Medical tracking aids rescued soldier

FARWANIYA, Kuwait — Just as people have been engrossed by the story of Army Pfc. Jessica Lynch since her rescue from an Iraqi hospital, the Defense Department has tracked her progress with a Web-based system that was created to ensure that servicemen and women wounded in combat receive the care they require.

Lynch was treated for broken bones in both legs and an arm at a facility in Kuwait, then flown to an air base in Germany, where she is receiving more care before returning to the United States.

That is a common itinerary for soldiers wounded while serving in the Middle East or other distant locations. DOD's Transportation Command (Transcom) developed the Regulating and Command and Control Evacuation System, or TRAC2ES, to manage patients' care while they are in transit.

Lynch has been in TRAC2ES ever since she was rescued and taken to a medical facility in Kuwait, where she "was treated and observed, and then MedEvac'ed" out of the war zone, said Army Lt. Col. Eric Radford, medical regulating officer for the Third Medical Command in Atlanta, during an April 3 phone interview from Camp Arifjan, Kuwait.

Radford said Lynch does not appear to have life-threatening injuries, but that is often not the case for wounded servicemen and women. In many situations, the quality of care depends on how quickly they are treated. TRAC2ES helps by automating the process of assigning patients to suitable medical facilities and assists with arranging and monitoring transport.

TRAC2ES helps medical personnel prepare the space and equipment needed to care for patients sometimes hours before they even arrive, said retired Col. Carol Bomar, who was a chief flight nurse for the Air Force. "TRAC2ES allows the caretakers to get a better picture of what is happening with the patient," said Bomar, who is now an associate with Booz Allen Hamilton, which developed the system launched in 2001. "Before TRAC2ES, we had to make numerous phone calls to find that same information — if you were able to get a hold of the people who had it."

TRAC2ES has provided command and control of global patient movement ever since Operation Iraqi Freedom began March 20. It is managed by Transcom at Scott Air Force Base, Ill., where users undergo a two- to three-day training session, then receive a password and identification to log into the system, said Radford, a reservist from Aikens, S.C., who has been in the Middle East since December 2002.

"It is the primary means of evacuating out of...Iraq and Kuwait," he said. "It's been very effective for us because of the speed, accuracy and ability to move [wounded soldiers] throughout the world."

About 50 doctors and military medical staff in southwest Asia use the system, or about four trained users in each hospital, Radford said. He would not reveal the exact number of wounded soldiers who have been entered into TRAC2ES.

"The system came about as the result of after-action reports from [Operation] Desert Storm, when DOD recognized it could do better in tracking patients," said Air Force Lt. Col. James Patterson, deputy functional manager for TRAC2ES at Scott Air Force Base.

"It gives us in-transit visibility, so we know where the patient is going, what their status is and what wounds, injuries or illnesses they are suffering from," he said.

TRAC2ES also helps DOD identify trends, Patterson said. "In Afghanistan, we noticed some illnesses that were curious and were coming from one particular area," he said. "Because we [had] a real-time snapshot, we were able to prevent the outbreak of an epidemic" of salmonella.

The No. 1 challenge is a lack of bandwidth. "Nonsecure bandwidth becomes smaller and smaller as the war" progresses, Radford said. "It has affected the speed of the system somewhat and the number of people on it."

But DOD has used some workarounds that enable medical personnel to save patient data and then send it later when more bandwidth is available, as long as the wounded soldier won't be adversely affected by that delay, he said.

Still, even with the bandwidth constraints, TRAC2ES is light-years ahead of its predecessors, which were all closed, stand-alone systems, Radford said.

This is a joint system "used by all the services, which is much more of a benefit," he said.