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Advanced Information Technology to Improve Mobility, Interoperability, and Survivability of Expeditionary Medical Command, Control, Communications, and Computers (Direct to Phase II)




OBJECTIVE: This topic is intended for technology proven ready to move directly into Phase II and is accepting Direct to Phase II proposals only. Develop expeditionary and interoperable information technology (IT) to enable health care delivery (HCD), medical command and control (MEDC2), medical logistics (MEDLOG), and patient movement (PM) in austere and contested environments.


DESCRIPTION: No capabilities fully bridge the gaps between expeditionary medical (EXMED) units, civilian and military brick-and-mortar medical facilities, and other healthcare providers, such as civilian emergency medical service (EMS) providers. Although standards exist to facilitate data interchange, there are limited solutions that offer robust communications and computer IT packages to implement standards at all levels of care, across military and civilian healthcare organizations.


Currently, EXMED units, like many civilian EMS providers, present paper charts or verbal reports when transferring care. These methods of information exchange lead to errors, reducing timeliness and quality of care. Even within such units, medical functionality is not fully interoperable; for example, information from diagnostic equipment must be manually captured in electronic health records (EHR) [2]. Further, administrative and public health functions are often disconnected from EXMED and civilian care providers, limiting visibility of logistics needs (e.g., supply) and safety considerations (e.g., disease vectors). Agile and interoperable solutions are required to improve healthcare provision both on the battlefield and at home.


Mobile and rugged C2, communications, and computer (C4) IT solutions and medical applications are required to ensure uninterrupted and secure HCD within medical units and throughout the continuum, from en route care (ERC) provided during PM to hospital care. Solutions must enable interoperability across all medical and administrative functions (MEDLOG, MEDC2) and domains, securely connecting medical and support endpoints (e.g., laptops, mobile x-rays) to each other and the enterprise.


C4IT solutions must achieve interoperability by implementing joint/industry communications and health IT standards (e.g., United States Core Data for Interoperability [USCDI] [2]) and meeting cybersecurity requirements (e.g., National Institute of Standards and Technology [NIST] Risk Management Framework [RMF] [1]). EXMED C4IT solutions must be resilient, scalable, and extensible. Solutions must survive and operate with limited degradation in various environmental conditions, including climatic extremes, degraded/denied external communications, and in the face of threats such as cyber attacks. Scalability is required to ensure the solution can be tailored to meet the mobility and capacity needs of various medical units. Extensibility is critical to ensuring solutions can incorporate new functionality and additional interfaces as civilian and DOD medical technology improves. For example, C4IT must connect to various civilian health information and DOD networks (e.g., Joint Health Information Exchange). Resiliency and interoperability require an innovative application of networking/communications, artificial intelligence, data storage/management, and other technologies that facilitate realizing smart hospital [3] benefits in a distributed and expeditionary environment.


PHASE I: This topic is intended for technology proven ready to move directly into Phase II. Therefore, the offeror must be able to demonstrate and provide documentation to substantiate that the scientific and technical merit and feasibility described in Phase I has been met and demonstrates the accomplishment of a "Phase I like" effort, including a feasibility study. Documentation shall address employment of novel technologies or innovative applications of edge computing, asynchronous / store-and-forward communications, data storage (e.g., data lakes), machine learning, or similar concepts to deliver a solution that provides secure and continuous operations in a hybrid cloud or distributed environment and maximizes interoperability both with enterprise solutions and between local endpoints. Conceptual design and feasibility studies do not need to be limited to military or medical applications. However, documentation should indicate applicability to EXMED operations described herein. Documentation should include the following:

(a) Preliminary data to support the security and efficacy of concepts

(b) Specifications that describe/illustrate mobility, modularity, scalability, extensibility, and resiliency of design

(c) Statistically significant performance data, if available

(d) Applicability to EXMED operations


PHASE II: The phase will include:

(a) Design refinement, specifying mobile and rugged EXMED C4IT, including:

1. Structure: hardened enclosure, network components, endpoints, dependencies, and connectivity

2. Functionality: security, enterprise and standalone operations, and wired and wireless connectivity

3. Interfaces with Joint Operational Medicine Information Systems (JOMIS) [5], including solutions requiring client applications and browser-enabled access

4. Security measures

5. Standards and protocols

(b) Prototype implementation planning; includes risks, mitigations, timeline, cost, and critical design aspects

(c) Prototype development. Prototype must:

1. Implement approved design

2. Be transportable in and include a hardened 10-foot ISO container (or comparable)

3. Include

i. Mobile network infrastructure

ii. Endpoints, minimally:

a. Twenty mobile computing devices: a mix of laptops, tablets, and thin-clients

b. Three printing and scanning devices

c. One mobile x-ray

d. One mobile diagnostic laboratory device

e. Patient monitoring equipment for three patients

(d) Test planning and execution; includes reporting actual characteristics (e.g., security, interoperability, performance) and improvements required

(e) Transition planning; includes timeline, production and sustainment costs, production and commercialization risks


Required deliverables include one prototype as described herein, design and plans specified herein, regular progress reports (with risks, cost and schedule impacts, mitigations), and a final report (with findings and recommendations).


