The opening session centered on USAMRDC’s distinct but complementary focuses on research and acquisition, and was led by Dr. Mark Dertzbaugh, Principal Assistant for Research and Technology and COL John Nuckols, Acting Principal Assistant for Acquisition. Dr. Dertzbaugh outlined key elements of the 2040 USAMRDC vision for science and technology including the need to push medical capabilities far-forward to the leading edge of a conflict zone. This correlates to medical capabilities of lower size, weight and power to improve mobility and better accommodate mass casualties. Other key parts of the vision document include developing solutions that can leverage robotic/semi-autonomous systems and maximize human performance. Dr. Dertzbaugh further highlighted the ongoing transition of research and development activity to the Defense Health Agency (DHA). He noted the overarching priorities of three existing USAMRDC portfolios relating to combat casualty care, infectious disease and operational medicine will not change with the transition.  COL Nuckols discussed the remit of his command which is centered on meeting well-defined requirements with solutions that are in more advanced stages of development that can be fielded in the nearer term (e.g. by 2030). He further emphasized that the ‘golden hour’ for stabilization of battlefield-induced traumatic injury and admission of casualties to a hospital is an outdated concept. The new paradigm is ‘golden hours’ and even ‘golden days’ prior to hospitalization, in part due to the rise of near peer adversaries and an inability to assume air superiority conducive to medical evacuation.

A subsequent session moderated by COL Andy Nuce, featured leaders from the U.S. Army Medical Materiel Development Activity (USAMMDA) group. Individual project management offices (PMOs) coordinate with extramural performers, DoD and non-DoD stakeholders to develop and deliver FDA approved medical solutions for specific areas of combat casualty care. PMOs include brain health (solutions for TBI, psychological health), expeditionary medicine (hemorrhage control, burn care, organ damage repair) and protection and acute care (diagnostics and treatments for infectious diseases, wound infections). Each PMO leader discussed notable solutions that their group had developed recently and overall priorities for their teams. Also represented at this forum were leaders from the Force Health Protection group whose mission is centered on delivering investigational medical countermeasures via emergency use authorization in times of acute need and the Solider Medical Devices Group which focuses on hospitalization, health prevention, logistics, treatment and evacuation of warfighters.

Another key session of the day featured Nathan Fisher, of USAMRDC’s Telemedicine and Advanced Technology Research Center (TATRC) who discussed the directions his Medical Robotics and Autonomous Systems Group is taking to fuse data, humans and machines into trustworthy solutions to optimize warfighter care. He noted that collection and maintenance of casualty data during conflicts is notoriously poor. Developing solutions to passively and remotely collect data from the field (e.g. from cameras, wearables), extract relevant parts of the data and furnish it to military medical decision makers is a priority for his group. A related element of this work is developing a remote patient management system wherein different medical devices integrate into a single data set. This would allow a medic to operate disparate medical devices with a common interface, without needing to be trained in the individual operating system of each device.  Overall, it was emphasized that medical robotic and autonomous system are not being designed to replace human providers, but rather to offload select cognitive and physical burdens. This paradigm would allow a single medic to better distribute their time during a mass casualty event, both in terms of providing intensive care for seriously wounded warfighters for longer periods and to attend to multiple less serious cases within a shorter period. This algins with earlier remarks during the day about the need to advance far forward and prolonged care, and the end of the golden hour.

The latter half of the day included sessions on USAMRDC centric funding opportunities and award mechanisms. This included a session on the Congressionally Directed Medical Research Programs (CDMRP) that was co-led by current program director COL Sarah Goldman and her designated successor COL Mark Hartell. CDMRP is a unique family of programs that funds biomedical research that aligns with the stated interests the military and that other agencies typically do not fund. However, CDMRP opportunities and programs here are not limited to areas of traditional military medicine and include work in areas such as cancer, epilepsy, vision health and Alzheimer’s disease to name a few. For FY2024 CDMRP has $1.546 billion in funding across ~40 disease and injury focused programs. The session highlighted CDMRP’s unique two-tiered review process that encompasses both conventional scientific peer review and programmatic review that includes consumers (e.g. patients, caregivers), and the nuances of program development via yearly Congressional appropriations. The session concluded with the opportunity to engage with program managers (PMs). We spoke  with PMs for the Joint Warfighter Medical Research Program which augments support for previously funded DoD research that meets critical military medical needs and the Peer Reviewed Medical Research Program which has the single largest CDMRP allocation ($370 million) and supports the whole spectrum of basic to translational to clinical research across eight portfolio areas.

These highlights represent only a fraction of all sessions from this Capability Day – which also featured affiliates of the US Army Institute of Infectious Diseases (USAMRIID), Institute of Surgical Research (ISR), Medical Research Acquisition Activity (USAMRAA), the Medical Technology Enterprise Consortium (MTEC), the Walter Reed Army Institute of Research (WRAIR), the Office of Regulated Activities and several others. While navigating the DoD medical space can be daunting – regularly attending forums like these is key to building relationships with program managers, understanding the military’s evolving requirements and tailoring your medical innovation endeavors to meet these requirements in order to obtain funding, establish cooperative agreements and secure contracts.