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

2. 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

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

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

5. 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.

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

7. 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

8. 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.)

9. 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.

10. 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.

11. Patient Movement
USTRANSCOM

12. 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

13. 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

14. 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

15. 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.

16. PATIENT MOVEMENT Logging on to TRAC2ES
Must be from .mil or .gov computer Recommended browsers: Mozilla or Internet Explorer Will work with other versions but performance may be sub-optimal URL: Exercise Servier:

17. 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

18. 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.

19. 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.

20. 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.

21. 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.

22. 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 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.

23. 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

24. Questions?
(618)
DSN: