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USTRANSCOM'S Global Patient Movement Requirements Center moves patients

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SCOTT AIR FORCE BASE, Ill. (USTCNS) --- The Global Patient Movement Requirements Center coordinates the global movement of patients. The GPMRC falls under the U.S. Transportation Command Surgeon General.

Previous to the GPMRC, there were two separate organizations to coordinate the movement of patients. On the operational side of the house, the people that coordinated the airlift worked in the 375th Airlift Wing, however, the medical regulating was a joint effort. These were later combined into one unit named the GPMRC. Because it is a USTRANSCOM unit, it is made up of members of all military services.

The GPMRC operates 24 hours a day, seven days a week, with approximately 35 operations positions and 25 support/readiness personnel.

"Several years ago, as the result of Desert Storm, the USTRANSCOM Command Surgeon came up with a basic concept of having one stop shopping for patient movement globally," says Maj. Rick Miles, chief, Mission Support Branch. "This is when the GPMRC came about. Any patient movement clerk at a medical treatment facility around the world need only call the GPMRC, which coordinates patient movement by ground, sea or air. A majority of the patient movement is, of course, by airlift.

"We do not maintain command and control over any transporters," he says. "We coordinate the patient...The patient is reported to our regulator staff made up of corpsmen and nurses who get all information on the patient's condition."

Once the regulator completes the task they pass it on to the operations staff who review the location of the patient and suitable airfield availability. They additionally determine if a scheduled flight is available or if the patient's condition mandates a special flight, double check the patient's condition one day prior to the flight, then brief the medical crew that will transport the patient and ensure all required equipment is available. The mission is then turned over to the Air Mobility Command's Tanker Airlift Control Center for control of the flight.

The GPMRC maintains control of the patient. If there is any change in the status of the patient, the MTF calls to consult with the GPMRC. If the patients' condition changes while in the care of the aeromedical evacuation crew, the GPMRC is again consulted.

"In the early 90s, then Brig. Gen. Charles Roadman II (now Lt. Gen. retired) and others saw the need for Intransient Visibility (ITV), maintaining a picture of where a particular patient is throughout the system," Miles points out. "During the Gulf War, concerned family or friends would call to find out where a servicemember was in the system, and it would take days to track him or her down. Often times they were in a MTF waiting for transportation back to the United States.

"In theory, we would like to have constant ITV; to know where a patient is at any moment," the major adds. "It's almost impossible to achieve. When a patient transcends from one phase to another for treatment, it gets reported back here. If it doesn't, we begin to investigate the location of the patients."

ITV is done manually now, but USTRANSCOM has been tasked to develop an automated tracking system for patient movement. This new system, called TRANSCOM Regulating And Command and Control Evacuation System (TRAC2ES), is scheduled to come on line in June and does much more. TRAC2ES makes it much easier to track patients, and will also update the GPMRC computers with a better program than what is used now for planning patient movement.

There are also two Theater Patient Movement Requirement Centers, one in the Pacific (TPMRC-P) and the other in Europe (TPMRC-E), that coordinate the patient movements within theater. When a patient moves out of theater, it is reported back to the GPMRC for monitoring further movement.

The GPMRC does not normally get involved with intratheater TPMRC-E or TPMRC-P movements.

The GPMRC is actually a third TPMRC with responsibility for North, Central and South America.

Routine patient movement is accomplished using scheduled flights. The aircraft follows a specific regional route, stopping to drop off or pick up patients along the way. Then a few days later the aircraft reverses its path to bring patients back to their home bases. This is a reliable system that transports most of the patients. These routes may be adjusted to meet any special needs of a patient.

The C-9A Nightingale is mostly used for these flights. It is specially designed as a medical airlifter and carries a minimum medical crew of five; two flight nurses and three medical technicians. The inside may be configured to accommodate a combination of seats and litters as required. There is a nurse's station and a treatment area on board. When possible, space available passengers can hitch a ride, but patients have priority.

Patient movement falls into one of three categories; routine, priority or urgent. Routine patients go on the next available transporter, while priority patients usually move the same day. Urgent, or life threatening patients, leave as soon as possible, even if it requires generating a special launch aircraft.

Just to throw out some numbers, there were a total of 9,290 patients transported within the continental United States in FY00. Urgent was 67, priority 81, and routine 9,142.

"We also respond to contingency missions using the Joint Patient Movement Requirement Center, supported by Reserves and active duty members," said Miles. "These are three Unit Type Codes (UTCs) that are made up of 12 individuals similar to our GPMRC staff; corpsmen, medical technicians, hospital administration and nursing. These teams have the capability of mobilizing to a natural disaster or contingency in the Joint Operations Area to coordinate with one of the TPMRCs for patient movement. This is extremely useful in an area where communications is not available such as with Hurricane Mitch. They also participate in various exercises.

"We were involved in the USS COLE bombing, acting in conjunction with TPMRC-E as the global contact for all patient movement."

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