Team 6

Week 12: Last Week of Interviews!

In our last week of interviews, we presented our product for the military use case after learning that while the dual use case could be viable in the future, it would cost too much for us to deploy it in the commercial marketplace. This highlighted some other avenues for us to gather and consolidate information into our product, such as health plans like Kaiser Permanente which hold medical provider information for their own customers. Thinking through these alternate sources, we know that people generally desire sharing  medical asset information more freely than they do other kinds of data, but we need to outline strategies for obtaining data regardless- and compiling it into our product in a way that improves its accessibility compared to the way it is accessed right now. In the future it would probably be more helpful to partner with the holders of this information directly to upload it onto our source, but again we need to decide how to approach that strategically and consider if it might be possible to generate revenue from this.

Interview #1: Jennifer, Company Physician (New User)

• Jennifer graduated from SOCM in 2016 and has a medical degree from Vanderbilt University. She is currently working with Thai medics on a joint combined training exercise in Asia.
• Thoughts on acquiring users:
  • Suggests looking into consumer market for inspiration. How did Uber or Lyft or Tinder handle location services.
  • Concerned about the compliance/legal components to the app
  • Some degree of uncertainty with the app being used with untrained users. What could go wrong if used improperly?
• Fan of the concept but cautious on the widespread adoption. Considers the app useful for most medics who are willing to adopt more tech in their regimen

Interview #2: Josh, 18D (SOCM instructor) transitioned from Navy SWCC (Repeat)

• Josh has deep knowledge into the medic training schema as a SOCM instructor. He works with the foreign medics to train them on US standards.
• Thoughts on cost/resources:
  • Interested in seeing if data sources can be linked to NCBI or NIH pipeline to integrate with existing data
  • Wondering if incentivizing current vendors of 18Ds would be beneficial. Palantir is a good example of a vendor that has done it right. Partnership opportunity here.
• Hesitant to say he would believe the data without understanding a clear system of validation and quality metrics instilled that feeds back to US establishments.

Interview #3: Karl, Implementation Architect, Raytheon (Tech Expert)

• Karl is currently with Raytheon working with the small liabilities innovations group that funds small pilots for the military in ad-hoc projects.
• Thoughts on overall strategy:
  • Are there health plans or provider groups that have established systems that are willing to donate data? Suggested Kaiser Permanente as an example.
  • Concerned with issues when crowdsourcing goes wrong. Likes the concept to keep costs low but what if it goes unregulated? Could lead to massive litigation downstream
  • Would want a feature that allows one to “bookmark” certain assets that are working right or have high satisfaction ratings
• Suggests running a focus group to test the functions and really focus on “breaking” the app to anticipate potential weaknesses proactively.

Interview #4: Jon, 17 years as Special Forces Medical Sergeant and now instructor of 18D/SOIDC refresher course (Repeat)

• Can you show me how the search capability would work? Right now, I can search an area for medical assets, but can I actually search through the feedback?
• Even for deployment within the military you may need to think about some kind of knowledge management system
  • Mentioned the user profile rewards, but who would you have kind of verifying the data as you go along?
  • For starting out on the military side, would recommend just building out from the open-source information that we already use like the CDC sources
    • to provide proof of concept in this way rather than in the commercial way you need to have information on it- relying on 18D’s would take too long for small deployment

Interview #5: Xiuyuan Hao, Surgeon of international aid team in Morocco (Repeated)

• Compared with assessments made by medical faculties, the assessments made by patients (public users) are less reliable and accurate
• It’s important to make this app usable to the doctors who make the assessments.
• How to deal with the conflict assessment could be the next step.

Interview #6: Sam,

• The medical asset info is something that needs to be verified by military personnel
  • There should be an icon that shows verification by the military (other verification itself might not be considered trustworthy for our standards)
• Would like to see what the user component would look like

Interview #7: Kirk, Former 18D/JSOC Regional Team Lead

• To leverage user profiles, definitely continue using the game aspect to verify these medical assessments
  • You can allow options of contact information (like Craigslist email) if it is just for the military use case
• You may need someone monitoring the feature-based asset search because the features that matter might change every so often
  • Especially for the information on there that is crowdsourced because you want it to be the most accurate and helpful it can be
  • Standardizing the level of information that is provided (across crowdsourced and across the NGO sources) would be a step up from current sources like Lonely Planet
• Most NGOs will be open to partnerships that help spread medical information like the WHO
  • It’s a platform that will help them too
  • Purely for information sharing
  • Some NGO’s *might* not be completely ok with the military flavor, like maybe Red Cross

Interview #8, Chandler, 18D, Repeat User (haven’t spoken to since the first week)

• Thought it was a “really good idea”, had some data and security concerns about the product which was understandable because we hadn’t talked to him since January.
  • He liked the idea of open source – “hide the noise”
  • Liked that it was adaptable for his personal devices
• Tried to make an ArcGIS account just so he could mess with the application

 

Interview #9, Stephen, Retired Army Surgeon (Repeat)

• Thought it was a very cool concept and liked the user interface
• He travels a lot and would like to see the hospitals in neighboring countries

Interview #10, Dave, CSM (Repeat)

• Wants there to be upload and download capabilities with low bandwidth, still be able to use the overlay features but may be more raw data
• Huge application for this with NGOs and sees more of an advantage with on the ground use
• Rethink using ArcGIS potentially work with ATAK – He’s going to connect us in order to get the ball rolling on this
• Said people seem excited about this

This week, we were able to test our product’s value proposition with a couple of new users who hadn’t heard about what we were doing. This was a great opportunity to hear the questions they had for why we were involved and how our solution would really be different from what currently exists. Through these experiences, we were also able to see how many different resources and communities there are for Special Operations medics to join, but how they all speak to different aspects of the problems. This brings us back in a way to the first few weeks of this course, where we were still attempting to understand the different challenges that medics do face and how we could make a difference. But it also brings us forward to thinking about how we can actually deploy our product, including the costs and technical steps required- and how the level of security we need to develop Mediscope is certainly great and certainly not something we know a great deal about. We also have been thinking about how it might be beneficial to deploy the dual use public version before the military version to establish a proof of concept. This will require a different kind of marketing and fundraising, apart from small business and woman-owned businesses, as well as the various ways to obtain a contract from the government. These contracts could be completed through licensing the app as a SaaS (software as a service) category product, but there are different levels and different pricing structures to consider based on how much our product actually ends up costing to make.

