1. Headquarters U.S. Air Force
Integrity - Service - Excellence
Forging a Better Tomorrow
Lt Gen C. Bruce Green CMSgt Charlie Cole
Surgeon General CMEF
AWC
13 December 2011

2. We’re All In
AF Mission
The mission of the
United States Air Force is
to fly, fight and win%in air,
space and cyberspace
AFMS Mission AFMS Vision
Seamless Health Service World-Class Healthcare
Support to USAF and for Our Beneficiaries
Combatant Commanders Anywhere, Anytime
Through Global Vigilance, Reach, and Power!
Integrity - Service - Excellence

3. Heritage of Innovation
Past Conflicts Military Transformation Today
Disruptive Innovations Have Shaped The Conduct Of War
& Safely Brought Our Heroes Home For Decades
Integrity - Service - Excellence

4. Then.Re-organization &
Budget Cuts
Integrity - Service - Excellence 4

5. Now.Re-organization &
Budget Cuts
Walter Reed National San Antonio
Military Medical Center Military Medical Center
(WRNMMC)
San Antonio Military
Health System
SAMHS
Ft Belvoir Community
Hospital (FBCH)
Wilford Hall
Andrews Ambulatory Ambulatory Surgery Center
Care Center
Building Upon Past Experience to Shape the Future
Integrity - Service - Excellence 5

6. Leadership
Leaders Understand They Must Earn/Maintain
Trust to Achieve Their Vision of the Future
“The Crucible of Experience”.
Early Aviators: Lt Hap Arnold, Lt Roy
Kirtland, Lt Tom Milling, Lt Sam Rockwell
Misty FACs 1969: Standing: Maj. Tony McPeak, Capt. Ron Fogleman,
Kneeling: 1st Lt. Charles "Clay" Veach
Experience Builds Expertise and Fosters Insight
Integrity - Service - Excellence 6

7. Leadership Recognizes Excellence.
Patient Evacuation
World War I through Vietnam
“We evacuated almost everyone from our forward hospitals by air,
and it has unquestionably saved – thousands of lives.”
18 June 1945, I n t e g rDwightS e r v i c e - E x the lSupreme Commander 7
General i t y - D. Eisenhower, c e l e n c e

8. Gaining Expertise
Resident/ED Mt Pinatubo
SrA Crowley (4N) MSgt Ergenbright (4E)
Eglin AFB Clark AFB
Cranial Bleed ATTC
MSgt Stone (First Sgt) SMSgt Withers
Lajes AFB Mt Home AFB
Air Evacuation
MSgt Cole (4N) AF/SG
Scott AFB (AMC) CMEF (4N)
Today: < 1/10 Beds in Theatre Compared to DS/DS
> 92K tpatients- SafelycMoved e l l10 Years
I n e g r i t y S e r v i e - E x c in e n c e 8

9. Future Based Agile Thinking (FBAT) for 2045
Drivers Scope the Trajectory
Drivers are key factors that influence the future. FBAT researched
to fully define and characterize each driver, its polar description, its
constituent elements, and its current status and indicated trajectory
Identify key Determine Adjust Maintain
Build
drivers of strategic Organization Learning &
Scenarios
change implications Strategy Monitor
Primary Drivers
- Knowledge: Science & Technology AFMS Vector
or String
- Geopolitics
- Culture
- Resources: Economic & Human
Coloring Drivers 2015
- Environmental Change 2027
- Human Factors 2035
2045
Strategy -- Common Practice -- Culture
Integrity - Service - Excellence 9

10. Shaping the Future of Military Healthcare
Synergy- Patient-Centered
Joint & Coalition Care
Organizational Precision
Agility Healthcare
Technology
Integration
Working Together, Achieving Success Through Common Vision
Integrity - Service - Excellence

11. Our Framework Provides
Focus and Alignment.
Strategies
Overlapping
Mission Areas Transform Deployable Capability
Rapid Response to Any Worldwide Contingency
Fit
Force Build Patient-Centered Care
Continuity & Prevention to Optimize Health
Invest in Education, Training & Research
Sustain Our Future Capabilities
Strategy Common Practice Culture
Integrity - Service - Excellence

12. In Pursuit of Lighter &
Leaner Medical Response
Humanitarian Assistance Health Response Team (HRT)
Rapid Response Team (HARRT)
Airlift Deployment Requirements:
Earthquakes
Indonesia < 24 HRS +
C-17’s
Rapid Response Medical Capabilities:
Emergency, Resuscitative, & Surgical Care
Earthquakes
Chile T+0 hrs Operational
Results:
Immediate Care
< 20 min
ER
Earthquakes < 2 hrs
Haiti OR & ICU
< 3 hrs
T+3 hrs
Pursuing Perfection in Medical Response Capability
Integrity - Service - Excellence

13. Continuous Advances in
Casualty Care
WWII
30% Learning From Coalition Partners, We
Leveraged Trauma Registry Data To
Build Innovative Solutions
> 80 Patients Moved as of Nov 11
Combat Mortality Rate
Korea
25% Tactical Critical Care Evacuation Team (TCCET)
Vietnam
24%
INTERFLY AGREEMENT
Applying Lessons Learned From the C-17
*AeroSpace Interoperability Council
Persian
Gulf
24% Creating a “patient staging” continuum
Modular Aeromedical Staging Capability (MASC)
OIF/OEF New CASF Activated at SAMMC
<10%
Re-engineering Global Patient Staging
Expeditionaryt Operationse Evolving tocSave n c e Globally
I n e g r i t y - S r v i c e - E x e l l e Lives

