N241-002 TITLE: Medical Echelon of Care Conceptual Models for Wargaming

OUSD (R&E) CRITICAL TECHNOLOGY AREA(S): Advanced Computing and Software

OBJECTIVE: Develop Medical Echelon of Care models for wargaming, sufficient to withstand review board scrutiny to support model verification, validation, and accreditation, as required. The focus is on developing and implementing the models referenced herein, not on the underlying mechanics of the Program Manager Wargaming Capability (PM WGC) materiel solution simulation framework.

DESCRIPTION: This SBIR topic addresses two parametrics of interest for future inclusion in the Neller Wargaming and Analysis Center (NWAC), formerly the Marine Corps Wargaming and Analysis Center (MCWAC). Both parametrics are related to medical echelon of care. In the table below, the two major parametrics considered are "Echelon of care" and "Time requirements between echelons of care". The specific conceptual model requirements are listed for each parametric.

ID	JCA	Parametric	Parametric Description	Conceptual Model Requirement
L4	Logistics	Echelon of care	Represent the different classes of casualties and echelons of care	Represent entity-level casualties including time of injury, class of injury (per International Classification of Diseases, 9th Revision (ICD-9)), location, detailed injury information, rate of recovery, and return to combat effectiveness.
L5	Logistics	Echelon of care	Represent the different classes of casualties and echelons of care	Simulate application of the six echelons of care per Fleet Medical Pocket Reference of 2016.
L6	Logistics	Echelon of care	Represent the different classes of casualties and echelons of care	Output updates to casualty status based on care and movement: location, detailed injury information, rate of recovery, and return to combat effectiveness.
L7	Logistics	Time requirements between echelons of care	Represent the time to transition a casualty from one echelon of care to another	Output time and location of entities as they transition echelons of care.
L31	Logistics	Maneuvering shock trauma team with vehicle capabilities, resuscitation capabilities, and a shock trauma bay with blood supplies and independent power supply.	Represent a maneuvering shock trauma team.	Simulate specific trauma services provided by shock trauma teams.
L32	Logistics	Maneuvering shock trauma team with vehicle capabilities, resuscitation capabilities, and a shock trauma bay with blood supplies and independent power supply.	Represent a maneuvering shock trauma team.	Simulate movement of casualties as enabled by shock trauma team transportation capabilities.
L33	Logistics	Maneuvering shock trauma team with vehicle capabilities, resuscitation capabilities, and a shock trauma bay with blood supplies and independent power supply.	Represent a maneuvering shock trauma team.	Represent shock trauma team levels of supply.
L34	Logistics	Maneuvering shock trauma team with vehicle capabilities, resuscitation capabilities, and a shock trauma bay with blood supplies and independent power supply.	Represent a maneuvering shock trauma team.	Modify casualty survival rate based on trauma team actions.
L35	Logistics	Maneuvering shock trauma team with vehicle capabilities, resuscitation capabilities, and a shock trauma bay with blood supplies and independent power supply.	Represent a maneuvering shock trauma team.	Represent location of shock trauma teams.
L36	Logistics	Medical facilities.	Represent casualty survival rate based on trauma team actions.	Modify casualty survival rate based on surgical capacity of medical facilities.
L37	Logistics	Medical facilities.	Represent number of surgeons at medical facilities.	Represent the surgical capacity of medical facilities by number of surgeons.
L38	Logistics	Medical facilities.	Represent capabilities at medical facilities.	Identify medical facility capabilities in accordance with Fleet Medical Pocket Reference of 2016.

 

The purpose of the models is to support realistic evaluation of medical support systems within USMC future concept and capability development and Operational Plan assessment wargames. The prototype would provide medical treatment simulation from time of injury to return to combat effectiveness via the various echelons of care.

Some examples under the above headings include, but are not limited to:

- Establish baseline performance characteristics of existing medical support systems under a given scenario.

- Model novel ways of treating/transporting/managing Marine casualties occurring in austere environments within challenging operating environments, with imposed limitations on naval medical support.

- Model the complex relationships between location and type of injury, types of medical transport available, location and capabilities of the various echelons of care available, eventual return to combat effectiveness, and associated critical time and resource metrics.

Full satisfaction of each conceptual model requirement is the end goal, however partial solutions will be considered. This topic specifically focuses on developing the mathematical, algorithmic, and data aspects of the conceptual models. The mechanism by which these conceptual models would be integrated with existing wargaming kinetic models resident within the NWAC is not the focus. Documentation of the conceptual models with Cameo Systems Modeler (Cameo/SysML) is desirable, but not necessarily a strict requirement, if another representation is more suitable [Ref 2].

PHASE I: Develop concepts for an improved representation of medical echelon of care in wargaming M&S that meets the requirements described above. Demonstrate the feasibility of the concepts in meeting Marine Corps needs and establish that the concepts can be developed into a useful product for the Marine Corps. Feasibility will be established by evaluation of the plan of attack for the development effort including data availability. Provide a Phase II development plan with performance goals and key technical milestones, and that addresses technical risk reduction.

PHASE II: Develop prototype conceptual models. The prototype will be evaluated to determine its capability in meeting the performance goals defined in the Phase II development plan and the Marine Corps requirements for medical echelon of care M&S. System performance will be demonstrated through prototype evaluation over the required range of parameters. Evaluation results will be used to refine the prototype into an initial design that will meet Marine Corps requirements. Prepare a Phase III development plan to transition the technology to Marine Corps use.

PHASE III DUAL USE APPLICATIONS: Support the Marine Corps in transitioning the technology for Marine Corps use. Develop medical echelon of care conceptual models for evaluation to determine effectiveness in an operationally relevant environment within the NWAC. Support the Marine Corps for M&S Verification, Validation, and Accreditation (VV&A) to certify and qualify the system for Marine Corps use.

The conceptual models described herein are not only a high priority within the Marine Corps [Refs 1, 3], but are equally applicable across the Services, to support not only wargaming, but also analysis, training, and experimentation. Successfully developed conceptual models would likely be of great interest across these communities. DoD components and prime contractors are in need of accurate medical casualty/echelon of care simulation representation to support gap analysis and solution assessment. Potential civilian applications include emergency medicine and care after the emergency room.

REFERENCES:

1. "Commandant’s Planning Guidance." 38th Commandant of the Marine Corps, 2019. http://www.marines.mil/Portals/1/Publications/Commandant's%20Planning%20Guidance_2019.pdf?ver=2019-07-17-090732-937
2. "IEEE Recommended Practice for Distributed Simulation Engineering and Execution Process (DSEEP)", IEEE Standard 1730-2022, https://standards.ieee.org/ieee/1730/10715/
3. "Force Design 2030 Annual Update, June 2023. 38th Commandant of the Marine Corps. https://www.marines.mil/Portals/1/Docs/Force_Design_2030_Annual_Update_June_2023.pdf

KEYWORDS: MCWAC; NWAC; USMC; M&S; Modeling and Simulation; medical; conceptual model; analysis; Neller Center; wargaming; Force Design;

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