Interview #1: Jon,  17 years as Special Forces Medical Sergeant and now instructor of 18D/SOIDC refresher course (New User)

• It seems simple but the ability to search this information would be so powerful- right now, the medical asset information might be “in an electronic form” like a Word doc, but a bunch of word documents in a folder is the same thing as a physical file cabinet- it just lives on a computer
• With technology (including in the military) advancing and information tools becoming specialized, it would be helpful to separate the medical information from everything else because it is a huge priority
• App is great, here are some cautions for development:
  • Information like number of beds can mean so much, and isn’t telling- but you wouldn’t know that unless you have experience as a medic (It seems like we really need to identify who can help us develop the assessment guidelines to be even more useful than what exists today)
  • User profiles or rewards for reviewers like on Yelp would be great because “you start to go and see who tends to be right”
• Suggestions of how to market the product:
  • SOMSA and other events where medics and other people involved in military medicine gather
  • Relying just on 18D’s to get this rolling is not feasible because there’s only about 3000 active duty and that’s not nearly enough to get towards building info on geographic coverage that you need

 

Interview #2: Rod, Currently SOF Medic Instructor, Retired after 20 years of experience in Iraq, Afghanistan, and Africa (New User)

• Seems like a Google Earth overlay of medical facilities
• Definitely uses apps for planning and health information (Relief Central)
• Crowdsourced info: this will be the difference between the resources we use that are out there (like Relief Central app) and what we have, and that could be useful if deployed properly
  • Key is getting verification of crowdsourced information right

Interview #3: Josh, Special Operations medic with MARSOC and 13 years of Navy experience in Middle East and Afghanistan, founded SOM+C (New User)

• Usage of NCMI for current medical planning needs- what gets addressed, what doesn’t get addressed
• Take a look at https://www.promedmail.org/aboutus/ for infectious disease information
  • Uses multiple sources of information, is free and anonymous to access, to display reports of health outbreaks and toxic emergencies for human and animal health
  • Uses a map format and helps encourage collaboration between medical personnel
• Example of a messy scenario:
  • “a host nation with 100 hospitals but all the assessments are 5 years old and only 1 is approved through tricare and 2 have a helipad and 1 is the only trauma capable for our guys in the country” —> where our product could be useful

Interview #4: Will, Special Forces PA (New User)

• CDC Website is what he uses currently
  • Thoughts on deploying the dual use scenario first and get an active user base, and then the military would really see the value in use (like how they use Google Maps or CDC Yellow Book to find the information they need right now)
  • The CDC would be big partners by providing mapping
  • From the get go you would have a huge mapping
• Need a clearer definition of:
  • “Are you still in the “good idea” phase or “how do we make it better” phase?”

Interview #5: Samuel Williston, Former 18D, Consultant @ Raytheon (Repeat)

• Sam has deep knowledge into the implementation and acquisition of military manuals from his 18D transition to an advisory role at Raytheon. He works with the ATAC test office to vet new vendors and capabilities
• Thoughts on acquiring users:
  • Suggests looking into consumer market for inspiration. Product must first be consumed before adopted.
  • Concerned about the compliance/legal components to the app
  • Some degree of uncertainty with implementing apps in a saturated mkt.
  • Interested in seeing if VC firms would invest in something that may be easily duplicated. Emphasize the “secret sauce” of the offering
  • Wondering if there there are similar services for doctors and if provider groups can be brought in to test
• Key to adoption is to have “power users” be advocates to the general success of the product. The cost to acquire these power users would be worth it since they have such lift towards general sentiment.

Interview #6: Josh Mosciwicz, 18D (SOCM instructor) transitioned from Navy SWCC (New User)

• Josh has deep knowledge into the medic training schema as a SOCM instructor. He works with the foreign medics to train them on US standards.
• Thoughts on cost/resources:
  • Suggests setting up a top user game system to reward frequent users
  • Concerned about the application of the service for all medics
  • Suggests that a pilot could be run with 18D trainees who are looking to increase their influence in the company
  • Interested in seeing if VC firms would want to invest overseas given the volatility of foreign markets
  • Wondering if incentivizing families of medics would be a good way to go. Give wife/dependants access to tools.
• Hesitant to say he would believe the data without understanding a clear system of validation and quality metrics instilled.

Interview #7: Karl Chopes, Implementation Architect, Raytheon (Tech Expert)

• Jon has deep knowledge into the development of code used for the AEGIS defense system used on DDR ships. He is currently with Raytheon working with the small liabilities innovations group that funds small pilots for the military in ad-hoc projects.
• Thoughts on cost/resources:
  • Partner with provider groups that have established systems to build off their infrastructure. Suggested Kaiser Permanente as an example.
  • Concerned about using the app in a non-secured environment. What happens if passwords or logins are compromised?
  • Reminds us to factor in maintenance and operational costs related to running an app. Software architect needed for update reboots and server refreshes. Need someone paid to handle password recovery and data backup.
  • Suggested a possible dual use would be with students studying abroad in college who look for resources and assets when injured or ill.
  • Wondering if the app can be a smaller size 50mb or less. This way it can be loaded and stored on local phones and web browsers in Humvees or other carriers easier.
• Suggests running a focus group that is representative of a particular deployment demographic to give a sense of how viable the app would be in that region.

Interview #8: Dan, Civilian EMT (Repeat)

• Certainly would use this, especially if it already has a well-populated database
• Super handy to see these things in the context of healthcare resources where if we had conflict somewhere in the last 6 hours, we may not want to go to resources there or don’t want a helicopter flying near there
• He would like access to the DOD/DOS version because of his work in conflict zones (aid groups need this access too)
• Talked about extreme sports enthusiasts being a niche segment of potential customers

Interview #9: Paul, CPT and Former Army Medic (Repeat)

• Thinks the interface is extremely well-structured
• Likes the idea of crowdsourcing information (good way to keep costs low) → definitely have to prove you can provide a solid foundation of this information refreshed regularly
• Social media portion seems confusing, what is the point? (Also not allowing him to login through Twitter function currently)

Interview #10: Justin, 18D (Repeat)

• In the user profile portion, have a way for medics to organize or ‘favorite’ assets and that way they can refer back to certain resources more customized to their personal context (area they are deployed in, resource needs)
• This is a great activation of a list of resources that is currently kept in a ‘virtual, dusty file cabinet’ — the app will allow us to do a lot more with the information that is collected
  • Definitely sees commercial value as well, loves idea of military version — “they would definitely pay money for it”

 

This week we were able to test our format of information input for Mediscope. In general, beneficiaries were excited about the format of the input. They were also enthusiastic about the idea of a game-like progression with badges or notifications to incentivize information input. Biggest concerns were around issues of security and verification of data, but they like the idea of a verification status on information of medical assets. Identified key activities include securing government subsidies or private equity funding to launch the framework of the project. We were able to identify potential key partners as well including large hospitals in operating environments, an acquisition group that created Data Miner which is currently used by Green Berets, and Spatial Networks which works with a great deal of geospatial data.

 

Interview #1: Kirk Ferguson, Former 18D/JSOC Regional Team Lead

• Says hello to Tommy!
• Strategically this product comes at perfect timing- one advantage is the widespread growth of Internet availability and usage but another is strategic regarding national security concerns
  • Return to more traditional SF missions following Iraq/Afghanistan where you never needed to really do medical planning well: this is more important than you would think
• Possible incentive for this product usage in Special Forces: Notifications or a game-like structure
  • To increase medical assessments that are actually done (not just out of immediate necessity): send an alert when you are near a clinic with 4-5 basic Y/N questions that you could fill out quickly, with the option of “Do you want to continue and complete a full medical assessment”
    • You might be able to tie in incentives to the number of assessments that are completed, or the number of clinics who are tied into this product
• Possible partner or resource: Spatial Networks, which works a lot with layout of geospatial data and guiding people through information collection per region
  • Could be useful for getting clinics involved, as well as for overall expertise- not sure if they do anything medical focused right now

Interview #2 Ethan, Cadet (New User)

• Feedback: Likes the format of the input form. Would like to see popular suppliers or most important information in a list (supplies, distance from airport/helipad).
• Enemy forces could be an addition so you can see where you wouldn’t want to fly over. Map is cluttered and would benefit from having a near me button.