14. Transforming Focus from
Healthcare To Health
Total Population FH Clinics Started- 69
Enrolled: 773,887 Peds Clinics Started- 35
Healthcare is a
Clinic Team Sport Health
Management Management
HEALTHCARE HEALTH
Right Patient, Right Prevention,
Right Time, Right Outcome,
Maximize Teamwork/Skill Set s to Deliver Better Health & Better Care
Integrity - Service - Excellence 14

15. Leveraging Medical Informatics
DATA INFORMATION KNOWLEDGE WISDOM CHANGE
Better Care
TMDS Clinical
Through
Practice
Evidence Based
Guidelines
DEERS Practice
CarePoint Medication Better Health
PDTS Health
Alerts Enhanced Patient
Services Registries
Data Safety
$ / M2 Warehouse
User Home Best Value
(HSDW)
Interfaces Sensors Healthy Behavior
DMHRS
i Better Care
Expedited
EHR Test Results Improved Patient
Experience
Decision Support is No Longer Just for Our Providers
Integrity - Service - Excellence

16. Transforming Data Into
Knowledge
Ready Better Health Better Care
Patients receiving Diabetic patient
massive infusions of > educated on
10 pints experienced “remote
mortality of 33% monitoring”
glucometer
Clinical Study
Readings
Practice registry MTF calls
automatically
Guideline to identify patient to
sent to
developed trends discuss
healthcare
management
team
Conclude infusing
whole blood
Uncontrolled sugar
reduced mortality
levels Identified
to less than 20%
Using Informatics to Accelerate Change in Practice Patterns & Behavior
Integrity - Service - Excellence 16

17. Activating Patients & Care Teams
Health
Team Patient
Decision Patient Decision
Support Support
Centered
PCMH Provides Improved Decision Support- For Patients c eHealthcare Teams
Integrity - Service Excellen &

18. Patient Centered-Precision Care
AFMS Patient Centered-Precision Care (PC2)
State of the art, evidence-based,
personalized care incorporating all
available patient information
Targeted prevention and therapy
Two parallel efforts
PC2-Z (Research)
PC2-Clinical (Application)
Leveraging Partnerships To Advance Precision/Personalized Medicine
Integrity - Service - Excellence 18

19. Investing In Education,
Training, & Research
*METC Awarded Institute for Credentialing
Excellence’s Presidential Citation 2011!
Keeping Medics Ready Through Joint & Civilian Partnerships
Integrity - Service - Excellence 19

20. Integrating New Technology
Hand-held,
Battery-powered,
Laser Cautery &
Ablation Tool
From Force Health Protection To Logistics To Portable Surgical Tools
Automated
Directed Information
Energy & Data
Sensors Collection
(AIDC) Future CCATT Mission -
Current CCATT Mission
Wireless
Reaching Beyond with Evolutionary Advances and Concepts
Integrity - Service - Excellence 20

21. Establish Continuous
Academic Partnerships
Physician/Dentist Education (GME/DME)
Stand alone programs
Masters with civilian universities
Integrated/affiliated with Federal partners
84 Advanced Education General Dentistry-1 slots/yr
Dental Specialty certificate/Masters program opportunities
Nurse Education (Transition Program)
Nurse Enlisted Commissioning Program (NECP)
50 per year with school of their choice
Research USAF Dental Hygiene Program
Diabetes 10 scholarships per year
Telepathology Trident Technical College (SC)
Teleradiology St. Petersburg College (FL)
Education & Research – Vital to Building & Sustaining AFMS
Integrity - Service - Excellence

22. Global Reach:
AFMS Supporting National Priorities
Kyrgyzstan
1 Jan 10 - 30 Jun 11, 275 Missions in 81 Countries
Ukraine
Dominican
Republic Mozambique
Timor
Pacific
Belize Angel
Honduras Indonesia Vietnam
Sierra Leone
Building a Stronger Tomorrow With Global Partnerships
Integrity - Service - Excellence 22

23. Activities to Foster Innovation
The Crucible of Experience:
“A great deal of research has been conducted on the benefits of stepping away
from a problem in order to look at it from a fresh perspective. One of the
interesting aspects of insightful thinking is that people who have experienced
sudden breakthroughs all report feeling “stuck” just prior to their “aha!”
moment. They bump up against some cognitive barrier that prevents them from
making the new connections needed to solve the problem. But once they step
away—relax and temporarily think about something else—bam! The answer
strikes from out of nowhere.” Rebecca Costa
Brain Fitness: Employ brain exercises to generate agile thinking and
insight; incorporate optimal sleep patterns & relaxation techniques
Brain Exercise: Brush teeth with non-dominant hand, read journals
from other fields of learning
Increased Collaborative Environments: Small teams with diverse
perspectives; use the best collaborative tools available for solutions
Parallel Incrementalism: Parallel performance of more than one
operation at a time
Exercise: Fitness for the body and the mind
Foster Insight to Resolve Complex Problems
Integrity - Service - Excellence 23

24. The Most Important Medic.
Is the One Providing Care for YOU When YOU are Ill or Injured
Integrity - Service - Excellence

25. Mission Ready Medics
Serving Proudly
Doctrinally Aligned
Healthy, Fit Force
Resilient Families
Operationally Focused Medical Support
Joint, Interoperable, Interdependent%
Mission Effective
RESULTS: The Trust of Our All Volunteer Force%
The Trust of Our Nation to Care for Its Sons & Daughters
Integrity - Service - Excellence 25

26. Be the Example –
Forge the Future
Leadership Requires Trust & Communication of Vision
Mentor, Develop, and Inspire Your Team
Eliminate Waste%Systems Thinking Drives Better Outcomes
Be Innovative and Share Solutions
Research Creates Knowledge
Measurement Causes Change
Knowledge/Wisdom Must Be
Shared to Change Culture
Integrity - Service - Excellence 26

27. “TRUSTED CARE ANYWHERE”
Integrity - Service - Excellence