Data and Medical Innovation: How America’s First Corps Seeks Digital Solutions to Save Lives

Story by Spc. Samarion Hicks

24th Theater Public Affairs Support Element

The speed, complexity, and volume of potential casualties of future large-scale combat operations (LSCO) will demand well trained and efficient U.S. Army medics and a data centric battlefield that links all warfighting functions.

As future combat shifts from counter insurgency operations to LSCO, lifesaving care and medical documentation in a complex, contested environment is required to save lives. This requires essential updates across the Army’s medical doctrine to help military medical personnel facilitate documentation that outlines medical logistics and care to help treat casualties.

Attempting to fill the gap, U.S. Army Col. Jay Baker, America’s First Corps Command Surgeon, has developed and put into practice a new innovative, data-driven concept called the ‘Automated Battlefield Trauma System’ through initial beta testing as part of the U.S. Army’s first-ever Warfighter held in Japan.

“The Automated Battlefield Trauma System is an approach to casualty care that collects and estimates numbers of wounded casualties by category to perform predictive logistics that informs evacuation movements,” he said. “The same goes for medical resupply to perform these critical functions more quickly and to save more lives of U.S. and Allied Soldiers on the battlefield.”

To have a cohesive and efficient system, every piece of the machine must work together to succeed. In that regard, trauma systems are no different than a traffic system or computer network.

Baker learned the need of a real-time data driven trauma system to support the warfighter while working alongside his medical colleague U.S. Army Col. Jennifer Gurney, Chief of the Joint Trauma System.

Like Baker, Gurney is a seasoned doctor who has seen the ebbs and flows of the military medical system throughout her career.

“In the early 2000s, we had Role 2 Forward Surgical Teams, we had Role 3 Combat Support Hospitals, we had substantial MEDEVAC platforms – but they weren’t integrated,” she said. “They weren’t talking with data. They weren’t a system. We did not go to war with a data driven trauma system, that should never happen again.”

“Data drives the system; systems should grow and improve over time,” she added. “At the JTS, we emphasize the importance of ‘saving lives with data’ – integrated data drives the system to be better and improves the quality of care delivered to casualties and decreases the case fatality rate.”

The Automated Battlefield Trauma System is a new component of the DoD’s Joint Trauma System (JTS), the Department of Defense’s Center of Excellence for Trauma. The JTS grew out of a critical battlefield need during recent CENTCOM operations. Not going to war with a trauma system that integrates care across the battlefield will cost service members lives.

“A trauma system should be seen as an essential warfighting capability,” Gurney said. “The system when working likely goes unnoticed, but when it is not working – casualties pay the price, sometimes with their lives.”

Data from a 2019 publication in JAMA Surgery indicated at that Joint Trauma System resulted in a 44% decrease in deaths from battlefield trauma. She credits Baker for the innovation he has brought forth to America’s First Corps, and he trying to bring to the greater Army.

“What Col. Baker is doing to get ahead of the next conflict has the potential to be transformative in saving lives and supporting commanders,” said Gurney.

JTS was created to give optimal care to the critically wounded on the battlefield. It helps achieve its goal of evolving the cycling speed through near-real-time data capture, analysis, and adaptation of knowledge and solutions to optimize battlefield trauma care. JTS uses data to save lives and improve battlefield trauma care.

However, LSCO will limit freedom of maneuver for medical evacuation, shorten medical evaluation windows, and may create medical logistics backlogs. These will be problems our military must be ready to face.

According to Gurney, having a data centric approach capitalizing on technology and data driven capability allocation will not only save lives, but the Automated Battlefield Trauma System will be able to be used as a commander’s risk management tool to allocate battlefield medical capability and logistic support. Other Corps and Division exercises should adopt, refine, and improve the rapid cycling of data that Baker and his team established.

THE INSPIRATION
The Automated Battlefield Trauma System strives to improve the already existing trauma system to increase warfighter survivability and improve the warfighting function.

Realizing that LSCOs will be a logistics war, Gurney mentions how we must stay realistic about the medical requirements to be able to transform in contact and save as many lives as possible.

