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will expand JBAIDS’ traditional role of environmental surveillanceto include clinical diagnostics of upper respiratory influenzapathogens.The data collection, distribution and analysis data systems ofEOS are becoming part of the Theater Medical Information Program– Joint (TMIP-J), now within Defense Health InformationManagement Systems (DHIMS). Our technical manager is fromthe Air Force Surgeon General’s office.Future generations of EOS will contain a much smaller footprint,will be more utilitarian, and able to recognize a threatusing advanced diagnostics which will push the envelope for futurecapabilities. We are pleased with the progress and believeEOS is going to be a big advance.We are also working on a proposal for a new joint capabilitytechnology demonstration. We can provide excellent care, aslong as the medics are on-site, and those injured can get to thedoctor and on to the hospital rapidly; however, operations in remoteareas do not have easy access to FSTs or theater hospitals.We are constantly asking questions like: What if a U.S. Navyfrigate operating in the Indian Ocean stops a suspicious vesseland a bunch of Sailors get injured? We seek to answer thesequestions, in part, by employing advanced technologies tobring supplies forward and return the sick and injured.Our proposed JCTD is titled Joint Medical Distance Supportand Evacuation, and it has support from USSOCOM, USPACOM,U.S. Northern Command and a number of the services.The proposal seeks to adapt the following: (1) current telemaintenancetechnology for battlefield telemedicine to providevirtual triage and automated patient monitoring/care at a distance;(2) aerial precision delivery capabilities to provide smallmedical bundles or equipment to dispersed ground and maritimeforces from a variety of rotary and fixed-wing aircraft; and(3) current unmanned aerial and ground vehicle systems (UAS/UGV) to provide rapid precision delivery of medical capabilitiesand casualty evacuation from ‘denied’ or remote areas.CHIPS: How do you choose what to investigate?Rear Adm. Timberlake: At the COCOM level, it has to have jointtheater-wide applicability. For example, there is a new tool thatis supposed to determine if someone who is unconscious has aconcussion or a blood clot in the brain. That would not rise tothe COCOM level.Generally, when a service or a COCOM has something thatthey think has wider joint applicability they look for an operationalsponsor or an operational manager. For example; USPA-COM is the operational manager for Medical Situational Awarenessin Theater. MSAT is a situational awareness tool that fusesmedically relevant information from a joint medical workstationto joint medical surveillance/intelligence.They are putting this information together so that the JTF surgeon,COCOM surgeon, or commander of the combatant commandhas robust situation awareness of medical information.Some questions this tool will aid in answering are: Are theredisease outbreaks? Is there an increase in people taking up bedsin an institution so they need to shift resources? Where shouldI put down my medical footprint if I am going into country 'X'to do a medical mission? It puts that all together for the commander.It is a common operating picture.I have two Air Force international health specialists dealingwith security, stability, transition and reconstruction operations(SSTRO) — commonly referred to as ‘soft power.’ There are hugeissues concerning what the military should do, and how theyshould interface with the rest of government, NGOs and IOs. Wehave the lead for medical operational expeditionary.Sometimes, I wonder how much we can do, especially addingon these soft power missions. In the medical community, wehave always answered the bell. Sometimes, I think we could dothings differently or better.We are starting to build the DOTMLPF (doctrine, organization,training, materiel, leadership and education, personnel andfacilities) because all the soft power SSTRO initiatives were not aprimary mission for the military prior to the publication of DoDDirective 3000.05 in November 2005 which said we had to giveequal priority to SSTRO as we have to major combat operations.SSTRO has never been a primary mission — we’ve done it —and we’ve done it well. The challenge is to embed these missionsets into our manning, training, equipping and doctrinepostures, so we don’t continue to start from scratch when theseefforts are called for by our warfighters.Rear Adm. Michael H. Mittelman will replace Rear Adm. Timberlake as U.S. JointForces Command’s (USJFCOM) top medical advisor in October when Timberlakeassumes duties as the Assistant Deputy Surgeon General for Active-ReserveIntegration.Military medicine transformation includes modular field medicalfacilities in forward battle areas and changes in the treatment of injuredwarriors in the combat care chain which dramatically reduce the timelinefor treatment of the wounded.Technology has assisted in the transformation with new ventilators,angiography, hemostatic dressings, bandages, tourniquets and muchmore.Corpsmen, medics and ground troops now have combat life-savertraining on how to stop bleeding and advanced first aid so that thoseinjured can successfully advance to the next level of care.Mark Arnold points out features of the ventilatory assist device for forward surgical teams(FST). Photo by Karen Fleming-Michael, American Forces Press Service.CHIPS October – December 2008 15