Joint Medical Command and Control
Written by MAJOR GREG STAUDENMAIER AND MAJOR J.D. WHITLOCK
A COMMON OPERATING PICTURE FOR MEDICAL HOMELAND DEFENSE PLANNING AND RESPONSE.
Hurricane Katrina and Hurricane Rita are two recent examples of natural disasters that have required assistance from DoD medical assets to aid in disaster relief efforts.
Even before these natural disasters occurred, Headquarters Air Force Medical Support Agency (HQ AFMSA) and the Air Force Command and Control, Intelligence, Surveillance and Reconnaissance Center (AFC2ISRC) were working with Lockheed Martin to develop a prototype common operating picture (COP) from which medical planners at various agencies such as the Federal Emergency Management Agency (FEMA), United States Northern Command (USNORTHCOM), and military service commands of the Army, Navy and Air Force could share and collaborate in their planning and response efforts. Joint Medical Command and Control (JMCC) was originally intended for responding to natural disasters as well as chemical, biological, radiological, nuclear or high-yield explosive (CBRNE) incidents within the continental United States, Alaska and Hawaii.
The most difficult part of JMCC was not the technology itself; it was understanding the processes and requirements of the medical planners within the various agencies. The bulk of research and development time for JMCC went into meeting with military staff at Joint Task Force Civil Support, Fort Monroe, VA, and other organizations such as USNORTHCOM in Colorado Springs, CO, to document their tactics, techniques and procedures.
IMPLEMENTING CHANGE
In September 2004, company engineers teamed with HQ AFMSA and AFC2ISRC to develop the JMCC Common Operating Picture (COP) as an independent research and development (IRAD) project. The plan was to use the Global Combat Support System-Air Force (GCSS-AF) to provide the infrastructure for JMCC. GCSS-AF is the “back-end” of the Air Force Portal. Lockheed Martin is currently under contract with the Air Force to develop and support the Air Force Portal acquisition effort. The idea was to use existing government infrastructure and technology to leverage the portal’s tremendous capabilities in order to develop a new medical planning and response system.
The resulting solution is the ability to fuse relevant information from a variety of sources, such as data on available Air Force medical personnel, equipment and supplies, and civilian hospital information. This information is then aggregated and made readily accessible to medical planners within the virtual environment of the JMCC COP.
JMCC is not currently a formal DoD acquisition initiative, and there is no formal funding for the program besides the initial outlay from the GCSS-AF Program Office. The GCSS-AF acquisition manager, Lieutenant Colonel Joseph Besselman at the Electronic Systems Center, Hanscom Air Force Base, was a huge proponent for JMCC development. Besselman wanted to use JMCC to help demonstrate the remarkable capabilities of the Air Force Portal to the Air Force community. He also wanted to extend the reach of the portal beyond simply displaying useful information to actually developing a tool that the warfighter community could use for current and future operations.
Once the initial work was accomplished on JMCC, the project team began to showcase the new technology at various conferences. The reactions from the audience were overwhelmingly positive, and thus encouraged some additional development. Besselman has been very pleased with the results of this experimental development work and hopes that the project will receive external funding for further expansion within the joint medical community, and with the other servicedeveloped portals.
The beauty of JMCC is that the only requirement for access is an Air Force Portal account. JMCC is a web application that resides on GCSS-AF and is normally accessed via an internet connection to the Air Force Portal. However, it can also be fully downloaded onto a laptop computer and will continue to function after the laptop has been disconnected from the internet. Once the internet connection has been restored, the local information will be refreshed from the central database, ensuring that the most current information is available to the medical planner. Although JMCC currently operates in an unclassified environment through the Non-secure Internet Protocol Router Network (NIPRNET), the plan is to eventually have a secret version of JMCC hosted on the Secure Internet Protocol Router Network (SIPRNET) version of the Air Force Portal. This will become a necessity as the data sources become more aggregated and the nature of the data becomes more sensitive.
One very powerful element of JMCC is that data feeds can be quickly modified by Air Force Portal administrators to capture new data source requirements. An example of this might be to add a new stream of weather-related information to assist with the analysis of possible evacuee relocation areas in the event an area is projected to experience inclement weather conditions.
