MedCOP: A Step Towards Purple
Written by Major Betsy DeSitter and Major Max Ramirez
His guidance was simple. “No Captain can do very wrong if he places his ship alongside that of an enemy.” These were the famous words of Lord Horatio Nelson, Commander of the British Fleet that defeated Napoleon’s superior Franco/Spanish armada in Cape Trafalgar on October 21, 1805. Trafalgar was the most significant sea battle of the 19th Century and remains one of the finest examples of mission command. Nelson understood that the fog of war would hinder his ability to communicate and influence decisions. Therefore, prior to battle, he ensured his subordinates understood his intent, visualized contingencies, and rehearsed tactics. Through shared understanding, Nelson built confidence that led to mission success.
The DoD COVID-19 response demanded immediacy, which exposed the Joint medical community’s lack of shared understanding across the Services, Combatant Commands, and the Defense Health Agency (DHA).
Fast forward two hundred years. Despite advanced technologies, the ability to navigate a complex operating environment (OE) remains equally significant and challenging. Crises evolve at accelerating rates that require decisions at the speed of relevance. The DoD COVID-19 response demanded immediacy, which exposed the Joint medical community’s lack of shared understanding across the Services, Combatant Commands, and the Defense Health Agency (DHA). Looking ahead, multi-domain and large scale combat operations will increasingly test leaders’ abilities to make timely decisions in ambiguous situations. To prepare for future operations, the DoD medical community must increase collaboration and visibility by adopting a Joint medical common operating picture (MedCOP) today. In return, the stakeholders — operational units, medical treatment facilities (MTF), and logisticians — will accelerate decision cycles via an increased understanding of the Joint medical environment.
To prepare for future operations, the DoD medical community must increase collaboration and visibility by adopting a Joint medical common operating picture (MedCOP) today.
Mission command enables the Army’s operational concept of unified land operations. It resides within the warfighting function of command and control and is defined as “The Army’s approach to command and control that empowers subordinate decision making and decentralized execution appropriate to the situation.” Mission command is centered on seven (7) principles, including the need to create shared understanding of strengths, gaps, issues, and concerns within the OE. Collaboration and dialogue are critical to mission success. Though difficult, ADP 6–0 explains, “Collaboration is more than coordination. It is multiple people and organizations working together towards a common goal by sharing knowledge and building consensus.” A common operating picture (COP) is arguably one of the most effective tools in creating shared understanding of the battlespace and is frequently used to inform leaders’ decisions.
The DoD’s current medical command and control (C2) tool, Medical Situational Awareness in Theater (MSAT), is sporadically used due to a lack of access, awareness, and training; thus, during COVID-19 operations, it failed to satisfy senior leaders’ information requirements. Instead, the Services, Joint Staff, and DHA relied on multiple disparate systems, which resulted in redundant reporting and delayed analysis. The situation drove an urgent needs statement to rapidly develop and deploy a MedCOP that contained operational and MTF data and provided a comprehensive picture of DoD medical assets and missions around the world.
MedCOP construction began in April 2020 on the Automated Information Discovery Environment (AIDE) platform, which is already in use within the Army sustainment and intelligence communities. It pulls real-time data from dozens of programs including Theater Medical Data Store (TMDS), Joint Medical Asset Repository (JMAR), Defense Readiness Reporting System (DRRS), DHA CarePoint, Global Command and Control System (GCCS), and TRANSCOM Regulating and C2 Evacuation System (TRAC2ES). This data feeds medical reports and unit dashboards, reducing the need for manually generated briefing products. AIDE features map, chat, share drive, and task management applications and further integrates medical capabilities with the warfighter by offering a “medical layer” to the warfighting COP on GCCS.
The on-going development process has been groundbreaking for two reasons. First, to gain acceptance, the Joint Operational Medicine Information Systems (JOMIS) team established a MedCOP working group that contained subject matter experts from across the Joint Force. The working group currently meets monthly to provide feedback on current MedCOP tools. Current challenges include DRRS integration and establishing a common medical vocabulary (i.e., critical care nurse versus ICU nurse). Second, MedCOP was JOMIS’s first test with agile development software, which deployed an initial operating capability in weeks versus years. Its success raised the standard to deliver future Operational Medicine IT capabilities at the speed of relevance.
Relevance is built on acceptance and employment; therefore, directed use in real-world operations and training exercises is key. In 2021, JOMIS and the Joint Staff J7 will integrate MedCOP into Joint and Service training events, including Combatant Command, Global Medic, and Warfighter exercises. Once complete, MedCOP will enable medical organizations to achieve their training objectives by replicating a realistic OE that forces staff action on casualty management, patient movement, disease surveillance, medical resupply, and personnel and equipment inventory. Furthermore, MedCOP will replace MSAT training in medical courses. Increased exposure and hands-on training will better posture the DoD medical community for MedCOP use in contingency operations.
AIDE MedCOP is an opportunity for the Joint medical community to increase shared understanding and better track, manage, and display capabilities and capacities.
MedCOP success lies in the hands of its stakeholders, the Joint medical community. The COVID-19 pandemic provided the opportunity to address deficiencies and posture the force for the next fight, where decentralized leadership and distributed understanding will be crucial. Leaders should take a lesson from Lord Nelson’s playbook and strive to increase collaboration, improve communication, and empower subordinates. AIDE MedCOP is an opportunity for the Joint medical community to increase shared understanding and better track, manage, and display capabilities and capacities. DoD medicine is marching towards purple, and MedCOP is another step in the right direction.
Major Betsy DeSitter commissioned as an active duty Army Medical Service Corps Officer in 2006. She previously served as the S3 (Operations Officer) for Task Force Medical, 47th Combat Support Hospital (CSH), Combined Joint Task Force Operation Inherent Resolve (Iraq) and Executive Officer for the 47th Combat Support Hospital (CSH). She currently serves as a sustainment exercise planner for the Joint Staff J7, Joint Exercise Training Division.
Major Camillo (Max) Ramirez commissioned as an active duty Army Medical Service Corps Officer in 2003. He previously served as the G6, 18th Medical Command (Deployment Support), US Army Pacific and as the Health Information Systems Officer (HISO) for the USINDOPACOM Command Surgeon. He currently serves the Assistant Program Manager for Medical Command & Control (MedC2) and Medical Situational Awareness (MedSA) at the Joint Operational Medicine Information Systems (JOMIS) Program Office.
The views expressed in this article are the authors’ alone and do not reflect the official position of the Medical Service Corps, the Department of Defense, or the US Government.
