PATIENT MOVEMENT NDMS Conference Orlando, FL 1-4 May 2005 Mark Mahar

United States Transportation Command (USTRANSCOM) PATIENT MOVEMENT United States Transportation Command (USTRANSCOM) Responsibilities Global patient movement Joint policy guidance and doctrine Patient Movement Requirement Centers (PMRCs) Develop an Automated Information System (AIS) to support global patient movement: TRAC2ES 1) USTRANSCOM is the designated Unified Command responsible for both parts of the PATIENT MOVEMENT process—coordinating for lift and regulating the patient to the correct bed or medical capability Joint policy guidance/doctrine was developed and presented to the user community PATIENT MOVEMENT Requirements Centers (PMRCs) as organizational entities were created to manage and streamline PATIENT MOVEMENT coordination USTRANSCOM was tasked to develop an Automated Information System (AIS) to support the global PATIENT MOVEMENT process-- TRAC2ES

PATIENT MOVEMENT Directives DODD 6000.12 - Health Services Operations And Readiness (Jan 98) DODI 6000.11 – Patient Movement (Sep 98) Joint PUB 4-02.2 – Joint Tactics, Techniques And Procedures For Patient Movement in Joint Operations (Dec 96)

TRANSPORTATION COMMAND REGULATING AND C2 COMMAND AND CONTROL PATIENT MOVEMENT TRAC2ES TRANSPORTATION COMMAND REGULATING AND C2 COMMAND AND CONTROL EVACUATION SYSTEM

TRAC2ES MISSION STATEMENT PATIENT MOVEMENT TRAC2ES MISSION STATEMENT Combine transportation, logistics and clinical decision support elements into a seamless patient movement information management system which is capable of visualizing, assessing and prioritizing patient movement requirements, assigning proper resources and distributing relevant data to efficiently deliver patients. In other words: Gather requirements, match with available lift and facility capability. All data will be in an electronic format.

PATIENT MOVEMENT TRAC2ES Vision USTRANSCOM Manage patient movement with total visibility and worldwide responsiveness.

PATIENT MOVEMENT What is TRAC2ES? AIS that supports global patient movement Initial Operating Capability (IOC) - Jul 01 Primary user interface is web-based Used by PMRCs, Medical Treatment Facilities (MTF) fixed and deployed and Command and Control (C2) Units

PATIENT MOVEMENT What is TRAC2ES? - Cont. Available data consists of: Patient Movement Requests (PMRs) Mission data (routes, timings, patient loads, etc) Patient tracking data (itinerary, last reported location, etc) Facility data (locations, capabilities, contact numbers, etc.)

PATIENT MOVEMENT What TRAC2ES is NOT! TRAC2ES is not an “Air Force” system It is a Department of Defense system. USTRANSCOM is the primary agent for the management of the patient movement requirements. TRAC2ES does not own any lift capability. Lift information is input into the system. TRAC2ES only tracks patients while they are in the patient movement system. Once they are delivered to final destination, tracking ceases. Does NOT provide In-transit visibility (ITV) of patients while receiving treatment.

2. PMRC: Regulators/PMCC 4. PMRC: Duty Controllers PATIENT MOVEMENT 2. PMRC: Regulators/PMCC Validate PMR/Edit PMR Error Check PMR/Approve PMR 3. PMRC: Duty Officers Create Missions Create Lift Bed Plan Edit Lift Bed Plan Approve Plan 1. MTF: PM Clerks Submit PMR Edit PMR View Itinerary View Manifest Submit ITV TRAC2ES Database 4. PMRC: Duty Controllers Monitor Missions Monitor Move In-Transit Visibility TRAC2ES Users Are The Key Patient Movement requires the effort of multiple services and disciplines.

Patient Movement USTRANSCOM

Medical Treatment Facilities: Any Service PATIENT MOVEMENT Medical Treatment Facilities: Any Service Patient Movement Clerks: Prepare patients and documents for movement Coordinate ground movement to airfield Coordinate directly with PMRC for urgent, priority and any special moves Receive patients regulated to their facility Enter ITV events for patients leaving and arriving at their facility Bed reporting and medical capabilities Update facility contact info in TRAC2ES

