The new Joint Program Management Office for Medical Modeling and Simulation is stepping out with a new contract vehicle. MS&T’s Chuck Weirauch spoke with Deputy Project Manager Jude Tomasello about the present and the future of the office.

In 2016, the US Assistant Secretary of Defense for Health Affairs created the Joint Project Management Office for Medical Modeling and Simulation (JPM MMS), a partnership of the Defense Health Agency (DHA) and PEO STRI to fulfill shared medical training requirements across the continuum of care. The JPM MMS provides the Department of Defense with a centralized total lifecycle management approach for the advanced materiel development and procurement of medical Training Aids, Devices, Simulators and Simulations (TADSS) across the Military Health System (MHS).

MS&T interviewed Deputy Project Manager Jude Tomasello to provide an overview of the JPM MMS, and joint functionality with the two partners.

The current primary contract vehicle for the JPM MMS is the five-year, multi-award $186 million Virtual Patient Simulator System - Whole Body Patient Simulation System (VPSS) contract, possibly the largest for US Service medical modeling and simulation solutions to date. The contract was awarded to seven vendors specializing in medical simulation products: CAE, Innovative Tactical Training Solutions, KForce Government Solutions, Laerdal Medical Corp, Operative Experience, Simulaids, and SynDaver Labs. These companies will bid competitively on requirements released by the JPM MMS under the VPSS.

MS&T: Does the JPM MMS completely replace the earlier PEO STRI medical simulation and training office that managed such programs as the Medical Simulation Training Centers (MSTCs) and other earlier and ongoing medical M&S efforts?

Tomasello: Previously, we were Product Manager for Medical Simulation (MEDSIM), a subordinate level to a Project Manager. And that’s where some current projects are managed, such as the Warrior Injury Assessment Mannequin. The MEDSIM team grew into the JPM MMS team, and we are dual-chartered from an acquisition perspective for the Army and the Defense Health Agency.

The JPM MMS is a DHA program. That acquisition authority goes to the DHA acquisition component executive. If it is an Army requirement, it goes to the Army acquisition executive. So it really depends on who the program is for and how it is funded, either for the DHA or the Army that determines that path.

There are a lot of programs in the DHA that are in their infancy right now. They are just getting into the program acquisition stage at this point, so we are very early in the acquisition cycle.

(Note: MEDSIM office will continue to support the Army’s medical training needs and products.)

MS&T: Along with the increased scope of work for PEO STRI, will there be an increase of resources for the JPM MMS as well?

Tomasello: As far as the DHA goes, I see nothing but an increase, as the awareness and utilization of medical modeling and simulation increases. The technology is getting to the point where replication of the human body is very realistic. The Army and the other services are also recognizing that medical simulation is a huge part of any kind of training event, whether it is in the battlefield or a clinical setting. In the clinic and the battlefield, managers have not embraced it to a high degree until very recently, and I see that the recognition of the need and the utility of medical simulation is only going to rise.

MS&T: What is the scope of the work that is to be accomplished under MEDSIM and the VPSS contract?

Tomasello: The way we are set up, we have contracts that run the spectrum of medical simulation needs for the Army, whether at the point of need, all the way through hospitals and clinics. We support the Veterans Administration with training devices and training systems, and any of the hospitals out there, or training institutions when they need a whole-body mannequin, for example. They will come to us, and we have contract vehicles to provide that support. We can provide whole-body patient simulators, we can provide canine simulators, part-task trainers like birthing simulators, and pretty much everything in-between. We have contracts set up to meet all of these needs.

VPSS provides multiple award contracts, so there are seven businesses that are on contract. We will send out the requirement to that pool of seven contract awardees. They will provide a proposal, and we will source-select to pick the successful offer. So every time a requirement comes in, say a hospital needs 20 mannequins, we will put that requirement on VPSS and compete it amongst those seven businesses. So we are getting the best value for the customer. What we often find is that we are half-cost, as opposed to the customer just going out and ordering the product from a catalog through their traditional means. So VPSS is doing what it was built to do. We will provide the customer with the best deal for the dollar.

A student checks the vitals of a mannequin, affectionately named Frank N. Stein, in the simulation lab of the training facility at Madigan Army Medical Center Annex, Joint Base Lewis-McChord, Washington. Image credit: US Army/Kirstin Grace Simons.

