By Theresa Bradley

On April 8, PEO STRI activated the Joint Project Management Office for Medical Modeling and Simulation (JPMO MMS) and established a provisional program manager to oversee the office. Army Lt. Col. Chris Todd stepped into the role.

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Maj. Gen. Program Executive Officer for Simulation, Training and Instrumentation, Major General Jonathan A. Maddux (left), and Lieutenant Colonel (Promotable) Chris Todd (center) with Robert Bolluyt from the Defense Health Agency. (Photo by Doug Schaub)

The JPMO will bring standard processes, similar to other acquisition offices, to the fast growing segment of medical simulation. Chartered by the Defense Health Agency (DHA), but managed by PEO STRI, the office will be on par with counterparts, such as PM TRADE, PM ITE and PM ITTS, with the top leadership spot filled by the services on a rotating basis with a colonel or the equivalent.

The move is in response to the growing importance of medical simulations in medical training and is an effort to bring joint acquisition processes in line with DHA objectives. All services and the Veterans Health Administration currently utilize medical modeling and simulation in training, and often have similar needs, but each may fulfill those needs with different training tools and acquisition processes.

JPMO MMS is intended to:
• Support the services’ shared clinical training requirements through acquisition of medical modeling and simulation capability.
• Standardize Military Healthcare System (MHS) medical modeling and simulation capabilities and centralize life cycle management.
• Serve as the single transition office for Medical M&S Science and Technology into developing MHS programs of record for medical modeling and simulation.

Army Col. Dan Irizarry, command surgeon for PEO STRI and clinical advisor to JPMO MMS, said: “All health care facilities need to teach medical personnel skills, such as managing patients with heart attacks. Because they frequently use the same curriculum, there are opportunities to standardize training devices, such as medical manikins. This standardization can improve training outcomes and potentially reduce cost.”

The military has significantly improved battlefield casualty-survival rates, but the transition from the active battlefield to hospitals will make it difficult for medical personnel to sustain life-saving skills specific to wartime. Combat medical skills, used at the point of injury and in deployed hospitals, can only be learned through actual casualties or through simulation. Realistic medical training supported by simulation will be critical to ensuring these lessons learned are carried into future conflicts.

“By taking a more holistic approach to medical simulation requirements, JPMO will be better positioned to help the MHS and VA accomplish training goals in a more efficient and cost-effective manner,” Irizarry said.

It is not uncommon today that one military healthcare customer will purchase simulation-training tools for a requirement from one vendor, while another military customer purchases a solution from a different vendor for the same requirement. This leads to unnecessary redundancy, increased costs, and potentially diminished clinical skill. Also, because of different procurement methods in healthcare, it is likely that neither customer considered life cycle management implications for these items.

Irizarry said: “Medical simulation customers don’t typically view capability acquisition the way acquisition professionals do because that’s not the way medical procurement works. If they need something, they go to their procurement agent, and the item shows up. They don’t think about how it got there, its long-term maintenance or disposal. The JPMO MMS will bring expertise to the DHA’s medical acquisition system that addresses these shortfalls.”

The creation of the JPMO has been an evolution. It was envisioned initially by Dr. Jonathan Woodson, assistant secretary of Defense for Health Affairs, and got underway in 2013 as a joint effort between PEO STRI and the Tricare Management Agency. The office has fostered collaborative relationships that have enhanced its ability to meet the needs of the Military Healthcare System and the Veterans Health Administration. Today, the JPMO MMS engages with the Defense Health Agency, user populations, industry partners and the science and technology community. This enables the office to leverage better buying power and serve patient population more effectively.

MMAST improves training for both the Air Force and Navy.

MMAST improves training for both the Air Force and Navy.

For example, the JPMO MMS is building upon PEO STRI’s PM MEDSIM office, which currently supports the Air Force Medical Modeling and Simulation Training (AFMMAST) program and the Navy Graduate Medical Education training program. By merging and aligning solutions for two customers, the office improved performance and lowered cost for both the Navy and Air Force. For JPMO MMS, the goal remains the same: to develop and field advanced learning technologies and methodologies that improve medical education and training for healthcare teams and patients at the most affordable cost.

Waymon Armstrong, CEO of Engineering and Computer Simulations, contractor for MMAST, said: “We’ve taken advantage of the opportunities to standardize training and applied that across the Air Force and Navy, while at the same time provided flexibility to meet individual needs where that is necessary. As a joint effort, MMAST leverages economies of scale and results in an end product that meets everyone’s needs more cost effectively.”

Part-task trainer teach skills used by all branches of the military and the Veterans Health Administration.

Part-task trainer teach skills used by all branches of the military and the Veterans Health Administration.

There are many simulation products already in use by one branch that could easily extend to another. For example, two part-task trainers developed by Orlando-based SIMETRI teach universal medical skills used across the military and by the Veteran’s Health Administration. The Humeral Head Intraosseous Training System teaches medical staff how to rapidly insert fluid into the boney space in the humerus. The Venipuncture and Phlebotomy Training System allows trainees to practice drawing blood. Research and development (R&D) for both has already been funded by the Army.

Angela Alban, president of SIMETRI said, “More consistency in standards enables me, as a small business owner, to make more effective decisions about allocation of our R&D budget. We don’t want to develop two different solutions for the same training problem, even if both are good solutions, because that adds schedule and budget-cost risk.”

Armstrong and Alban see the establishment of the JPMO MMS as a positive addition to the simulation industry and the Central Florida community.

“We’re excited to have them here. The small business community supporting medical modeling and simulation consistently strives to improve quality and performance with the latest in technology. This is, of course, an ever changing and progressive landscape. A joint effort allows us to access the best of technology for all branches and the VA,” Armstrong said.

Orlando was selected to headquarter the JPMO because its status in the modeling and simulation community which includes a large number of simulation companies and military acquisition offices, as well as the host of the largest modeling, simulation and training conference in the world.

Irizarry said, “Orlando is truly the hub of simulation, and we benefit from the presence of Team Orlando. We need to stay close to industry to see what technologies are emerging.