ARMY AL&T
According to Ficke, the total burden of treatment, rehabilitation, and disability costs of significant extremity trauma is far greater than that of any other spe- cialized medical injury. “In fact,” Ficke said, “the burden of cost for extremity injuries is greater than the combined costs of treating Traumatic Brain Injuries and Traumatic Stress.”
Compared with injuries of the head and neck, abdomen, and thorax, extremity injuries require the longest average inpatient stay (10.7 days), and account for 65 percent of total inpa- tient resource dollars and 64 percent of total projected disability costs (see figure on Page 36).
Focusing and Expanding Resources for Research
The DOD Peer Reviewed Orthopaedic Research Program’s Clinical Consortium Award mechanism was offered for the first time in FY09 with the twofold intent of funding clinical studies focused on improving the outcomes of severe mus- culoskeletal injuries commonly associated with military combat, and challenging the scientific community to explore new directions and address relevant issues that had not received sufficient atten- tion and funding. The overarching intent was to find solutions in the field of combat-related orthopedic injuries.
The award is designed to establish large, multisite clinical trials by combining the population of military orthopedic trauma patients and the combat-relevant expertise of military treatment facilities with the patient populations and research expertise of civilian trauma experts.
The original Major Extremity Trauma Research Consortium, established in 2009, was a network of 12 core Level I civilian trauma centers and four military treatment facilities: the Naval Medical Centers in Portsmouth, VA, and San Diego, CA; San Antonio Military Medical Center, Fort Sam
Within five years, we will be able to routinely regenerate four or five inches of new bone in patients with open [compound fracture] wounds.
Houston; and Walter Reed Army Medical Center, Washington, DC.
Anchored by the Data Coordinating and Research Center at the Johns Hopkins Bloomberg School of Public Health, the consortium works with USAISR to conduct multicenter clinical research studies relevant to the treatment and outcomes of orthopedic trauma sustained in the military.
“The initial $18 million in fund- ing from DOD and the Orthopaedic Extremity Trauma Research Program was critical to establishing the con- sortium and providing the resources required to address some of the mili- tary’s immediate research needs in the acute management of severe limb injuries,” said Ellen MacKenzie, Ph.D., Principal Investigator and Chair of the Bloomberg School’s Department of Health Policy and Management.
“The new $38.6 million in funding,” said Wenke, “will support efforts to double the number of core civilian trauma centers from 12 to 24; coor- dinate a group of 30 satellite trauma centers from across the country that have agreed to support the consortium through their participation in one or more consortium-sponsored studies; and conduct research in areas that have historically hindered optimum treat- ment and rehabilitation outcomes.”
Research targets include, but are not limited to: bone regeneration in patients who have suffered severe bone loss; bone infection; nonnarcotic alter- natives to the management of chronic pain; and the challenges associated with
reintegrating Soldiers and civilians into their respective “units” in society.
“Textbook teamwork,” responded COL Dallas Hack, Director of MRMC’s Combat Casualty Care Research Program, when asked to describe the collaboration by his office, USAISR, Johns Hopkins University, and USAMRAA to make this award. “Our team, led by USAMRAA, was united by its common mission to support the warfighter and driven by the compel- ling need to deliver extremity injury outcomes that we all believe will have an immediate quality-of-life impact on Soldiers’ lives.
“When USAMRAA, after several fund- ing and programmatic delays, received our Procurement Request, they had less than two months of the fiscal year in which to make an award. In that time, USAMRAA’s White Team worked tirelessly to review nearly 30 business proposals with a total value of $38.6 million; analyze, negotiate, and approve 30 separate budgets; and obtain the necessary in-house, command and Department of the Army-level approvals.
“This is the way program offices and their acquisition activity counterparts are supposed to work together,” Hack said.
Editor’s Note: It is with great sadness that we report author Jack Meikrantz passed away Jan. 24, 2011. He was a Business Development Specialist at USAMRAA, Business Oversight Branch, Fort Detrick. Meikrantz held a B.A. in business administration and accounting from Lycoming College.
APRIL –JUNE 2011 37
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