Interview #3 Rose Ann, Ret. Army Reserves Nurse (Repeat)

• Need to figure out how to get past ArcGIS blocking because it’s hard to just tell what it can do from the pictures we sent.
• Information that would be helpful includes operation hours, address, phone number, names of doctors, or website. Also, knowing what services certain assets have is essential.

Interview #4, Samuel Williston, Former 18D, Consultant @ Raytheon (Repeat)

• Sam has deep knowledge into the implementation and acquisition of military manuals from his 18D transition to an advisory role at Raytheon. He works with the ATAC test office to vet new vendors and capabilities
• Thoughts on cost/resources:
  • Suggests looking into the AITI (Army Innovation and Technology Initiative) for funding and participants/resources
  • Concerned about the compliance/legal components to the app
  • Cost/benefit model not viable here because the benefit is hard to measure in the short-term
  • Interested in seeing if PE firms would mind setting up infrastructure and fund initial resources
  • Wondering if there there are similar services for doctors and if provider groups can be brought in to test
• Good start to a complex problem, will likely need to obtain extensive approval from Army legal and compliance offices before use

Interview #5, Ben Davies, 18D (retired) transitioned from BCT ranger school (New User)

• Ben has deep knowledge into the implementation and acquisition of military manuals from his 18D service. He works with the VA system to implement TriCare for all military retirees.
• Thoughts on cost/resources:
  • Suggests looking into gov’t subsidies to help fund the product. Several gov’t subsidies such as the TriCare Tech Grant to create tools to help 18Ds
  • Concerned about the application of the service for all medics
  • Cost/benefit model not viable here because the benefit is hard to measure in the short-term
  • Interested in seeing if PE firms would mind setting up infrastructure and fund initial resources
  • Wondering if incentivizing families of medics would be a good way to go. Give wife/dependants access to tools.
• Suggests a key partner would be the acquisition group that invested in Data Miner (current tool adopted by green berets) as a proof of concept

Interview #6, Jon Carpenter, Implementation Architect, Raytheon (Tech Expert)

• Jon has deep knowledge into the implementation of military software architecture. Previously he worked with the US Navy on the AEGIS defense system used on DDR ships. He is currently with Raytheon working with the small liabilities innovations group that funds small pilots for the military in ad-hoc projects.
• Thoughts on cost/resources:
  • Suggests finding a key advocate to vouch for the product. Says he’s never seen a successful pilot without a key advocate. Person must be someone of influence and doesn’t have to be military. He’s had Dr. Sanjay Gupta as advocate for a Army EHR system through partnering with CNN.
  • Concerned about the application of the service for all medics
  • Cost/benefit model not critical because implementation in a relevant environment isn’t going to require too much lift.
  • Interested in providing peripherals as hand-outs to gain users and incentivize adoption of product. Suggests giving out branded bandages, fanny packs, water bottles as peripherals
  • Wondering if the app can be a smaller size 50mb or less. This way it can be loaded and stored on local phones and web browsers in Humvees or other carriers easier.
• Suggests a key partner would be large hospital systems in the area that have large patient base. This way it can be validated and tested on wide range of civilians without needing to involve and incentivize many military. Civilians are easier to incentivize.

Interview #7 Jeremy, Captain (New User)

• Senior leadership within AFRICOM said that his job does so many things that are classified and real world missions so could not share information in an open source manner.
• Indicated that the medical information we’re working with could be classified to a difficult extent during product development.

Interview #8 Shengquan Zhang, Medical Insurance Analyst  of CCT in Morocco (Repeat)

• The percentage of resident who own the smartphone is about 70%.
• Except for private users, many institutions are also interested in the updated medical information in Morocco, such as homecare companies

Interview #9 Liz, Captain (Repeat)

• “The progress on the user form for putting in medical information is HUGE! I love it.” Emphasizes that the user component of the app should be expanded on further with points or some kind of acclamation given to users when they put in information that is verified and up-to-date.
• Emphasis on visual aspect of the user component of the app
• Color code users based on how many assets they have verified

Interview #10 Chris, Former 18D Medic (New user)

• This is “a very logical solution in this day and age to a problem like this one”
• Can user profiles be differentiated based on whether a person is a private citizen, military officer, hospital, NGO, etc? (The military officer ID should only show up for the “mil-ium” version of the app of course). This will help understand the context of information for military officers making plans.
• Can’t access map yet because it was blocked but make sure to be able to move around map with ease

One of the important hypotheses we tested this week was the concept that we can build this data input to accommodate all users. This was an important hypothesis to test because we have kind of determined that the most valuable way of using this product would be to extend it to all users. We wanted to describe how we can regulate it, and understand if our current interface prototypes address those needs- and especially understand if beneficiaries like our “Freemium” idea. So we heard that idea basically answered questions of access for our beneficiaries, and they were happy we had thought through the issues of security and classification. Next steps on that would focus on how the data is stored on a tech level, and deciding to delineate user input based on features of medical facilities rather than users themselves.

 

We also got a better understanding of concerns medical planners might have with our product, in that we tested if it would be valuable for users to be able to access data input right after they finish a medical facility assessment. Planners may feel that information needs to be vetted- so we need to reconcile with the fact that we cannot cover all aspects of the medical planning process, but at least we can make the information gathering easier from an unclassified standpoint.

 

For deployment, we are considering creating some testing with North Carolina facilities for users to test during training in a low-risk environment, and then slowly releasing it to Special Forces groups that can add info and bring back updated versions as they return. These would be possible deployment options to explore, based on tech readiness levels. Though with our product all of the components do exist from a technology standpoint, such as location services, cloud data storage, etc, we would need to build the app so that these parts all come together seamlessly. That integration is the major technological challenge.

