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«  The AMEDD Futures 2039  Project:  Phase 2 Final Report    June 30, 2009                             ...»

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The AMEDD Futures 2039 


Phase 2 Final Report 


June 30, 2009 




Table of Contents

AMEDD Futures 2039 Project Report

Provocative Forecasts

Sample Forecasts from Individual Papers 


Lessons Learned

Virtual Work Group Reports Military Medicine 2039 - Jointness and Beyond

The 2039 Health Care Model

Healthy Communities in 2039

The Optimization of Health is Achieved Through Science and Technology:

Professional Staff and Professional Roles in 2039

The Power of Military Medicine for Geo – Political Aims

Individual Papers Appendix 1: Jointness and Beyond (VWG 1) Individual Papers

Jointness and Beyond - COL Timothy K. Jones 

Primary Stakeholders of a Consolidated Healthcare System “Beyond Jointness” – COL Robert G Hale .. 95  Military Medicine 2039 Jointness and Beyond – Richard Beauchemin 

Major Events Influencing Reorganization/Potential Model for Future Military Medicine – Joseph Vancosky 

What existing Studies have been completed on Mil-Med Reorganization? – COL Thomas R. Tempel Jr.  04  Appendix 2: The 2039 Health Care Model (VWG 2) Individual Papers

–  –  –

An Integrated Federal Health System in 2039 - Col Denise McCollum & Mr. Angel Padilla 

Where Will Health Services be Delivered in 2039? – Dr. William Rowley 

–  –  –

  Pre-disease Management - COL Evelyn Barraza & LTC Patricia McKinney 

How Will the Health of an Individual be Coordinated and Integrated in 2039? - LTC Jennie Irizarry & SFC Daniel Watford 


Appendix 3: Healthy Communities (VWG 3) Individual Papers

Building Community Coalitions for Health – Anna Courie 

Using the Community as a Buffer for Poverty and Improving Lifestyle – Kathleen Haskell 

Achieving Healthy Communities Up to and Through 2039 - LTC Beverly Ann Beavers 

–  –  –

The Mind of the Warrior: Producing Psychological Body-Armor for the Army - Anna Courie and Kym Ocasio 

Community Health Capacity – COL Robert Mott 

Appendix 4: Science and Technology (VWG 4) Individual Papers

–  –  –

How Science and Technology Will Enhance Medical Education and Training in 2039 – COL Randall G Anderson 

Enhancement of Human Health and Performance - MAJ Robert Carter 

Nanotechnology, Biotechnology, and Robotics for Far Forward Diagnosis and Treatment of Casualties in Future Warfare – Dr. Cynthia Abbott 

Patient Transport in 2039 - LeRoy A. Marklund, MAJ, AN 

Future Organization/Structure for Military Medical Research to Insure Flexibility, Responsiveness – LTC Andrea Stahl 

Appendix 5: Professional Staff and Roles (VWG 5) Individual Papers

Impact Of Future Military Mission Changes (Or Non-Changes) On Professionals and Professional Tasks for Military Medicine In 2039 - LTC James Davidson 

Factors and Forces Driving Forecasts of the Size and Structure of the AMEDD - LTC William Todd Echols 

Factors and Forces Driving Recruiting and Retention for Military Medicine In 2039 - LTC Tracy Werfele  

–  –  –

  Technology and How It Will Change Education / Training and Make Many Professional Tasks Obsolete For Military Medicine in 2039 - MAJ Shawn Gelzaines 


Non-Technological Factors and Forces Driving Training for Military Medicine in 2039 - LTC John Kent  

Appendix 6: Geo-Politics (VWG 6) Individual Papers

Geopolitical Climate in 2039 – COL Dana Scott 

What Will Military Medicine Look Like In 2039? – MAJ Chad Dawson 

What will medicine look like in 2039? – MAJ Cindy Renaker 

How Could Medicine Influence Geopolitical Environment Of 2039? – COL Corinne Ritter ................. 244                              Thinking about the future is a key 21st century leadership skill. Leaders need to be able to identify emerging patterns in the external and internal environments, and lead their organizations through change. Missions are changing. Leaders should recognize potential future missions and develop the capabilities to achieve them ahead of time, rather than reacting to changes in the environment.