“No question, we’re not going to be able to move casualties like we wanted to, not just because of the potential sheer numbers of casualties, but because we’re going to be competing for getting resources,” said Gurney.

During Talisman Sabre 23, the largest bilateral military exercise between Australia and the United States with multinational participation, Baker and his team experienced this issue that Gurney asserted while participating in the exercise’s computer-based command post exercise.

“We got tens of thousands of casualties and didn’t really have a plan for how to take care of them,” said Baker. “The casualty management was largely handwaved, if not completely, and I thought that it was insufficient to be able to really exercise the kind of planning and operations that we really need to save lives in large scale combat operations.”

Inspired by “The Kill Chain”, a book that described the use of Artificial Intelligence for targeting purposes, Baker thought the same applications could be used for casualty care, especially with the projected larger numbers of casualties in LSCO.

He realized that through the implementation of AI, medical officers and non-commissioned officers could focus more on patient and casualty care and less on administrative tasks leveraging.

According to Baker, “it takes away that stubby pencil work, it takes away that blue-lighted Excel work, it does all of that in the background and quickly than humans ever could, allowing us to make more human decisions.”

HOW IT WORKS
The Automated Battlefield Trauma System starts with the first intervention that a medic performs during Tactical Combat Casualty Care or TCCC. Next, the medic follows the M.A.R.C.H. (Massive Hemorrhage, Airway, Respiratory, Circulation, Hypothermia) algorithm and documents the patient’s medical data. This aims to solve a critical need among medical personnel.

“The biggest gap we have in implementing the Automated Battlefield Trauma System or ABTS is the lack of acceptable documentation tools for medics,” said Gurney.

The casualties are then placed into triage categories built into the system based on the severity of their medical condition. The system determines the location they’re evacuated to depending on which facility fits their specific need. Ultimately, this real-time data-drive concept is designed to help filter the most severe casualties who require the most critical resources.

Simplicity is a vital component of the concept allowing medical personnel to leverage a user-interface to record medical data in a short amount of time to save lives.

“Keep it easy,” said Gurney. “We get the data. The data drives the system. The data improves the system. We improve battlefield survivability. And we are an essential war fighting capability, because if casualties are getting good care, if they’re moving, if the care is well resourced, if large volumes of casualties are not getting optimal care and dying on the battlefield from survivable injuries, other warfighting functions will get impacted, combat end strength will decrease, and overall lethality will be impacted.”

“Having a good battlefield trauma system improves lethality…. for some people that is difficult to understand, but if you walk through what happens when the battlefield trauma system (including evac) fails – it becomes apparent,” she said.

“Patients that need surgery and blood need to go to a surgical capability that has those resources closest on the battlefield,” Baker added. “Because in combat trauma, just like in all trauma, time is a critical factor.”

THE FUTURE
America’s First Corps’ Warfighter 25-02 was the first large-scale command post exercise that the Automated Battlefield Trauma System is being tested.

The event ran concurrently with Yama Sakura 87, a trilateral exercise, aimed to strengthen multi-domain and cross-domain interoperability while building readiness between the U.S.-Japan-Australian Alliance to ensure a free and open Indo-Pacific.

This was the first Warfighter to be conducted simultaneously with Yama Sakura’s 44th iteration, highlighting America’s First Corps’ emphasis on combat credibility west of the international date line.

The goal is to record the concept’s success and look for areas to improve. The lesson learned will be share with military medical leadership with U.S. Army Medical Command implementing the finding and building upon concept into more Operation Pathways exercises, and the Army Futures Command’s Project Convergence, U.S. Army’s landmark event.

“So we’re going to take the next phase into Project Convergence-Capstone 5,” says Baker. “We’re going to be taking this into the Philippines with the 18th MEDCOM and enabling them to use this function for medical operations in that exercise.”

Closing in on retirement, Baker wants to take all his experience over the last 21 years into making Automated Battlefield Trauma System an official U.S. Army Program of Record.

The end goal is to improve upon the Army’s life-saving functions and save Soldiers’ lives!