JMCC IN ACTION
Since JMCC has not been formally tested and is not part of a formal joint military medical acquisition program, there was a strong desire to test its operational utility. The first test of JMCC came in the aftermath of Hurricane Katrina. Medical personnel from the 106th Airlift Wing, New York Air National Guard, deployed with JMCC loaded onto their laptops. JMCC helped them respond to the aftermath of Hurricane Katrina by increasing their situational awareness of medical resources within close proximity to the disaster location.
Lessons learned from Hurricane Katrina will be vital to the future development of JMCC. Hurricane Katrina validated the requirement for medical planners to be able to efficiently work together to prepare for and respond to a natural disaster or CBRNE event, regardless of geographic location or agency affiliation. This capability will become even more important as we plan for response to other incidents such as a CBRNE event or an influenza pandemic.
FUTURE ENHANCEMENTS
Version 2.0 of JMCC is currently hosted on the Air Force Portal, and version 3.0 of JMCC is in production. The hope is to eventually test the new version of JMCC as a potential homeland defense medical command and control module of DoD’s Theater Medical Information Program (TMIP).
The JMCC team is presently working to make JMCC available through the other service’s portals, such as Army Knowledge Online (AKO) and Navy Knowledge Online (NKO). Medical planners from the other services will simply log on to their respective accounts and will be able to seamlessly access JMCC without having to establish a new account on Air Force Portal.
The key to the JMCC program is to leverage existing technologies and data sources to provide medical planners with the information they need in order to accomplish their mission. JMCC’s development team encourages collaboration with other development efforts and tries to develop a synergy from these efforts.
The JMCC development team is also currently working on enhancing the collaborative nature of the tool by introducing instant messaging, white-boarding and Voice over Internet Protocol (VoIP). The team is also looking at importing data feeds from other DoD systems, such as the Joint Warning and Reporting Network (JWARN) for CBRNE alert notifications and affected radius modeling, as well as other federal agency and service-related data feeds. The team would also like to begin incorporating medical resource information from the Army and Navy military health systems.
JMCC SOFTWARE
The JMCC application is a web-based application developed to utilize a variety of the technical services of GCSS-AF. Developed with limited or intermittent communication capabilities in mind, JMCC is delivered as an ActiveX application—able to function during intermittent connectivity conditions. JMCC aggregates data from a variety of application sources via the enterprise service bus (ESB) utilizing both modern web-service protocols as well as legacy mainframe transport protocols. JMCC access is secured via the GCSS-AF enterprise security layer. Users can log on to the application with a username/ password or CAC from both .mil and .com networks. Content delivery is accelerated via the GCSS-AF instantiation of Akamai edge server technology. JMCC also employs the use of machine learning and artificial intelligence (AI) to perform tasks that aid decision-making while using the tool. That functionality within the tool is known as the AICS—artificial intelligence cognitive services. For visualization and integration of geospatial data, the JMCC GIS component currently supports ESRI shapefile (.SHP), ArcInfo (.E00), and MapInfo (.MIF) formats. The JMCC tool allows for unlimited layers (limited virtually by machine computing capacity) for data manipulation and visualization. The geospatial visualization components of JMCC also support multiple modalities and options, including spherical and Mercator globe representation, multiple Cartesian coordinate systems compatible with domestic and foreign metrics, pan, zoom, and drilldown visual resolution to 1/1,500 of a second of an arc (1 real-world inch). JMCC complies with Department of Defense Joint Technical Architecture standards and operates on the first instantiation of the Global Information Grid Enterprise Services (GIG-ES), providing capability across each of the nine core enterprise services.
JMCC TABLETS WITH IRIDIUM/GPS
The JMCC development team is currently developing a mobile, tablet-PC-based version of the JMCC application that will provide the user not only satellite communications connectivity on the move, but also integrated GPS positioning directly into the JMCC application. This capability will not only eliminate the manual entry of location data, but will also “move” users within the application as their location changes. Carried in a JMCC-PAC (portable access console), the user has a convenient, lightweight backpack that contains the communications suite and tablet carrying case. Users can also authenticate via an integrated SmartCard (CAC) reader in the tablet. ♦