The Army Medical Department (AMEDD) has completed Phase 1 and Phase 2 of the AMEDD Futures 2039 Project, which explored many of the trends that will become increasingly significant to the missions, capabilities, and performance of the AMEDD. During Phase 1 of the project, participants discussed a set of 14 forecasts developed by the Institute for Alternative Futures (IAF) for the year 2039. Following, Phase 2 taught participants to conduct an environmental scan and create provocative forecasts regarding the following topics Phase 1 participants identified as


• Military Medicine 2039 – Jointness and Beyond

• The 2039 Health Care Model

• Healthy Communities in 2039

• The Optimization of Health is Achieved through Science and Technology

• Professional Staff and Professional Roles in 2039

• The Power of Military Medicine for Geo-Political Aims Participants were divided into six “virtual working groups” (VWGs), each of which was led by a Senior Futurist Facilitator provided by IAF. Each VWG collaborated online and through teleconferences to scan recent trends and developments in their assigned topic area, create plausible and provocative forecasts for how that area could develop between now and 2039. From the forecasts, participants formulated specific actions the AMEDD should take today to prepare for those changes. Participants met for a one-day off-site in Arlington, VA to share their findings with the other groups, receive feedback on their work, and present their recommendations to project champion Brigadier General Tim Adams. After the incorporation of feedback from BG Adams and the rest of the groups, the VWGs later presented their findings and recommendations to the Surgeon General and other AMEDD leaders.

The six VWGs foresaw similar worlds in 2039, forecasting that we will live in a highly globalized and urbanized world, where the U.S. will not be the dominant political entity. Humanitarian crises, pandemics and resource shortages will ensure that public health issues present the greatest challenge

- and the greatest opportunity for the AMEDD to make a profound contribution. As traditional war-fighting will largely give way to broader military missions, the role of military medicine will grow from one of caring for soldiers and families to providing health care to local populations in foreign countries and to training health professionals in the local public health systems. As preparation for this larger role, the AMEDD will add “cultural skills” to its world-renowned medical skills and its electronic database of health outcomes. In its larger role the AMEDD will help build a “medical bridge to peace” – which will win allies to the U.S. side through its support of global public health.

The forces of technological advancement and preventive medicine will fundamentally change health care. Nanotech, biotech, robotics, regeneration, stem cell therapies, biosensors (implanted and AMEDD Futures 2039: Phase 2 Final Report, Page 5      remote) and other technologies will provide effective therapies for many diseases. Self-care and prevention will become replace expensive medical interventions. These two trends will combine in the expansion of telemedicine and in the development of what one group called “functional decision-making capacity” in health – an avatar-based system for personal health coaching and medical evidence collection that will grow out of electronic medical records (EMRs). This avatar technology will remake the medical education system, providing customized training for medical professionals throughout their careers.

Also common to all of the papers was a high level of aspiration for the AMEDD’s role in this changing world. Many of the papers presented AMEDD as a principal component of America’s appeal abroad. It is clear that participants take great pride in the AMEDD and anticipate playing an even greater role as America’s future health ambassadors to the world.

Phase 2 proved that the AMEDD has in its officer corps a number of very good forecasters who can study the leading edges of change and see possibilities for the AMEDD that include the promise of greatness – a great future for the AMEDD, the military, our country, and the world our children will inherit. This paper highlights the key outputs from the AMEDD 2039 Futures Project Phase 2,

and is organized according to VWG topic and divided into four main sections:

• Provocative forecasts that IAF abstracted from VWG Final Reports and then from individual papers;

• Recommendations for the AMEDD presented by each VWG Leader to the TSG;

• Lessons learned from Phase 2 and recommendations for a Phase 3; and

• Appendixes of each VWG report and individual papers submitted for this project.