 

Interview #1: Eric, 18D (New User)

 

• Product would help refine processes and consolidate information that would normally take “an extraordinary amount of time and effort to consolidate” because while it is reported post-mission, it is difficult to access or find across multiple sources
  • The way it works right now, you complete a medical assessment and submit it in X form post deployment and it’s basically an input system only- no one knows where that information goes
  • Part of the problem is that the information is stored by agencies (like the Defense Health Agency) whose whole job is to manage that information, so they have never felt the need to simplify user interfaces for accessing it- no one outside the organization has success using it
  • Example: Like if someone’s entire job was to surf the internet, the army would have Internet Explorer as a career field, whereas we use it as a tool, it’s someone’s 9-5 so you can imagine how complex it could be to explore the internet if that was a job in itself,
• Would suggest expanding usage to NGOs, private companies, State Department, etc. both to cast widest net of input for that refresh and to mask metadata of input
  • Include not just medical capabilities but also info on each asset’s previous records of success working with local populations- things like how many patients they see per period of time, etc.
• Organizationally – the DoD is very protective about health information, who can input it, who can access it, who possess it etc…. so it will need to work within our current permission protocols
  • Authenticity measures, SIPR servers, etc. for tech readiness considerations

 

Interview #2: Darrell, PA (Repeat)

• Biggest concern is how we would populate this information and feed this database, and then how it would be maintained to have regular information
  • Likes the Freemium solution for classified versus unclassified kind of information, and being able to build something like that definitely mitigates a lot of the geo-based risks associated with medical information
  • Going through the interface, he can see a lot of value in this product being easy to populate the information and returning that information output back to the users much more quickly
• Traditionally, medical information has always been sensitive and on a need-to-know kind of basis, like with the forms you mentioned- an 18D might go through all the work of filling out an assessment, submit it, and because their deployments are short, never see it again
  • Involves Environmental Service Officers (preventive medicine or force protection)
  • The assessment form is evaluated at a higher headquarters level to look for completeness and presence of appropriate information
  • Then it is “put into a couple different systems” on the secret side
  • Knows this process works and at some point the information becomes searchable on JRAMP- but it takes several months
• Could definitely be useful in environments other than austere like in Africa
  • Based on his past experience, places like Kosovo where they relied heavily on civilian medical assets for specialty evaluations, etc. even in the conventional army

 

Interview #3: Dr. Yang (Repeat)

• 20$ for one assessment will be a huge incentive for updating information of healthcare facility, especially for individuals.
• Technical training and supports could be more attractive to those managers of clinics.

Interview #4: Mark Thomas, Librarian for GIS, Economics, Maps, & Geography (Tech Expert)

• Helped with the visualization of the map we have so far, discussed how to make it search just one country and gave several resources to use for political boundaries
• Showed how to join attribute data and add columns within the dataset more specific to hospitals (beds, surgery, emergency, etc.)

 

Interview #5: Rickardo, Former Medical Logistics Officer (New User)

• Told us that the medical brigade puts together a plan, briefs it, and provides oversight of the plan
• Not a need for our product because there is a Combat Service Support Plan so all medical echelons of care are planned

Interview #6, Samuel Williston, Former 18D, Consultant @ Raytheon (New User)

• Sam has deep knowledge into the implementation and acquisition of military manuals from his 18D transition to an advisory role at Raytheon. He works with the ATAC test office to vet new vendors and capabilities
• His insights on the MVP:
  • Enjoys the visual interface but feels icons can be cluttered when zoomed far out
  • Concerned about the compliance/legal components to the app
  • How can I trust the same asset will be there when I return?
  • Interested in seeing if there can be a rating system implemented instead of a yes/no appraisal
  • Wondering if there is a fail-safe if data is wrong or corrupt
• Good start to a complex problem, will likely need to obtain extensive approval from Army legal and compliance offices before use

Interview #7, William Dahl, 18D transitioned from BCT ranger school (Repeat)

• William has graduated the Special Operations Combat Medic (SOCM) program in June 2013 as part of pipeline to become a Ranger Medic. This is a condensed evaluation of the course to give any other Rangers an insight into what to expect.
• His insights on the MVP:
  • Asks if it is allowed to pay $ incentive to active users. Unsure if other 18Ds have received a $ incentive before
  • Interested in seeing if this works in enemy territories
  • Wondering if there is a fail-safe if data is wrong or corrupt?
  • Considers this tool as a “supplementary” feature as opposed to critical to mission success
• Good start to a complex problem but only valuable if good in enemy zones
• Wouldn’t use it himself until it’s been thoroughly tested

Interview #8, Robert Washington, Implementation Architect, Raytheon (Tech Expert)

• Larry was formally a engineer at Google Innovations working primarily on the deployment of autonomous car sensors before switching to defense and helping hte DoD design the data transfer protocols for military innovative projects. His most recent project has been implementing a pilot data transfer protocol on creating a system to help the F-35 fighter transfer sensor data back to mission control in a real-time manner.
• His insights on the MVP:
  • Love the use of location services (says that is next step for military)
  • How does this data get updated?
  • How can I trust another user will use it the way I want it to?
  • Interested in seeing if implementing a pilot of the service on a broader set of Army medics might make more sense. Test reach rate and general approval of tech before drilling into specific set of beneficiaries.
  • Interested in seeing if data inputted can be on a “delayed” refresh meaning there is a 3-5 day delay in uploading data points so they can be verified and vetted before someone accidentally uses a false/unproven medical asset.
• Wants to see if the infrastructure of this database can be combined with existing military systems. Might be lower barrier of entry if it can be interoperable with current tech.

Interview #9, General John Kelly, Retired US Marine Corps General and Former Chief of Staff, Raytheon (New User)

• Very excited by this question: “these are the best questions I’ve heard tonight”
• Deployment: effective deployment in the military means implementing it into our training mechanisms → tools for information management need to become part of the learning process for new, young military recruits
• If you are open sourcing this, the guard against security threats needs to be strong, especially because medical asset information is highly sensitive
  • How can you make sure updates are uncompromised and accurate? I like the idea of having another version for military men specifically that draws from and focuses on verification of all information, just think about who would be in charge of that verification process and how often they could do that job.
    • Every few months of refreshed data seems like a reasonable goal (and helpful timespan for military forces)

Interview #10, Kevin Schwartz, SOFAC Instructor, (Repeat)

• Gave us a new (pay) site: Travax that has good information but said the resources we’re using are similar if not the same ones that they use
• Doesn’t want it to turn into a “Wikipedia”, so want to make sure there’s a verification process
• Absolutely would use it and it wouldn’t be a problem to get it into a training or present it to a few people (More of a casual encounter – roundtable discussion where there’s education and training with open dialogue)
• Possible to update via military but really the only incentive would be to make sure that it needs to be as easy as possible – like the map function on iPhone

This week, we were able to make some progress technologically, as well as test the product and gather feedback from old and new beneficiaries (within the same beneficiary group of 18D’s). Using Overpass Turbo, a suggestion from one of our tech expert interviewees, and converting those open searches to ArcGIS, we were able to show beneficiaries how we might complete a search for medical facilities, using Morocco as an example. Showing them actively through a screen share during interviews proved to be more effective in clarifying the product’s function than just showing a video of the prototype. Through this, we also received many common suggestions on features beneficiaries would like to see, primarily photo capabilities and a “last verified” date for the information.

 

We also explored another complication this week in the current medical planning process we hope to alleviate: the sheer number of medical planning resources that 18D’s use, ranging from the National Center for Medical Intelligence to Google searches. We also found that there are also some classified resources, so ideally we would want our product to consolidate at least all unclassified medical asset information. Through this work we found that one possible saboteur could be groups of planners within the Defense Health Agency, whose roles are to identify gaps in military medical resources. It’s possible that they have begun similar projects and, as our mentor suggested, feel that we are overlapping with their jobs- we are planning to speak to DHA members next week though, hear feedback, and engage in discussion.

