U.S. Army Medical Department journal
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Today's operational environment in the support of counterinsurgency operations requires greater tactical and operational flexibility and diverse medical capabilities. The skills and organizations required for full spectrum medical operations are different from those of the past. Combat healthcare demands agility and the capacity for rapid change in clinical systems and processes to better support the counterinsurgency environment. ⋯ It discusses using the concept of the brigade combat team to develop medical capability teams as the unit of effectiveness to transform frontline care; provides a theoretical overview of the MCT as a "clinical microsystem"; discusses MCT leadership, training, and organizational support, and the deployment and employment of the MCT in a counterinsurgency environment. Additionally, this article proposes that the AMEDD initiate the development of an AMEDD Combat Training Center of Excellence to train and validate the MCTs. The complexity of combat healthcare demands an agile and campaign quality AMEDD with joint expeditionary capability in order to promote the best patient outcomes in a counterinsurgency environment.
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To understand the complexity of the medical task force mission in support of Operation Iraqi Freedom, we must first understand the operational environment and its impact on the military healthcare system and the medical task force charged with its execution in theater. Historically the medical task force has focused almost exclusively on delivering a robust and accessible set of level II and III care and force health protection support since operations began in Iraq. ⋯ Whereas our predecessors rightly focused on delivering combat health support during their tenure, we focused on the future, laying the foundation for the eventual transition to an environment similar to that in the Republic of Korea as the security situation improves. The foundation laid during Operation Iraqi Freedom 07-09 can be the foundation for the Army and the military healthcare system's vision in creating and modifying the delivery of US standard healthcare in a combat theater.
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Leading a deployed combat healthcare system is a very complex task and requires a command and control structure that is a unique blend of technical and tactical expertise to efficaciously deliver world-class medical care to America's sons and daughters. The medical task force in Iraq has successfully managed the transformation of the medical footprint from a tactically arrayed set of disparate medical units to a nascent integrated healthcare system with many features similar to the best healthcare systems in the United States. The American public demands, and Soldiers, Marines, Sailors, Airmen, and Coast Guardsmen deserve US quality medical care, whether they are being treated at a military medical center in the US, or a US medical facility in Iraq. This article presents an overview of the 62nd Medical Brigade's development of the combat healthcare support system during its tenure leading the US medical task force in Iraq.
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The Army Medical Department (AMEDD) will play a key role in the transition of detainee healthcare operations from US control to a designated authority, whether it is Iraq or a third party. Although the AMEDD has garnered significant experience in the provision of detainee healthcare over the past 5 years, it would be prudent to implement an interagency approach to transitioning detainee healthcare. That transition must start with leveraging of the subject matter expertise of the US Bureau of Prisons and National Commission on Correctional Healthcare. Curriculum development of detainee healthcare in the program of instruction at the AMEDD Center and School is critical.
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Medical regulating operations and the theater medical rules of eligibility are inextricably linked in the delivery of combat health service support in the Iraq theater of operations. The link between medical regulating operations and the medical rules of eligibility is more than the medical regulating operations officer (MRO). In an operational environment as vast as Iraq involving host nation civilians, Iraqi military personnel, Iraqi dignitaries, and a host of other potential patients, the complex mission of executing medical regulating operations while adhering to medical rules of eligibility is an extremely dynamic undertaking. The theater MRO is always expecting-but never knows-what to expect in that next call or that next email.