DOD bar code/database system proved inexpensive to develop and easy to use

GCN Awards When the Defense Department changed how it cared for wounded soldiers, the department’s medical logistics system had to change with it.

"We used to convalesce soldiers in-theater," said Army Col. Chris Harrington, Medical Logistics Division chief and deputy program manager of the Defense Health Services Systems. That meant maintaining large treatment facilities and convalescent hospitals. "We began to phase that out in Vietnam and then the first and second Gulf wars," Harrington said. "More and more, we began to see the need for evacuation. We're not convalescing in-theater any more. So we had a need for biomedical equipment to accompany the patient during this evacuation from the theater of operations."

The answer to that need is the Patient Movement Items Tracking System. Whether it is monitors, ventilators, transfusion equipment or other devices, PMITS tracks devices to ensure that they are available where and when they're needed.

"Keeping track of all of this biomedical equipment is the business need that our [information technology] solution was designed to meet," Harrington said. "The idea was that this equipment effectively rotates in a large circle. You never want to have a situation where you don't have it at the point of origin."

Army Col. Chris Harrington, Ernest Spain and  George “Dan” Magee

Taking the point: Army Col. Chris Harrington, deputy program manager, PMITS project manager Ernest Spain and Program Manager Dr. George “Dan” Magee led the tracking system’s development.

More than 94,000 pieces of biomedical equipment in the DOD Military Health System have bar codes. As equipment moves with patients from the battlefield or other theater locations to care facilities, medical personnel scan them using palm-sized, handheld devices. Personnel load the data into PMITS-connected laptop PCs via a USB port.

Once downloaded, the data — which includes the location of equipment and critical information about its condition — is immediately uploaded to a globally synchronized PMITS network and stored in a centralized database in the United States.

PMITS information is immediately made available via a searchable, read-only Web version of PMITS that medical logistics planners and command staff members can access worldwide.

Ernest Spain, PMITS's project manager, said the system is designed to fill three fundamental needs. First, he said, "we need to ensure PMI is available when needed. This system allows us to know where the shortages and the overages are."

The second goal is to prevent loss of equipment. "Many times in the past, stuff just went out in the world, some got turned in, some went to salvage...whatever," Spain said. "Now the property people have a system they can look at. If they're missing a particular item, they can look and see its movement history, its current status and location at that moment."

The third goal is to provide information to facilitate planning and execution. "This system gives information both to local managers and to commanders or planners about equipment status — where it is, how much equipment at a location is ready for use," he said. "You can generate reports by location, by equipment type, by equipment group or status. So it's not just a matter of reporting location. And it's very critical information for people who need to plan a mission."

Keeping it simple

From the beginning of the project five years ago, the PMITS team knew that it would be important to keep the technology solid and simple on the front and back ends.

“This is a joint application, so the driver for that technology and the authority to operate has to be DOD-wide,” Harrington said. “So we have to design the software and hardware to meet or exceed service standards.”

The team started with Plexus, a commercial program that developers modified to meet government standards for security and information assurance. The program runs on Windows Server 2008 and uses SQL Server 2008.

Project leaders also knew that because the system would often be used in trying conditions and by frequently rotating staff members, it needed to be simple for users to implement and learn.

"There's been an extremely good relationship between us and the folks at Air Mobility Command," Harrington said. "And Air Mobility Command touches out to all Air Force and Army users. They coordinate meetings with our customer base so that we have regular, routine contact with the boots on the ground that are using the system. We take what they need and we incorporate it into what we do."

Spain said the system "has to be easily configured and set up so they can be taken down very quickly and moved. We can set up a mobile site on very little notice for anything from a hurricane to a major battle. We have rapid deployment kits set up, allowing us to set up a new site in 24 hours almost anywhere in the world."

Randy Rodgers, deputy branch chief for medical readiness logistics at the Air Mobility Command at Scott Air Force Base, praised the systems' simplicity. "We have people who are continually rotating through the job," he said, and PMITS "is so simple that anybody could track and scan. I could teach you in less than 15 minutes how to do it."

Users of the system say it has made a huge impact.

"I've been a 'loggy' for 30 some years," Rodgers said. "Before, it was pen and paper and hoping for the best. To put it bluntly, we would be dealing with three times the amount of equipment and much more waste of equipment if it wasn't for PMITS. The system is a champ. It works 100 percent of the time. To date, we've successfully moved over 50,000 patients and, to my knowledge, we've not yet been unable to move a patient due to the lack of" patient movement items (PMI).

What makes the system special, said Air Force Maj. Andrew Kaczmarek, chief of the medical readiness logistics branch for Air Mobility Command at Scott, is how much it is accomplishing with a relatively small staff. "There are over 94,000 items that are managed worldwide at hundred different sites," he said. "Our office has one full-time person that is dedicated to manage the system. This tool is amazing in the staff savings alone. Right now there's $84 million of assets in the PMI inventory."

If PMITS is not demanding on staff requirements, it is also easy on budgets. Total development cost is estimated at less than $3 million. And the annual IT cost to maintain the system is less than $500,000 a year.

The team expects the next iteration of PMITS to be even more effective. By incorporating radio frequency identification tags, the system will make even fewer demands on staff and will deliver even more timely information about equipment.

"We're pretty excited about that," Harrington said of RFID. "We will be setting up three sites within the next six to eight months."


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