 

Interview #1: Rick Hines, Currently Medical Instructor SFMS Refresher and Retired 18D

• Loves the idea of the product- one issue with the current forms is that if 18D’s don’t know a field to fill out or if it isn’t relevant, they may not submit the information at all- but if you can “skip” a question when filling out information on your assessment, it will make it even easier to keep it updated
• If kept classified just for 18D’s or within the military, you could add a way to contact whoever updated the information to talk to them directly about a clinic’s capabilities
• But he sees benefits with making it open to the public- imagines it like Wikipedia where information would be updated enough to be generally accurate over time
• Product could also be helpful in finding doctors for certain procedures- more specifically:
  • He is, as an 18D, trained to do anesthesia and surgery but if he can find someone who does that regularly, lose limb, etc. then he will pull out all the stops to go to nearest clinic and find any qualified assistance before attempting complicated procedures

Interview #2: Chris, 18D (Repeat)

• Over time, with a couple of iterations, this could become the primary tool for medical planning, apart from the classified assets that he uses for planning purposes; he would still call the clinics in the area to “verify” the information but he would not have to look at 10 different databases
• Google Maps satellite map interface would be most intuitive to use, especially if you could zoom in to an area that shows clinics maybe across the border that are easier to get to; if you could also look at the map and have icons for Role 1, 2, 3 facilities that would be helpful
• Shared story of treating 2 men who were hurt in a sandstorm and had broken pelvises and desperately needed blood- they did a walking blood bank within their camp but eventually decided to use blood from a local clinic because it was a life or death situation
• This product could help you make those decisions by seeing proximity and resource availability for all kinds of medical situations that you can’t specifically detail on a medical plan- particularly if you can offload the maps

Interview #3, Dennis Jarema, Former 18D and current Assistant Deputy Director SOCM

• Hosts the prolonged field care podcast and has a deep interest in all things medical care in austere environments
• Some things to think about with the MVP:
  • Transferability of criteria of civilian hospitals to military medical assets and how they align when searching for a medical asset
  • Possibility of saving your progress when adding clinics- might be useful in environments when you can’t finish a full assessment, but you want to put in any information on a clinic that you did see
  • Be careful about adding options to upload photos, and make sure faces aren’t shown
  • These concerns suggest it might be best to do a limited release to military users first
• Good concept but there are some challenges to getting it regularly used in the military, ex. Many teams working on the same issue, like his efforts with the PFC resources
• Value in use because the drudgery of filling out these forms on what 18D’s saw on a mission; many will say “I didn’t see anything” just because the forms are such a pain and this would really make it a lot easier
  • They want to share that info but it’s just kind of hard to do so right now

Interview #4, Benjamin Schwartz, Director of Content at Tesla Government Inc.

• Overpass turbo allows you to pull from open strings and Wikimaps and pull data sets from there using Python- provided step-by-step tips on how to create these for an area
• Dig deeper to find what military technology and software we would have access to for this project specifically
• To keep your customers using the product, need to consider how it will be integrated into their daily workflow and how it will be an easy thing to use- not just make things easier
• Getting as much feedback as possible will really shape product to where it’s really good- think about how you want to keep testing with a more advanced product each week and who you want to test with

Interview #5, JJ, 18F

• If this product is deployed in a constantly changing operational environment like Africa, it could be really helpful, if it is regularly updated
• ArcGIS is used by the military so that would be a good way to compile geospatial data
• Suggested several improvements and features to make the product easier to use, like hovering over a symbol could show the full information, and differentiating between pharmacies, clinics, hospitals, etc. easily

Interview #6, CPT Liz, Air Force ER DIrector

• Integrating into training is essential for implanting such a technology and ensuring it is used
• If open sourcing information on facilities and their assets, maybe a useful feature could be having information that is reviewed and identified as being correct starred (a review mechanism of sorts is absolutely necessary if you open source)
• Information should include medical services offered and type of medicine practiced

Interview #7, Xiuyuan Hao, Medical Aid team in Morocco

• Ground Ambulance Services are available in city area. The time for an ambulance to reach to an rural area could be 1-2 hrs
• Air Ambulance is a new program for emergency launched by the government
• There are also some commercial companies providing this service, but mostly for prolonged medical care transferring
• International medical aid teams have better medical capabilities but is harder to assess and update

Interview #8, Jonathan, Former 18D and military consultant for SOCM training AIT group

• Jonathan has deep knowledge into the implementation and acquisition of military manuals and protocol for AIT Advanced Individual Training (AIT) at Fort Sam Houston to obtain their 68-Whiskey Military Occupational Speciality (MOS) and Airborne School at Fort Benning.
• His insights on the MVP:
  • Love the visual interface
  • How are these assets vetted?
  • How can I trust the same asset will be there when I return?
  • Interested in testing it on his former SOCM trainees
  • Wondering if there is a fail-safe if data is wrong or corrupt
• Good start to a complex problem, will likely need testing before 18D’s can use reliably

Interview #9, William, Current 18D transitioned from BCT ranger medic school

• Graduated the Special Operations Combat Medic (SOCM) program in June 2013 as part of pipeline to become a Ranger Medic. This is a condensed evaluation of the course to give any other Rangers an insight into what to expect.
• His insights on the MVP:
  • How much would this cost?
  • Interested in seeing if this works in enemy territories
  • Wondering if there is a fail-safe if data is wrong or corrupt?
  • Interested in seeing if existing tech can be used to boost the MVP potential. Used example of AirBnB and Uber.
• Good start to a complex problem but only valuable if good in enemy zones
• Wouldn’t use it himself until it’s been thoroughly tested

Interview #10, Larry Mills, Just retired 18D transitioned from Navy SWCC medic

• Larry was formally a Navy SWCC after-SOCM and transitioned to a different environment entirely. Says 18Ds mission quite physical. As a SOCM you are considered a mid-level provider. He cites his mixed feelings about the steep learning curve that really never ends as an 18D.
• His insights on the MVP:
  • Love the use of mapping to chart the assets
  • How does this data get updated?
  • How can I trust another 18D will use it in the right way?
  • Interested in seeing if this works in enemy territories
  • Interested in seeing if it would work with the 18D ‘battle buddy’. These are partner medics who may not be as trained as you. This was especially difficult for some new 18Ds who transitioned from civilian careers as a Registered Nurse.
• Wants to see if this can be vetted with other branches such as Air Force or Navy where land isn’t the only arena of battle. Where would I find a pharmacy in the middle of the Indian Ocean? Islands? How does that work?

Week 7: Mission Achievement

 

This week we wanted to make sure that we were headed in the right direction and continued to ask our target beneficiaries, 18D’s, about our MVP. We were even able to show the MVP to an 18D in person this past weekend. The responses to the MVP were great ranging from they would absolutely use it or it would make their process of evaluating medical assets so much easier. One quote was “I think what you have is going to be a very simple but effective fix to a problem we have”. This app could solve many problems from minimized work hours to the larger equipment problem. In terms of mission achievement, 18D’s reported it takes them days to come up with a medical plan for these operations and the medical slide has to be presented to the commander before going on a mission. Instead of going through old paperwork, and many do not, 18D’s can look through this app and immediately translate it into the mission. The app can also improve the larger equipment problem because 18D’s can see the equipment available in the region and go without packing it. In terms of access to the app, we still want to make it open source with a veritability option. Our main goals of this MVP is for 18D’s to have easy access to medical asset information and easier collaboration and information flow with medical planners and commanders. We will also address how we are adapting to feedback from 18D’s in our presentation.

