Net Ready Key Performance Parameters for military medical operations

¶ … capabilities of key medical personnel operating in an austere environment in terms of their performance measures on key indicators, the skill sets that they must possess and the method in which equipment and supplies will be transferred to the location where medical personnel are to provide care. NR KPP requirements are also set out as well as parameters for measuring the desired goals and needs of this operation. The systems needs are also set out in this study along with requirements of integration and joint communications. The implementation of scheduled delivery of increments is set out as well. Included in this report are illustrations in the form of charts and tables to assist with the understanding of the concept, strategy and implementation of this program.

Revision History

NR KPP revision history reported by the Joint Chief of Staff Instructor includes renaming the instruction which was previously named 'Interoperability and Supportability of Information Technology and National Security Systems' to "Net Ready Key

Performance Parameter (NR KPP)." (Chairman of the Joint Chiefs of Staff Instruction, 2012)

It is reported that the revision "eliminates previous elements and activities (information assurance, data and services strategy, GIG Technical Guidance compliance, supportability compliance) from the NR KPP that are accomplished through other processes." ( Chairman of the Joint Chiefs of Staff Instruction, 2012) The other processes are reported to include the following:

(1) Compliant solution architecture-within the context of the refined

NR KPP-now DODAF Architecture data. (Chairman of the Joint Chiefs of Staff Instruction, 2012)

(2) The requirement to comply with the Net Centric Data and Services

Strategies remains, but is no longer part of the NR-KPP. For NR KPP purposes compliance verification information (Data/Service Exposure Verification. Chairman of the Joint Chiefs of Staff Instruction, 2012)

Tracking Sheet - "Bluesheet" - data) is provided DIV-3 submissions.

(3) GIG Technical Guidance (GTG) - exists in the ISP. Chairman of the Joint Chiefs of Staff Instruction, 2012)

(4) DOD Information Assurance (IA) requirement - exist as a DAA

responsibility.

(5) Supportability requirements - exists in the ISP but spectrum requirements compliance will continue to be analyzed within the refined NR

KPP. The NR KPP was redefined as three attributes focused on, validated, verifiable performance measures and metrics. NR KPP architecture development methodology (based on DODAF architecture or the optional NR KPP Architecture Data Assessment Template) was added with a requirement to align with DOD Information Enterprise

Architecture (lEA) (reference m), the current DODAF, JIE ORA/WEA and JCSFL. Process details were removed from the instruction and added to the NR

KPP Manual Wiki page to allow for more rapid dissemination of changes." (Chairman of the Joint Chiefs of Staff Instruction, 2012)

Stated as NR KPP Attributes for Certification are the following:

(1) IT must be able to support military operations;

(2) IT must be able to be entered and managed on the network

(3) IT must effectively exchange information. ( Chairman of the Joint Chiefs of Staff Instruction, 2012, )

Integrated architecture products used for support include the Joint Common Systems Function List needed to assess information, exchange information and to be effective operationally. Three architectural views are those of technical, operational and systems in compliance with the DoD Architecture Framework version 2.0. Required is compliance with DoD Net-Centric Data and Service Strategies which is inclusive of services exposure and data criterion. Provided is the model for the structural architecture and compliance with relevant Global Information Grid (GIG) Technical Guidance (GTG). Also required is that the systems used be compliant with supportability factors stated to include "Spectrum Analysis, Selective Availability Anti-Spoofing Module, and the Joint Tactical Radio System." (Chairman of the Joint Chiefs of Staff Instruction, 2012)

Point of Contact:

DOD HD and CS JOC: CAPT Bill Cogan, USN, Chief, Strategy and Policy Division (J52), USNORTHCOM DSN: 692-1097 Commercial: [HIDDEN]

Table of Contents

Capabilities Discussion

5

Concept of Operations Summary

7

Threat Summary

10

Program Summary

10

System Capabilities Required for the Current Increment

11

List of Figures

Figure 1 -- JCIDS Process

11

Figure 2 -- Net-Centric Data Strategy Goals

12

Figure 3 - Key Performance Parameter Table

13

Figure 4 -- Additional Attributes

13

Concept of Operations Summary

Included in key Medical Personnel is the Medical Advanced Echelon (ADVON). It is reported that these medics "bring unique capabilities to support the deployed joint SOF commander. SOFME personnel should deploy in advance of main forces to conduct in-theater site surveys of HN medical facilities, public health, health risk, and disease surveillance at deployed locations. The ADVON team should identify all medical assets (including other SOF medics/medical capabilities/PJs) in the AOR and begin to establish lines of communication. Medical personnel can be sourced for the ADVON from the FFQEK or FFQE8 medical UTCs or the JSOAC medical staff positions assigned to 9 AAHQ UTC. The 9 AAHQ UTC is an AFSOC Headquarters UTC that provides the core staff for the theater AFSOF for contingency and wartime requirements." ( Air Force Tactics, Techniques and Procedures 3024.6, 2005)

