Air Force - AF/SGR - Overview
Overview: The lack of consistency and availability of medical information and lack of interoperability between information systems was identified as a serious military deficiency during the Gulf War (Operations Desert Shield/Desert Storm). The result was a mandate to establish an integrated medical information system, completely interoperable, and capable of rapid mobilization during war or peacetime, among all the military services. The Air Force Surgeon General’s Modernization Directorate was created to provide oversight, direction, policy and resources to leverage technology, science and industry to transform and modernize medical capabilities and address critical long-term challenges in support of the Air Force medical and line operations.
MELE staff manage 26 Congressional telemedicine programs for the SGR with a value of more than $100 million; develop and manage Air Force budget and planning for the telemedicine projects; provide critical support and representation on the TMIP-J software integration program; and provide security management for SGR. A sample of current AF/SGR Telemedicine projects include:
- IMITS (Integrated Medical Information Technology Systems):
- Teleradiology: transmission of digitized images over electronic networks, and diagnostic image interpretation
- Teleophthalmology: retinopathy screening
- ECMO - (Extra Corporeal Membrane Oxygenation): in-flight life support for aeromed-evac infants requiring heart-lung bypass
- Diabetes
- Telepathology
- Static imaging
- Robotic microscope
- Whole slide imaging
- Tele-echocardiology
- Rapid ID: therapeutic countermeasures for war fighters exposed to bio-threat agents
- Laser Eye: protection/detection
- Virtual Medical Trainer: internet based military virtual medical scenarios and simulations
Theater Medical Information Program (TMIP): TMIP software is a set of medical information systems used on military bases to support peacetime requirements tailored and integrated to provide automated information management support in a theater environment and deployed on Service-provided computer hardware and communications infrastructure in accordance with individual Service requirements. TMIP specifically supports the Military Health System (MHS) mission and specifically the requirement to provide, and maintain readiness to provide, medical services and support to the armed forces during military operations.
TMIP applications are currently used in 28 locations in Iraq, Kuwait and Qatar in support of combat operations. Seven major applications cover Medical Command and Control, Medical Logistics, Blood Management, Outpatient Care, Limited Inpatient Care, Aeronautical Evacuation and Patient Tracking. Additional capabilities are covered within specific modules of the major applications set.
A recent briefing to the Office of Management and Budget provide sample statistics of TMIP use in the Middle East. For the period 29 March 2005 to 11 June 2005, 5,953 patients were registered resulting in 4,800 outpatient encounters and 546 admissions. There were 10,267 inpatient and 7,113 outpatient lab tests as well as 8,157 prescriptions filled and 3,144 radiology procedures performed.
MELE provides project management and technical support to TMIP, a Defense software integration program that satisfies joint needs of Army, Navy, Marine Corps and Air Force in these areas:
- Medical Command and Control
- Patient Movement
- Medical Logistics
- Health Care Delivery
- Transferring and Sharing Medical Information
MELE Associates supports the Air Force TMIP Program Office across the entire range of life cycle of activities. Air Force requirements are validated against the current or projected capabilities of individual applications. TMIP documents are reviewed for accuracy and consistency with Air Force needs. Changes to address Air Force concerns are prepared, submitted through the change control process to the appropriate boards and tracked through the change control process.
The MELE Team supports Air Force representatives on a number of Integrated Product Teams (IPTs) where operational requirements are developed and in some instances the MELE Team serves as the Air Force voting representative. The MELE Team is responsible for analyzing the proposed recommendations, developing the Air Force position and coordinating it before each IPT meeting.
The MELE Team also supports the full cycle of testing of applications. We represent the Air Force on all key configuration management boards beginning with the Issue Review Board (IRB), the System Change Request (SCR) IPT and the Configuration Control Board (CCB). MELE is responsible for analyzing all issues presented to the IRB, the SCR IPT and the CCB, to include those identified by the other Services, for accuracy and completeness and then determining the appropriate corrective action.
The overall life cycle costs of the TMIP program is in excess of $500M. As such the TMIP program is subject to intense DOD and OMB oversight. The Air Force leadership is heavily involved in the DOD oversight process and receives periodic updates on its status. The MELE Team reviews the updates prepared by the Joint Program Office and develops recommended changes to the program direction, as appropriate. MELE supports the TMIP Program Manager during presentations to the Air Force leadership and serves as the technical expert on specific questions.
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