 

Interview 1: CPT Stephen, Battalion PA

• Spoke about this web portal where medical reports would go and it was a shared website for everyone to pull information. However, it was deleted because the person who made it left. This was pretty helpful, but not there anymore.
• A different thing: MEDSOC is a medical operating document that is supposed to have every medical asset on the ground. It only has US assets on the ground. No communication between NGOs and US military. Also, it didn’t have any information on local national capabilities.

 

Interview 2: CPT James, Former Alpha on JED, Current Student at Fuqua

• Talked about Palantir-Gotham which is a live time track of where everyone is in a general area (this was a new software we were unfamiliar with).
• Likes the idea of it being open sourced but there are some dangers with that – who runs it?
• Said it would be great for planning purposes for every team.  All medical planning is deferred to 18D.

 

Interview 3: CPT Chris, First Group 18D

• Talked about SODARS which are medical assessments filled out after a trip. They break down everything from where the team stays and lives to partner forces they worked with. However, he never used it and said that people usually want to figure it out for themselves.
• Feedback on MVP: Said he would 100% absolutely use it. Capabilities is the biggest issue and finding the next best place to go. One of the biggest tasks is going back to assets and validating that this information is still correct. Talked about if we incorporated with telemedicine, would be great.

 

Interview 4: Paul Loos,

• Incentivizes the 18D’s who don’t usually keep this information updated because this app makes it so much easier.
• Sometimes the same clinic is evaluated by multiple 18D’s or teams so the head of surgery or doctors in those clinics become frustrated they see guys in uniform every few months. If there was a way to share this information so it wasn’t always questioned, it eliminates potential of damage to relationships.

 

Interview 5: SGT Conner, 18D

• Building trust through efficiency will be key. Show me how I can trust a serviceman/woman’s life with this resource.
• Accuracy will be the easy-to-understand way to build trust with me. This can decrease inaccurate diagnoses, reduce prescription errors and eliminate many other confusing scenarios. Accuracy also avoids medical malpractice, which is always desirable.
• My favorite part about the app is the promise of convenience. I want it accurate and efficient, but to have it available right at their fingertips….wow. No longer do they have to travel, search through huge textbooks or run back and forth from patients to computers to access data.

 

Interview 6: Kevin Iskra, 18D

• This kind of app makes medical planning much easier because of how easy it is for information to become outdated. The process for verifying medical assets before deployment is very lengthy.
• The app should have a filter that includes helipad (and other helicopter landing zone locations, i.e. soccer fields) because a huge issue with evacuation is transportation to facilities. Have capability to charter a private helicopter — just need to know where they can land it.

 

Interview 7: CPT Liz, Special Forces Surgical Team, Air Force ER Doctor

• This kind of technology has the potential to vastly improve information management which is extremely slow running in the military. Just need to be able to trust it is current and accurate.
• Security concerns with open-sourcing: minimal, although there should maybe be a barrier to posting information (outsourced verification?) to again keep it accurate. Verification of assets is what takes a long time on medical planning side— so this is crucial.

 

Interview 8: CPT Bauer, 18D, SOCM instructor

• The benefits of this technology are quite impressive. I’d want to volunteer my trainees to be end-user testers of this product in a pilot controlled and small setting first before trying it overseas.
• It would incentivize me to update/contribute data to the database if we could somehow get priority treatment or status at the hospitals/clinics/resources that I endorse. Can my patients be seen faster there? That would be great for us.

 

Interview 9: CPT Sichel, 18D

• It would incentivize me to keep the data refreshed in the app if I saw the difference it made if I did so. Show me how a pilot is working well and what benefits I would see with the updated data. That is all it would take to win me over.
• This app would be a homerun tool if it were translatable to several languages so that we can use it as a training tool with our joint allies. Many of their medics speak only broken English and this would bridge cultural and language gaps.

 

Interview 10: Sean Harrison, CEO of Wizeview

• It would be more competitive if you can add AI on the dual-use of MVP
• The average cost of develop AI could under 30,000 dollar based on a open source service.

 

This week, the team spent some time talking to course advisors to gather feedback on our progress. We had been a little concerned about whether the product was technologically feasible, as well as if we were making progress at the right pace- should we have something developed at this point, and other similar questions had popped up. But in hearing from advisors, it seems like our work in identifying if information gaps on medical assets is a core problem plays a significant role in the timeline of product development. We also heard that it would be helpful to develop some sort of prototype, like a user interface screen, to continue testing with beneficiaries, as something visual would help them understand what we are thinking about as well. This week, we asked beneficiaries questions on how important usability with partner forces was, as well as offloading capabilities, and found that yes, both parts would be ideal.

 

Here is our current MVP below- we plan to continue testing it out with more beneficiary-focused interviews next week.

Interview #1: Dillon Buckner, Course Advisor

• Often the military has a lot of information that may not be communicated clearly due to access restrictions or changing needs of data, so when investigating similar product(s) that already exist, try to think about all the ways the information from those similar products isn’t getting to the end user
• To hear more specifically from your beneficiaries about their daily lives and responsibilities, try to understand their group’s mission as much as possible
• Then, in these interviews, you can show them what you know- which will help them open up to you more about the challenges they have or the feedback on your product

 

Interview #2: Xinwen Zhang, General Surgeon in Algeria

• Even in smaller cities, they have capabilities to address local diseases like malaria- and you will be able to trust them because these clinics/assets know how to deal with these diseases
• The medical resources allocate regionally, according to the population and economy, so large national hospitals only exist in the big cities.
• Some epidemic disease such as Brain Malaria may cause to death

 

Interview #3 Kevin Iskra, Former 18D

• Since a big issue is information gaps over situations that develop and change rapidly, the product will need to address that and update information just as quickly to really add value
• He would use this product in austere environments, if it did have regular information updates and could operate offline
• Think about how this could help build relationships with local partners- often, they rely on money to get information
• In planning for med evac, one challenge is communication with partners outside of the US military, so if this product could help streamline that chain of command it would save a lot of time/effort

 

Interview #4 Jon Andrews, Former 18D

• Information management is the biggest issue with technological adaptation in military
• Knowing there is a higher purpose that my adapting will serve helps me do things I don’t necessarily agree with/want to do
• Communication is absolutely necessary with partner forces –– they don’t have prior knowledge of our work and what we can share is very limited by bureaucratic processes (any app should must work around that)

 

Interview #5: Yuyun Yang, Emergent Surgeon in Algeria

• Pre-communication of Medic evaluation could save half hour for repetitive work
• Mutant Malaria could be difficult to diagnose even with pre-communication efforts, so time is very important
• Could not communicate with English but French- highlighting importance of additional languages or easy-to-understand pictures in the product

 

Interview #6: Dr. Jared Dunnmon, Course Advisor

• Use the progress you have made so far to make a prototype to show beneficiaries- but you don’t need to have a finished, tangible product by the end
• When you’ve identified a key core problem, you are more than halfway to the solution
• With the product idea here, definitely doable from a technology standpoint, especially if something similar exists in the military system that you can improve or build on
• Think about product life beyond the initial data scraping though- are there other ways to maintain it in addition to medics inputting information?