It is stated that the crisis characteristics drive the response of medical personnel. Stated as core concepts of AFSOC Medicine in the Battlespace including: (1) Forward Operating Base/Intermediate Staging Base (FOB/ISB) Base Operating Support (BOS).." ( Air Force Tactics, Techniques and Procedures 3024.6, 2005) This is constructed on tiered supply and equipment packages and include the "SOFME medical backpack, aircraft rollpacks and RRDK which are the initial building blocks for AFSOC medical support and may be built upon as the contingency intensifies or as workload increases. The amount of basic care and clinical oversight responsibilities are based upon a population at risk assessment." ( Air Force Tactics, Techniques and Procedures 3024.6, 2005) Stated as the secondary operational mission of SOFME is what is termed 'CASEVAC' which means to "stabilize and transport (with en-route medical care) patients from battlefield forward locations to advanced medical care facilities using vehicles/aircraft of opportunity. The CASEVAC package and RRDK provide equipment and supplies to perform casualty evacuation in austere environments. The basic CASEVAC capability of the SOFME can be enhanced with support from the special operations critical care transport team (SOCCET) however; the SOFME is trained and equipped to be the first option." ( Air Force Tactics, Techniques and Procedures 3024.6, 2005)

Other members of the medical personnel team include the following:

(1) Advanced Surgical/Critical Care and Transport. "This capability is met by adding SOF Surgical Teams (SOSTs) and SOCCETs to provide a far-forward surgical intervention, stabilization and patient holding and transport capabilities. These teams in combination with other joint medical support assets can provide a robust critical care capability." ( Air Force Tactics, Techniques and Procedures 3024.6, 2005)

(2) Casualty and Disease Management in SOF Operations. The SOF mission requires medical preparation to stabilize injured or seriously ill members while moving them towards definitive care. This may occur in environments quite distant from acceptable sources of definitive care and distant from conventional aeromedical evacuation support. AFSOC deployed capability for management of disease and injury can be characterized by four phases: 1) SABC; 2) initial response; 3) stabilization and treatment; and 4) CASEVAC. Phases two through four may overlap and occur simultaneously to varying extents, depending on the scenario. If movement by air is immediately available and/or rendered urgent by the tactical situation, stabilization may occur during CASEVAC. The SOFME provides casualty and disease management during SOF operations to stabilize injured or ill patients while moving them to/towards definitive care." ( Air Force Tactics, Techniques and Procedures 3024.6, 2005)

Medical Personnel Considerations stated in "intermediate situations where tactical extraction and initial stabilization are necessary under high threat but less than active combat conditions, PJs in combination with SOFME assets can be used to provide greater monitoring and treatment capability and would provide a high level of medical capability immediately to the casualties. Environments where extended transport time (over two hours) are expected or there is known disease component along with the trauma or other complicating medical factors may be part of the injury scenario, SOFME and/or SOCCET assets should be considered." ( Air Force Tactics, Techniques and Procedures 3024.6, 2005)

Casualty Stabilization and Disease Treatment has the objective of "achieving a stable airway, control of hemorrhage, treated shock, and splinted fractures. Stabilization begins with the first responders and continues as the casualty is transferred to the care of the SOF Medical Element flight surgeons and technicians and moved towards definitive care. Serious disease requiring evacuation is stabilized and moved in the same fashion." ( Air Force Tactics, Techniques and Procedures 3024.6, 2005) Stabilization may become prolonged in nature if there is not air evacuation of an acceptable nature available.

Threat Summary.

