Bruce A. Doll, director of research, development and acquisition for the Defense Health Agency.
Those advances in theater medicine, as with most gains involving military medical research, relied on collaboration - between branches of service, between allied forces and between military and industry, Doll
To reinforce the need to share life-saving and health-inducing ideas, the Defense Health Agency
last month hosted a four-day Military Health System Research Symposium in Fort Lauderdale, Fla. Government and private sector experts discussed continuing progress against signature wounds of recent wars, infectious diseases and operational hazards.
"It's all about our discovery, development and deliver" of products to better care for service members, to make them more resilient in whatever environment they operate and, for the severely wounded, to restore quality of life as best as possible through timely care and rehabilitation, Doll
, the 19 percent represents "a mandate to improve our delivery of care.
Though increasing "survivability in the face of severe wounds is a challenge," he
said, for researchers it must remain "a very high priority."
Spending on military medical research, including combat casualty care and traumatic brain injury treatment, has leveled off.
annual medical research budget, to include spending on medical information technology, has averaged $1.37 billion over the last five years.
Given tighter budgets, it's increasingly important that Army, Navy, Air Force and outside partners not move separately down the same research paths, unaware of progress made elsewhere.
Doll's RDA is to prevent such overlaps as a "shared services" directorate under the two-year-old Defense Health Agency.
It exists to coordinate research that benefits any military member while acknowledging that unique expertise resides in each service.
"The RDA is all about support to the services" in advancing collaborative, innovative research, he
But to do so better, "we agree among the services there are certain practices we can consolidate."
RDA also is developing a database of research across defense components "to make sure that everybody knows what everybody is doing," Doll
compared it to a catalogue of expenditures and results that National Institutes of Health
publishes for all NIH-funded projects.
"The economies of scale that come from this constant awareness of products being developed - and where the experts are - is something we are committed to enhancing" to improve care delivery to ill or injured and to assist warrior in achieving optimal performance in any mission environment.
"We understand that every service has certain unique areas" of expertise such as undersea medicine for Navy.
In those areas "we're not looking to do anything but assist," Doll
"They do it well."
But every member bleeds, he
directorate is coordinating research to address those deaths from hemorrhaging.
"To the extent we have those types of projects, beneficial to all the services, we look to fund those and to do so consistent with the priorities that we review every year," Doll
The U.S. military estimates that more than 300,000 service members have suffered some traumatic brain injury since 2001.
About 82 percent of those cases are categorized as mild.
"That's the broad focus on all these topics: How does this map back to individuals on the frontline who are performing the mission," Doll
The U.S. military "does not lay claim to the best in its own environment of research and development.
But what it does do very well, through organizations like NATO or individual nation relationships…is to look for collaboration, look for areas of expertise resident in countries that we can partner with," Doll
For example, the efforts of Scandinavian countries to optimize performance in cold-weather environments "become something we can learn from them and, together, move forward."
Given the number and severity of injuries in Iraq and Afghanistan, however, the U.S. military has led in developing tourniquets, medical evacuation techniques and critical refinements to trauma care.
As wounded "are moved back from the site of injury," Doll
said, "their care is improving in terms of technology and expertise brought to bear" at every stage.