of a training scenario, the facilities and vehicles (the other simulations in the federation) each have a set amount of products on-hand, and medical logistics people have designed a supply chain to provide them with more products to meet their demands as the scenario plays out. As activities occur in each individual simulation, their product usage and product on-hand status is communicated to SCM Globe where it is displayed in real-time (as shown in the screenshots here).
Facilities and Routes Show Where Other Simulations in the Federation Happen
Simulation results are accurate and easy to understand because map and satellite views provide organizing context within which to display lots of operating data. Each of the other simulations in the federation is represented as a facility or a vehicle in the supply chain so we can zoom in on the map and turn on the satellite view to locate those facilities and vehicle routes where they actually are in the real world, or where they could be. For instance, the surgical hospital facility is located at Bagram Airbase in the real world, so that is where we put it in the supply chain model and simulation. This is shown in the screenshot below.
The software connecting the federation of simulations makes it possible for the training scenario to combine different simulations of activities happening at each facility and in each vehicle. And the different simulations are all running at the same time (as would be the case in the real world). Since they are linked into a federation and share data with each other, if one simulation is affected by outcomes from another simulation, it can respond appropriately in real-time. This creates a training experience that views a scenario from multiple perspectives such as: emergency care at point of injury; wound care at field and surgical hospitals; and the logistics operations that support these different levels of care.
For instance, imagine the emergency medical care given at a point of injury shown in the screenshot above left, and the care given in an operating room at the surgical hospital at Bagram Airbase shown in the screenshot on the lower right. These point of injury and operating room simulations are independent simulations running in the federation of simulations. Medical caregivers work with these simulations as part of their own virtual reality medical training program. Shown in the picture above center are two medical trainees working on a virtual patient. As they work, they use products in their simulations to carry out various activities. And product usage is shared with other simulations in the federation such as SCM Globe. (screenshots and picture courtesy of SimX and Arch Virtual)
Next, suppose patients are brought into the surgical hospital from the mobile field hospital, or directly from the points of injury. The SCM Globe screenshot shows one of those routes by which patients are delivered from a point of injury to the surgical hospital. The vehicle traveling that route is defined as a HH 60 Pave Hawk helicopter (click on screenshot for larger image). You can see the helicopter drops off products it brings from the surgical hospital, and picks up patients from the point of injury location in a mountainous area.
The image of medics rushing a wounded soldier to a waiting medevac helicopter illustrates activities happening in the simulation on that vehicle as it travels its route from Bagram to the point of injury and back again. When patients are picked up products such as stretchers and other medical supplies are used to give emergency medical care on the trip back to the surgical hospital. (image courtesy of U.S. Navy and Pitch Technologies).
Integrated Real-Time Training Environment
The integration software enables SCM Globe to track product usage and on-hand product amounts in all the other simulations in the federation. SCM Globe flags and shuts down facilities or vehicles (other simulations) where critical products run out or where too much inventory accumulates.
Logistics people have to create supply chains that keep up with the needs of caregivers and patients in the other simulations. Otherwise, individual simulations will stop when they run out of products. That’s what happens in the real world. When supplies run out other activities come to a halt. (screenshot courtesy of Offworld Industries)
Logistics people can see what happened to cause the problems and look at ways to fix them. And everybody else in the training scenario can also see what happened. There’s no place to hide, but that’s what happens in the real world. People notice right away when they can’t get the stuff they need to do their jobs, and when that happens logistics always gets the blame.
This puts medical logistics people into an integrated training environment with medical caregivers performing different activities at various facilities. For logistics people these integrated simulations move their training to a more realistic, real-time experience than what was possible before. For caregivers it changes their perspective of logistics from something taken for granted to something taken seriously.
All players in these simulations coordinate with each other as needed to get things done. Everybody gets practice working as a team, and everybody benefits from the experience.
Our logistics simulations are easy to use – and they are not just for training. See how to use SCM Globe for logistics planning on real missions…
- The Syria Evacuation Scenario case study shown in this video explores logistics planning under conditions of stress and uncertainty
- See a humanitarian logistics training case study – Nepal Earthquake Disaster Response Supply Chain created with Global Logistics Cluster of World Food Program
- See other military logistics training and planning applications provided by SCM Globe