Biological warfare is cited as a threat by the Department of Defense and it is reported that the Department of Defense biodefense efforts need to ensure development and licensing of "vaccines, therapeutic drugs, and antitoxins to protect members of the armed forces against biological warfare agents." (DOD, 2014, p.1) It is reported that the environment of projected threat and the capabilities to countering threat must include considerations of "the nature of the threat, threat tactics and projected threat capabilities" including lethal and nonlethal threats across time. (DOD, 2014, p. 1)

Program Summary:

The program strategy set for reaching full capability involves putting into place the most efficient IT operations that functions in a 'Family of Systems' (FOS) environment with joint operations communications capacity. The IT operations must be compact and able to be moved quickly and efficiently comprising the least load weight possible for use in austere locations. In addition medical supply inventory must be standardized and as with IT operations comprise the lead load weight possible while ensuring the supplies necessary for treating the wounded and sick, providing disease prevention and decontamination measures. Incremental delivery to the austere location environment will ensue as follows:

(1) First increment -- IT operations

(2) Second increment -- food, water and fuel

(3) Third increment -- medical supply packs which are prepackaged according to determination of critical supplies

(4) Fourth increment -- vaccines, decontamination equipment, and specialized medical supplies for treating transmissible diseases.

This program will utilized the JCIDS Process: Capabilities Based Assessment (CBA) with the requirements stated as follows:

(1) Define the mission;

(2) Identify capabilities required

(3) Determine the attributes/standards of the capabilities;

(4) Identify gaps;

(5) Assess operational risk associated with the gaps;

(6) Prioritize the gaps

(7) Identify and assess potential non-material solutions; and (8) Provide recommendations for addressing the gaps. (Acqnotes, 2015, p. 1)

The following chart shows the conception of these requirements.

Figure 1 -- JCIDS Process

System Capabilities Required for the Current Increment.

(1) Family of Systems (FOS): Information technology systems that has the ability to communicate with others in the austere environment including military personnel and other services.

(2) Commercial Off the Shelf System (COTS): COTS will be used to fill in any gaps in IT for this medical team in the austere location.

Net-Centric Data Strategy Goals are listed in the following table.

Figure 2 -- Net-Centric Data Strategy Goals

Goal

Description

Goals to increase Enterprise and community data over private user and system data

Visible

Users and applications can discover the existence of data assets through catalogs, registries, and other search services. All data assets (intelligence, no intelligence, raw, and processed) are advertised or "made visible" by providing metadata, which describes the asset.

Accessible

Users and applications post data to a "shared space." Posting data implies that (1) descriptive information about the asset (metadata) has been provided to a catalog that is visible to the Enterprise and (2) the data is stored such that users and applications in the Enterprise can access it. Data assets are made available to any user or application except when limited by policy, regulation, or security.

Institutionalize

Data approaches are incorporated into Department processes and practices. The benefits of Enterprise and community data are recognized throughout the Department.

Goals to increase use of Enterprise and community data

Understandable

Users and applications can comprehend the data, both structurally and semantically, and readily determine how the data may be used for their specific needs.

Trusted

Users and applications can determine and assess the authority of the source because the pedigree, security level, and access control level of each data asset is known and available.

Interoperable

Many-to-many exchanges of data occur between systems, through interfaces that are sometimes predefined or sometimes unanticipated. Metadata is available to allow mediation or translation of data between interfaces, as needed.

Responsive to User Needs

Perspectives of users, whether data consumers or data producers, are incorporated into data approaches via continual feedback to ensure satisfaction.

Source: (Defense Acquisition Guidebook, 2015, p. 1)

Net Centric Service Users Strategy Goals include the following stated goals:

(1) Provide Services: Make information and functional capabilities available as appropriately secure services on the network. (Defense Acquisition Guidebook, 2015, p. 1)

(2) Use Services: Use existing services to satisfy mission needs before creating duplicative capabilities. (Defense Acquisition Guidebook, 2015, p. 1)

(3) Govern the Infrastructure and Services: Establish the policies and procedures for a single set of common standards, rules, and shared secure infrastructure and services throughout the DoD Enterprise to ensure interoperability. (Defense Acquisition Guidebook, 2015, p. 1)

(4) Monitor and Manage Services via GIG NetOps: Implement services in accordance with DoD's GIG NetOps Strategy and concept of operations to ensure situational awareness of the NCE. (Defense Acquisition Guidebook, 2015, p. 1)

Figure 3 - Key Performance Parameter Table

Key Performance Parameter

Development Threshold

Development Objective

Provide what is needed

10

10

Optimize Resources

10

10

Provide Options

8

7

Figure 4 - Additional Attributes

Attribute

Development Threshold

Development Objective

Disease Prevention

9

10

Decontamination

9

10

Preventive medicine

9

10