Provocative Forecasts

The following are a synthesis of forecasts that were presented in the VWG Final Reports:

AMEDD Leads Health Mission for Achieving U.S. Global Aims In 2039 The U.S. will not be the dominant political entity in 2039. It will hold the role of “first among equals” with the European Union, China, India, Russia and Brazil … [which] will require the U.S. to work much more cooperatively with nations and non-state actors to achieve political goals … Nonstate actors [multinational companies and NGOs] will play a major role in addressing resource shortages, particularly … food and water. [VWG 6] [The] 2039 military operating environment … [is] a complex network of state and non-state actors creating challenges on multiple continents … many as a result of overpopulation in under-developed areas and wasteful consumption in developed areas. In 2039 sickness prevention is an economic issue, not just a healthcare issue, as businesses, communities and governments come together to address behavioral and social challenges leading to expensive ill health in a population. [VWG 5] [N]atural catastrophes will continue to require military assistance … We might often be deployed for extended periods of time to provide stability and build capacity for self sufficiency in a region …

AMEDD Futures 2039: Phase 2 Final Report, Page 6   

  Personnel are also expert in helping build health infrastructure and teaching local professionals how to effectively create their own health systems. [VWG 5] The U.S. strategic goals will focus on continued economic growth in areas of the world that are outside [the] growing circle of economic prosperity that globalization has created. While enemies still create security threats that war fighters face, military medicine works to reduce the number of areas in the world that support those enemies. U.S. military will still be relied upon to be [a] major security provider in…hot spots, but [building] security will be…more through relationship … than at the point of a gun … [VWG 6] In 2020 one of [AMEDD’s] biggest exports is ‘health’ to the Geographic Combatant Commander’s area of involvement. [VWG 1] With regard to military operations … [on] the battlefield … increasing [the] emphasis on non-kinetic operations supporting civil authorities … [These] operations demand a high degree of diplomatic skill from AMEDD leaders and mental agility to move from combat to humanitarian support within the same operation. [VWG 5] In 2039 the “conventional” war machine … will look drastically different with fewer war fighters in harm’s way … with … combat controllers working at a remote location. [VWG 5] AMEDD will still provide direct patient care to beneficiaries and to selected patients within deployed populations, but their primary role will be integration of medical training and resourcing within specified high risk regions throughout [the] globe. AMEDD will be [a] valuable arm of U.S.

geopolitical strategy building bridges to peace by making global health a politically stabilizing force.

[VWG 6, VWG 1] [A] cabinet level position [will be] created to help coordinate U.S. Government activity with multiregional companies and NGOs … co-equal with Secretaries of Defense and State. [VWG 6] Jointness & Beyond in the 2039 Healthcare Model   The cost of health care will prompt national governance that includes the military health system, the VA, Health and Human Services, and civilian health organizations in joint efforts that … ensure the quality of healthcare services … [and] medical readiness of the armed forces … [with a] National Insurance System. [VWG 1] Over the next 30 years there will be a shift from the medical home to home self-care and prevention to virtual self-care in cyberspace to prospective medicine and auto-care facilitated by nanobots.

These changes in care venues will dramatically change the role of the hospital to a few regional high capacity facilities shared by all health providers. [VWG 2] In 2039 individuals will be the driver of their health care rather than recipients of it. Data of their health status and behaviors will be continuously, automatically captured by sensors and displayed on an electronic dashboard. Individuals will have the knowledge and assistance to control their health, but they will be accountable and responsible for their outcomes. [VWG 2] Virtual knowledge management [is] the driving enabler of health … [through the] Health Advocate Avatar—an intelligent agent to detect diseases, repair cells and eliminate harmful pathogens while monitoring guidance from health providers on our behalf. The education avatar remains engaged

AMEDD Futures 2039: Phase 2 Final Report, Page 7   

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