 

Interview #7: J.R. Caldwell, Civil Affairs Officer

• When gathering medical information (i.e. for clinic assessment forms) you want to be inconspicuous, so think about that in product development
• Think about adding a method to take pictures within the app- adds lot of value
• Differences in medical information Civil Affairs might collect or value versus an 18D

 

Interview #8: Connor, 18D

• Key role players in arranging for a med evac are: lead medic, asst. lead, platoon physician, SOFACCs, JCET medics
• How can you get buy-in on this product and improve it so that it won’t take 10 years+ as usual military innovation does to get people using it?
• Maybe running it or testing it in civilian usages before using it in the military because that helps speed up the process by half

 

Interview #9: Samuel, 18D

• Interface looks nice and ties in with what gaps in information we might have on medical assets but you may want to test in civilian settings first
• Think about how it might work with partner forces though, because a lot of what SF medics and SF missions deal with is building relationships with partner forces
• Maybe these partner forces would be better at gathering information on medical assets because they are from that place, but they would need language capabilities or images to best input that information

 

Interview #10: Leo MacKay, SVP at Lockheed Martin

• Preparing for military operations inherently introduces a dual-use system of products
• Even in the processes, systems, and logistics you can get dual-use whether it’s planned or not, but one example of planned systems is disaster relief
• It makes sense then to deploy certain technologies and innovations through the military because you know they will be maintained and they will be used (vs. Dept of State)
• Dual Use and two sets of purpose- you need to consider that when you think about the size of the DoD budget and how that dual-use benefit is almost intangible with innovation that comes from or works with military needs

 

The biggest lesson for us from this week is that information on medical evacuation and procedures to access it exist — but the root of the problem is how to organize & update information so that it is actually used in a way that cuts down on-the-field med evac logistics planning time. Our interviewees shed some light on it below:

 

1. Ron Aplin, Technical Liaison at Teleflex Inc.

Provided an experience-based perspective on designing and bringing to market medical products for use by military beneficiaries

• Whenever you are designing products for military beneficiaries, you need to try your best to relive their daily lives because it’s so different from product design in civilian world
• Example is sterilized equipment- put a lot of effort into that for civilian medical products but you see that for medical equipment in the military, soldiers will strip off all the packaging and toss it into their bags
• 3F’s: Form, Fit, and Function and consequences of not fulfilling that
• The worst case scenarios are hearing customer complaints from military customers because of the heightened circumstances in which your product failed

 

2. Estban Barfknekt, Sergeant First Class

Medical evacuation is a complicated, multi-step process but the toughest part is working with local facilities in austere environments.

• Go to a hospital and they don’t trust you because you don’t have the “Doctor” title in front of your name, don’t understand your capabilities, don’t trust US military
• In the field planning (contingencies/surprises) done by putting in information requests with JMRC: Joint Multinational Readiness Center where all info of regional resources is aggregated
  • When this isn’t enough, next step is contacting US embassies or in-person scoping out
• Medic training is needed to provide quality of life care (beyond just maintaining a life) for lower level officers

 

3. Ham, Sergeant First Class

Discussed how important a higher level of care is when the medic has done all they can do.

• “We always look into certain areas where there’s medical clinics, do follow-ons with other teams, when we’re replacing teams, we have a hospital or clinic here” – Discussed the importance of going out and talking to local medical personnel and how visiting these clinics and hospitals and providing them with some assistance goes a long way.
• Medics never stop being medics.
• Going out to clinics is one of the most time consuming ventures

 

4. CPT Joe

Brought up a great point about not being able to access medical evacuation or medical facilities while in enemy territory.

• From an 18A’s perspective, a medic’s main role is knowing how to deal with a casualty and the 18A needs to make sure the medic saves that person’s life. Second job of a medic is to teach partner forces how they deal with injuries and illnesses.
• From an 18A perspective, by spending time on setup (3-4 hours for basic medical equipment to 8 hours for something more extensive), they are giving up doing assessments on partner forces or training partner forces.

 

5. Stephen, Ret. Army Surgeon

Discussed his experience in Vietnam working as an army surgeon in three different capacities.

• No road and no boats and therefore had to always take the helicopter 30-50 miles from the next highest levels of care, making it difficult when weather conditions were bad
• Transportation was very important; when you’re thinking about major trauma, need to consider the “golden hour” and getting the patient to the right facility within an hour can save the patient
• Major injuries require a team approach, cannot rely on just one doctor and it can take 16 hours to get a seriously injured patient stabilized

 

6. Rose Ann, Ret. Army Reserves Nurse

Discussed how she would set up and take down a “blow-up hospital” every weekend and how difficult it is for one person to do alone.

• Set-up of mobile hospitals would take 4-5 hours, unload all the cases and it would be ready to set up patients – super heavy material, huge wooden boxes, used a large area of land to set up. Everyone kind of knew where everything was supposed to go – no plan.
• 4-5 hours again to take down, wasn’t part of repacking or loading up but said it probably also took hours. However, this set-up and take-down took about the whole company – 50 people.

 

7. Darrell Owens, PA

Discussed a similar product: JRAMP, that exists using a Google Earth overlay, however this product is classified, unsure of its accessibility/efficiency

• The medical planner is responsible for the logistics organization of med evac and keep what is essentially a spreadsheet of contacts of all US medical personnel and those of partner forces (usually French in regions like Africa)
• JRAMP has to be updated through chain of command, lengthy process

 

8. Jarred Coughlin, 18D MarSOC SOCM trainee IP SO

Planning logistics alongside providing medical care is cumbersome. An app to access evacuation database could ease the process of making plans when new situations arise

• Wishes usually to have done better job with diagnosis and documentation after patient is moved to higher care
• Medical decision making time is slowed down when logistics have to be organized/approved
• Data security is a concern for the training period of implementing such a device  

 

9. Rosie Chamberlain, 18D SOCM trainee TIP SO

Evacuation app could help with documentation, but could take away more time from medical care instead of giving more time for it?

• Documentation is a big problem in a time of chaos and confusion
• In general, are carrying 70-90 lbs of gear so any solution needs to be light and easily transported

 

10. Esteban Ruiz Sarc, Navy SWCC SOCM Medic

Provided insights on technical hurdles, i.e. solution has to be interoperable with current tech.

• Logistics are a huge strain, usually takes 20-30 minutes to organize them
• Barriers to implementation would include: funding, testing, translatability, ease of use

 

Advisor interviews with Jared Dunnmon and Dillon Buckner are scheduled for next week.