PMRC LOCATIONS PATIENT MOVEMENT REQUIREMENT CENTERS -RESPONSIBLE FOR REGULATING AND OVERSIGHT OF STRATEGIC PATIENT MOVEMENT INTO/WITHIN THEIR AOR -VALIDATE THE PATIENT MOVEMENT REQUESTS AND PASS THE REQUIREMENT ON TO THE OWNERS OF THE LIFT; 99.99% OF LIFT PROVIDED BY AMC GPMRC- GLOBAL PATIENT MOVEMENT REQUIREMENT CENTER LOCATED AT SCOTT AFB, TRANSCOM ELEMENT. SERVES AS GLOBAL OVERSIGHT FOR PATIENT MOVEMENT AND TPMRC FOR CONUS, SOUTHCOM AND NEAR OFFSHORE (GITMO, PEURTO RICO0 TPMRC(E)- LOCATED AT RAMSTEIN AFB GERMANY, RESPONSIBLE TPMRC FOR EUCOM, ICELAND AND GREENLAND TPMRC(P)- LOCATED AT HICKHAM AFB HAWAII, RESPONSIBLE FOR PATIENT MOVEMENT IN PACOM JPMRC- JOINT PMRC LOCATED IN QATAR, AOR IS CENTCOM

Patient Movement Requirements Centers Global Patient Movement Requirements Center: USTRANSCOM Theater Patient Movement Requirements Centers: EUCOM/PACOM Joint Patient Movement Requirements Centers: CENTCOM/ Notional in Korea Responsibilities: Validate requests for movement within their theater Pass validated requirements to lift agencies Monitor clinical status/trends of patients being moved Coordinate special requirements for patient movement TRAC2ES Subject Matter Experts Control access to TRAC2ES servers Exercise participation

How do you access TRAC2ES? PATIENT MOVEMENT How do you access TRAC2ES? PMRCs: Responsible for the area where you are located. Issue: User Logins and Passwords to access their server. EUCOM, PACOM and CENTCOM users: routed thru GPMRC server Back Up server up and running in CONUS User Logins issued to individual users. No “office” logins permitted. No sharing Logins or Passwords.

PATIENT MOVEMENT Logging on to TRAC2ES Must be from .mil or .gov computer Recommended browsers: Mozilla 1.7.3 or Internet Explorer 6.0 Will work with other versions but performance may be sub-optimal URL: https://www.trac2es.transcom.mil Exercise Servier: https://www.exercise.trac2es.transcom.mil/etdbs2

TRAC2ES: Security Features PATIENT MOVEMENT TRAC2ES: Security Features Handles unclassified information to provide patient and mission information - Security features include the following * Safeguards Sensitive But Unclassified (SBU) information * Creates a permanent record * Provides an audit trail of all data There is a High Side TRAC2ES * “One way” Guard to transfer data low to high

PATIENT MOVEMENT TRAC2ES: User roles What you see in TRAC2ES will depend on the role you are assigned by the system administrator. Roles are assigned based on your job description and requirement to access the database. Possible to assign C2 leadership access to track their soldiers without revealing personal medical information. Users are expected to access only information required to perform their duties. Violation of patient’s confidential information using information acquired thru TRAC2ES is an offense.

PATIENT MOVEMENT TRAC2ES: Tidbits -Will not accept a PMR for the same person, based on ID number, from the same originating facility with the same ready date. Prevents duplication of requests to move a patient. -Has a “Time Out” feature of 20 minutes after inactivity. Make sure you save often or you will lose work. -Primary and back up servers replicate to each other. Replication normally takes between 5-10 minutes. Ability to see all move requests worldwide. - Archive server maintains record of PMRs forever. Records are moved from active to the archive server 60 days after they are placed in the COMPLETED state.

PATIENT MOVEMENT TRAC2ES: Tidbits, cont. -Has a download file that takes data from TRAC2ES and imports it into an Excel spreadsheet. Data can then be manipulated to suit user requirements. -Download file only available to Surgeon General offices and only contains data on that services movement. -Has capability to generate reports on movement data such as aircraft usage and inter/intra theater moves.

PATIENT MOVEMENT TRAC2ES: Limitations -Users have access to a vast amount of information contained in the database and can modify the data Solution: Users must only access and edit records that are from their MTF -When the server goes down at one location, this affects replication and records that are in the system. These records may not be visible to users looking at the system from another server. Solution: Call the PMRC. They may have visibility that you do not have access to.

TRAC2ES: Limitations, cont. PATIENT MOVEMENT TRAC2ES: Limitations, cont. -If bandwidth is narrow, TRAC2ES is very slow and can take HOURS to submit a single PMR Solution: The PMRC has a form you can email or fax to them and they will input the record. TRAC2ES Mobile(T-mobile) is designed to work offline with connection to the internet only required to send and receive data. T-mobile also allows users to save data to a disk.

The Bottom Line “Timely, customer-focused global mobility in peace and war through efficient, effective, and integrated transportation from origin to destination.” RIGHT TIME RIGHT MODE RIGHT CARE My bottom line leaves you where we began USTRANSCOM is a peace and wartime force We work hard to be both efficient and effective in leading the Defense Transportation System

Questions? mark.mahar@hq.transcom.mil (618) 229-7172 DSN: 779-7172