MS&T: How significant does the DHA and the JPM MMS consider new technologies in the development of medical training devices, and what part might they play in the future development of such training devices for the agency?

Tomasello: VPSS is pretty much a non-developmental contract in putting new technology into mannequins. It is built for speed and convenience. Folks come in with a requirement, but we are competing to a small pool, seven businesses. Because of that, we can turn orders around very, very quickly. So that is the value added. Those seven companies that are VPSS contractors are pretty much the cream of the industry when it comes to whole body mannequins, we have all the big players, so we are getting the best product they have for the requirements at a very competitive price, and at a very responsive turnaround. That is the beauty of the VPSS.

There is also an interesting nuance here. The guys in the hospitals are used to ordering what they need by serial and part number and make. In our world, maybe that’s not the best solution for the requirement. Instead, we will help them, and go through their requirements, so what we are buying them meets their specific task. And that is a tremendous value added. 

A team of nurses attend to mock Ebola patient "Garth." Image credit: US Army/John Liston.

MS&T: If the goal of the contract is to virtually replicate the human body, are there certain technologies, such as VR, AR and mixed reality that you see as being the ones that would provide the best tools to develop the end product?

Tomasello: Obviously when you are replicating the human body, you don’t just want a basic mannequin. We want to replicate to every extent that we can technologically. We work with the Defense Health Agency’s scientific and technology arm, the Joint Program Committee 1 (JPC-1). And their whole lot in life is to do the science and technology on medical simulation. They are at the very forefront of these technologies.

The other advantage for the medical world is that we keep up with what the commercial market is doing with these technologies as well. There are two sources for technology that we can readily take advantage of. These technologies will transition to this office. We are known as a material developer, and we will take those technologies, and either continue developing them, or produce them, or integrate them into some existing capability like a mannequin. For instance, like an improved airway. We can field an airway as it is, like a part-task trainer, or incorporate that airway into our existing mannequin fleet so that now that component of that mannequin can help that trainer become more realistic than it was before.

MS&T: What trends do you foresee for MEDSIM, the JPM MMS and the VPSS? Can you describe some of the training products that are in the works under the VPSS contract?

Tomasello: As we move forward, I see that the work is going to increase. Our Army work will remain steady-state for the near-term. DHA specific, there are a couple of programs that we are currently working on. One is the Joint Evacuation Transport and Training Simulation. That is simulating taking a patient from a point of entry on the battlefield through the different roles and handoffs and transitions. This effort includes all of those things that you need to do to get injured persons stabilized and into a hospital. Believe it or not, this patient transport is done differently wherever you look. So getting that process to where it is trainable, and those steps within it repeatable, is a big training gap solution for the medical service force.

The other device is the Point of Injury Training System. This is getting an injured person from point of injury on the battlefield, or shipboard, or wherever that may be, depending on what Service you are in. That is a DHA program that will span across all Services. Both of these programs are in their pre-milestone stage with nothing built yet, but there is a lot of coordination between users and refinement going on, with long-range planning for budgets. We are currently in that acquisition stage.

MS&T: What do you see as the future for DHA medical modeling and simulation and PEO STRI?

Tomasello: Like any other new entity (we just turned two), a lot of people don’t know about us. People are still doing their own thing as to how they acquire their simulation capabilities. We are a small office here, and just like a lot of folks in the Army, we are resource-constrained. There is lot of improvising as we grow – but I have been doing simulation acquisition work for over 30 years now, mainly on the combat arms side. But I see tremendous promise with what we are doing here – we have a lot of seeds planted. I think that those seeds are going to grow, and someday I think that we will be the biggest project manager here at STRI just because of medical simulation going into use.

MS&T: Thank you, and we’ll be sure to visit at I/ITSEC 2018.

Note: At I/ITSEC 2018, PEO STRI will be providing a major focus on medical simulation and training. With a quite large booth, Tomasello likened it to a “coming-out party” for his office to the I/ITSEC community. He said that while currently the JPM MMS is not that well known in the simulation community, he suggested this would change with the growing call for medical simulation solutions.

Originally published in Issue 6, 2018 of MS&T Magazine.