This week, we further explored the medical evacuation logistics problem in our beneficiary interviews and found that, in general, this could help 18D’s save time and improve work focus during the right point in time as compared to the standardized clinic set-up. Having a more accessible database of information- ideally with pictures and filters for higher levels of care, such as availability of safe and vetted blood, or sterile surgical equipment, could mean the difference between a med evac 48 hours away versus 12 hours. This eases the burden of shrinking resources on the medic as well as the time the medic would spend sitting on a patient in prolonged field care. The major challenges to this kind of product, though, stem from the need for a database that can be offloaded due to cost and reliability of cell service, security in geo-based products, and implementation among groups so that this information on such a database (on higher levels of care) is constantly refreshed by medics and does not go stale.

 

Interview 1: CPT Amanda Canada

• Testing of new technology could be an essential part
• Better diagnosis, documentation will be beneficial for med eva and database or guide will help make decisions
• Extra work like availability of higher levels of care and prolonged field care slows medic down

Interview 2: SGT Bill Kelly

• It takes 2-5 minutes sometimes 30 or more to figure out med evac logistics
• Clinic set-up is not really a huge need

Interview 3: SGT John Carlson

• Role of medic: Triage, treat, stabilize, delegate, repeat, document
• Need high level of testing to ensure safety in the field

Interview 4/5: General Stanley McChrystal

• Curious about possibility of disconnect between higher ups (Central Command) and individual operations/missions.
• Risk understanding to force, mission, reputation…can be variable and has high effect in decision making.
• Captains tell Central Command that it was high risk and it’s hard to understand what happens when you don’t know the situation.

Interview 6: General Dempsey

• Get specific on what medical scenarios we want to be able to aid medics in treating on the field
• Even solving a niche problem (such as 1 aspect of the med evac logistics) would provide value
• Advised us to get more anecdotal context from our beneficiaries on what they need/want from this product

Interview 7: SFC Chase

 

• Need strong validation- what we see from info online often doesn’t align with reality, and SF’s own clinics often are better than what these hospitals can provide
• Main issues in solving problems that aren’t covered in training, which is why he sees the clinic set-up as a possibly valuable tool for new medics
• Not always about time saving: Increasing survivability in that you’re providing shared understanding of how it’s supposed to work and where they are

 

Interview 8: SOFACC Trainee Michael

• SOFACC Trainee binder is pretty well organized, in a training setting it’s very helpful to have even if it’s more brief and not fully in depth for what may be necessary
• An app solution could be helpful but needs to be really easy to navigate- and a lot of the binder info should be in our heads already anyway so an app would be looked to as the last resort

Interview 9: 18D Mike

How useful would a database be?

• Usually don’t have internet access in austere environments
• A lot of info about local facilities and resources already exists, it’s just about having to find and organize the evacuation based on all that information
  • 18D’s have someone else doing that logistics work as they perform patient care
  • Database/app could be more helpful stateside but wouldn’t be super operable abroad

Interview 10: Army Nurse Josette Noxon

• Medical Evacuation process, what it looks like:
  • Role 1, Role 2, Role 3, Germany, then US Hospital (either DC or San Antonio – where the burn center is)
  • Existing system: A “JSTAR” system currently exists for home theater medical evacuations where patients are tracked and evacuated based on acuity of injury
    • “Med evac” means critically ill patients
    • “Air evac” means less urgent or serious injuries
• The core of the issue is that Role 1/Role 2 facilities can be 8-10 hours away distance wise

Interview 11: Company Physician Assistant – 44th Medical Brigade – US Army Garrison CPT Bob

• Medics need to decide what method of transportation to use (helicopter, ambulance, etc.)
• Be aware of data security concerns

In our third week, the team travelled to Fort Bragg on Wednesday, January 23rd. There we saw all of the equipment that medics have to take inventory for but really don’t use. In general, the equipment medics do take on missions is left up to them and what they believe the team needs. In addition, we went through a quick 30 minute training session in how medics treat a patient after a casualty occurs using the MARCH acronym. M stands for mass hemorrhaging; A for airway; R for respiratory; C for circulation; and H for hypothermia and head injury. After this crash course, we were quickly put into basic gear (a helmet and chest pad) and told that we were going through a training scenario. We were able to use the knowledge from the quick class and turn it around into a real life scenario. The 18D and 18A must work together to coordinate evacuation scenarios and treatment while also securing the perimeter. It made our team realize how stressful these situations can be for medics and how much they are responsible for. In light of this, we want to take the load off the medics in a way that eases the burden of all they have to do. Our new MVP for next week will focus on relieving some of the stress and burden of multitasking, and possibly looking to pivot towards improving availability of information for medical evacuation decision making.

 

Interview 1: CPT Holly

• She talked about the importance of team cohesiveness and  how she interacts with medics, particularly during cross training
• She mentioned that there is no baseline for equipment and the importance of including medical assets when going on a mission

 

Interview 2: 18D Chris

• He responded to our checklist app and clinic model idea and said it would be hard to make it personalized because every mission and location is so different but would be beneficial
• He talked about how difficult it is to figure out logistics and arrangements of med evacs including describing a PACE plan

 

Interview 3: CSM Dave

• He talked about the limitations of equipment, space competition, austere environments and how situational dependent each deployment is
• He added suggestions to a potential app, wanted a foolproof way to catalogue care and treatment, and spoke about how important a database could be of medical facilities

 

Interview 4: CPT Joe

• From the captain’s perspective, operational readiness rests on having a clinic setup and wouldn’t be able to start a mission without doing that (leads into overall DoD mission)
• Whatever is developed could be helpful if it could cross language barriers because of working with partner forces

 

Interview 5: 18D Chandler

• What he actually takes on a mission is up to him and he’s used his own Government Purchasing Card to get equipment he believes is useful (not something SF thinks/knows is necessary)
• Point of injury care is something medics are well practiced in which is what training focuses on and often gets used in incidence number

 

Interview 6: Kevin – SOFACC

• He says that reliance on technology can’t happen because SF is trying to have greater levels of strategic success so once SF leaves, they won’t give technologies away
• Really want to focus on lasting solutions and finding a next level of care which may not necessarily be a doctor
• Medical knowledge doesn’t have to be secure and gave us information on where to find unclassified information

 

Interview 7: Eric – SOFACC

• Make their students develop their own solutions so they can teach them how to innovate in environments they’re unfamiliar in
• They believe that the best information and resources for 18Ds are other 18Ds

 

Interview 8: Medical Director of SOFACC David

• PFC is mimicked in SOFACC training by having trainees take patients across North Carolina for a few days and having them think on the fly
• Talked about the importance of developing local relationships on missions

 

Interview 9: Winnie, SOFACC Trainer

• Goal of SOFACC training is to get as much basic knowledge taught as possible to perform care for 5-10 hours
• Getting that EMT certification allows SOFACCs to jump a lot of hurdles in acquiring medication/aid from bureaucratic agencies/local pharmacies

 

Interview 10: Sergeant Jim (SOFACC Trainee)

• Certain materials in SOFACC training won’t be present on the field usually like the backboard litter (meant for spinal injuries)
  • The resources come with evacuation chopper/plane – not helpful in the moment for men on the ground
• Certain SOFACC training modules are more realistic than others in representing battle field operations, important to imitate the pressure/lack of resources in the real environment