ALL ROADS LEAD TO SUSTAINMENT

For many U.S. Army weapon systems, sustainment planning is inherent in the acquisition and development process. When the Army builds a new weapons system, for example, program managers collect data during testing and evaluation to understand the system’s maintainability and reliability. They use this information to calculate future sustainment needs. They know how much power or fuel the system needs. They estimate what repair parts it will require over its life cycle and then source those parts. They project when the system will need major overhauls.

For many years, medical materiel, known as Class VIII materiel, functioned differently. In part, this variation was because most medical devices used by the operational Army were developed by private industry for use in hospitals. In Operation Enduring Freedom and Operation Allies Welcome, the U.S. had air superiority and evacuated injured warfighters within 60 minutes. Research suggests that this “Golden Hour” can result in an impressive survivability rate of over 90% for victims of warfare and trauma. With air superiority, the medical commodity was able to overcome challenges typically encountered on the battlefield.

The Golden Hour will be impossible in a contested environment with limited air and ground evacuation and congested logistics. The wounded won’t be able to get out, and new equipment and resupply will not be able to get in using tactics from the last conflict. To accomplish our mission in future fights, medical logistics will need to be integrated into the Army sustainment enterprise and sustainment integrated into all medical acquisition programs.

Since its activation in 2019, U.S. Army Medical Logistics Command (AMLC) has been focused on ensuring that operational medical capabilities are sustainable for Soldiers and the joint force. As the Army’s Life Cycle Management Command (LCMC) for medical materiel, AMLC’s focus is to integrate sustainment considerations from the start of the acquisition process.

To lead this change, AMLC’s Integrated Logistics Support Center (ILSC)’s acquisition professionals are working in collaboration with materiel developers to bring key sustainment considerations, including centralized supply chain, materiel management and catalog standardization, into every stage of the acquisition process.

CENTRALIZED MATERIEL MANAGEMENT

The current military medical supply chain relies heavily on a global “just-in-time” manufacturing, inventory and distribution process. Surges in demand or disruptions caused by natural disasters or global conflict can have catastrophic impacts on turnaround time, especially because many pharmaceuticals and medical devices are manufactured in other countries.

From an acquisition standpoint, that is why cataloging and sourcing—a function of the acquisition life cycle—and supply chain management become very complex. The Army doesn’t produce its own medical equipment and supplies. Therefore, the Army does not control defense contractor production lines.

Instead, AMLC partners with a global commercial industry including hundreds, if not thousands, of vendors, each of which has its own cycles of product development and business-driven change. The Army isn’t the only—or largest—customer for these high-demand medical devices and supplies.

To ensure the Army has the resources it needs, the AMLC’s ILSC is focused on centralized materiel management—a function most ILSCs are responsible for within their respective commodity. However, historically, the approach to medical materiel management varied by region and operational theater and relied heavily on commercially available products. The outcome of this approach was varied silos of supply.

To break down these silos and increase asset visibility across the force, the ILSC has been supporting an Army initiative called Medical Logistics in Campaigning (MiC). MiC is a combined effort of 16 different agencies working to streamline and integrate medical logistics processes into the wider Army sustainment enterprise, so that the Army can quickly transition from peacetime to a wartime operational environment.

MiC aims to simplify and standardize the medical supply catalog and integrate medical materiel into the Army’s systems of record, aligning with other commodities. The ILSC is enabling this integration by compiling and analyzing data to ensure supply and demand for medical materiel is captured and tracked within Army systems to allow commanders at echelon to make data-driven decisions about their medical readiness.

SUPPLY CHAIN RESILIENCE

When the Army must transition from competition to crisis, AMLC must be prepared to mitigate risk, especially if supply chains are contested or otherwise disrupted. AMLC must understand what Soldiers will need, when they will need it and the prioritization of limited resources.

To be successful, AMLC must integrate with the joint force and the Defense Logistics Agency to generate a common operating picture of global supply chain risk and proactively prioritize investments for surge capacity requirements.

AMLC must be proactive to ensure global sourcing and distribution strategies. One key element is maximizing partnerships with allied nations and their corresponding health care systems. By adding rigor to our requirements and maximizing interoperability as part of the acquisition process, the Army can increase responsiveness to the warfighter and provide better supply chain resilience.

The AMLC’s ILSC has a multi-faceted role and has to consider both the operational and clinical aspects of medical logistics support for Soldiers. As the medical Life Cycle Management Command, AMLC focuses on the Soldier as a “weapon system,” considering the entire continuum of care for the Service Member, and not just the hardware associated with medical care on the battlefield. (Graphic by Katie Ellis-Warfield and Leigh Anne Alexander, AMLC).

PREDICTIVE LOGISTICS

Data is a precious commodity to all classes of supply, including medical. Other Army commodities have embraced predictive logistics, and medical is now doing the same.
Predictive logistics is the use of data analysis, machine learning and statistical algorithms to forecast future supply chain requirements, identify potential disruptions and optimize resource allocation.

AMLC must consider data requirements as part of the acquisition process. By curating medical materiel management processes and data to incorporate advanced analytics and predictive logistics, AMLC’s ILSC will be able to anticipate needs and mitigate risk in real time, while streamlining our technology-enabled operations—all in lockstep with goals and strategies set forth by the U.S. Army Materiel Command.

While AMLC’s use of data science is just in the beginning stages, the ILSC is building the groundwork. This means working to integrate data from disparate sources, ensuring data security and privacy and overcoming cultural barriers to adoption. Predictive logistics will be the key that unlocks AMLC’s ability to enhance readiness, improve supply chain resilience and reduce overall costs as the Army prepares to fight and win future conflicts.

A CASE STUDY

The COVID-19 global pandemic tested our medical logistics capabilities and underscored the power of information. During the pandemic, many medical devices and supplies were in high demand, resulting in shortages. The initial pandemic response faced challenges to scale up manufacturing and deter counterfeit materiel. The demand on critical medical supplies extended far beyond just government agencies, forcing some health care providers to compete for limited resources.

These experiences showed the Army why asset visibility and supply integration are so critical to the mission. During a large-scale combat operation, the Army will likely face similar challenges of needing to predict where supplies will be needed and how to prioritize limited resources.

CONCLUSION

Every other Army weapon system is centered around deployable hardware or equipment. For medical, AMLC must also consider the well-being of the Army’s most valuable commodity—our Soldiers. Health care on the battlefield starts with medical logistics, but the medical materiel demand extends to brick-and-mortar DOD and Department of Veterans Affairs medical treatment facilities.

The Army’s system of health is built on a foundation of acquisition decisions that must include the full life cycle—from development through sustainment. All roads lead to sustainment.

For more information about AMLC’s ILSC and its worldwide support mission, go to: https://www.amlc.army.mil/ILSC.

LEIGH ANNE ALEXANDER is the director of the Integrated Logistics Support Center at AMLC, the Army’s Life Cycle Management Command for medical materiel. She holds an MBA and an M.S. in biotechnology, both from the University of Maryland, University College. She holds a B.A. in chemistry and a B.A. in American studies, both from Lafeyette College. Before joining AMLC, she served in project management and acquisition roles under the U.S. Army Medical Research and Development Command and Joint Program Executive Office for Chemical, Biological, Radiological and Nuclear Defense Medical Countermeasures Systems