PHASE III DUAL USE APPLICATIONS: Using the results and progress made during Phase II, a Phase III effort will complete all required work to deploy the C4IT capability in an operational environment. This phase will include the following tasks:

(a) Engineering, production, and management support, including support to transition the solution to (or coordinate with) PMS 408 for further deployment and evaluation

(b) Optimization of design to develop commercially viable product that can also meet military requirements

1. Design must clarify modifications required to maximize commercial viability. Innovative approaches are required to ensure design is extensible and interoperable such that the capability can be marketed to a wide audience

i. In addition to implementing specified standards, C4IT design should enable exchange consistent with standards developed by organizations like Digital Imaging and Communications in Medicine (DICOM), Health Level Seven International (HL7), and National Council for Prescription Drug Programs (NCPDP)

ii. Design should employ technologies like machine learning and data lakes to collect and process unstructured data and structured data of various formats

iii. Design should include creative approaches to enable rapid integration of new endpoints; endpoints may be vastly different in purpose and construct

2. Design must clarify modifications required to enable operations in military environments/conditions, including operations ashore in austere environments (e.g., little/no communications/connectivity provided by other organizations) and operations on aircraft and ships

i. Modifications should detail requirements to fully implement interfaces/integration with JOMIS [5], including:

a. Operational Medicine Care Delivery Platform (OpMed CDP)

b. Military Heath System (MHS) GENESIS Theater (MHSG-T)

c. Operational Medicine Data System (OMDS)

d. Medical Common Operational Picture (MedCOP)

ii. Modifications should detail requirements to

a. Scale the system up (150-person team) or down (2-person team)

b. Integrate new/alternative endpoints

c. Employ new/alternative information exchange mechanisms to ensure interoperability with latest DOD enterprise information systems (IS), including administrative (i.e., non-health) IS.

iii. Design must account for modifications to fully meet DOD cybersecurity per DODI 8510.01 [4] and enable operations on DOD networks afloat and ashore

(c) Optimization of plan to produce and sustain systems; plan must account for:

1. Timeline and cost to become production ready

2. Modernization of Phase II prototype to meet updated design

3. Production of three systems within twelve months of design optimization

4. Sustainment of four systems, to include maintenance of cybersecurity (e.g., software/firmware patches)

5. Modernization, production, and sustainment of additional systems to support various organizations/applications, within and outside the DOD

Potential commercial applications cover both medical and non-medical industries, including:

(a) Organizations requiring distributed operations or operations in austere environments, e.g., North Atlantic Treaty Organization (NATO) forces, including medical units; civilian and military support to disaster relief and humanitarian aid efforts; and mobile clinics/healthcare

(b) Industries that struggle with stovepipe systems, disparate/non-existent standards, or rapidly growing base of distributed users and require the ability to quickly integrate new technologies/endpoints



  1. Computer Security Resource Center (CSRC). (2024). “NIST Risk Management Framework.”

• This reference provides information about the NIST RMF process to comprehensively and measurably managing information security and privacy risks.

  1. Health IT. (2024). “The ONC Health IT Playbook”.

• The Health IT Playbook is a tool for anyone who wants to leverage health IT, including electronic health records and health IT certification.

  1. Kaldoudi E. (2023). Smart hospital: The future of healthcare. Computational and Structural Biotechnology Journal, 24, 87-88.

• This article describes the critical characteristics of a modern smart hospital.

  1. Office of the DOD Chief Information Officer. (2022). DOD Instruction 8510.01, “Risk Management Framework for DOD Systems.”

• This issuance establishes cybersecurity RMF for DOD Systems.

  1. Program Executive Office (PEO) Defense Healthcare Management Systems (DHMS). (2023). “Joint Operational Medicine Information Systems.”

• This reference describes the JOMIS Program Management Office health IT portfolio, including Operational Medicine Care Delivery Platform (OpMed CDP), MHS GENESIS-Theater, and Operational Medicine Data Service (OMDS).


KEYWORDS: command, control, communications, and computer (C4) systems; communication networks; artificial intelligence (AI) computing; smart technology; cloud computing; information technology (IT); health care technology; Joint Operational Medicine Information Systems (JOMIS)

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