PATIENT MOVEMENT

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PATIENT MOVEMENT
NDMS Conference Orlando, FL 1-4 May 2005 Mark
Mahar
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PATIENT MOVEMENT
United States Transportation Command
(USTRANSCOM) Responsibilities

• Global patient movement
• Joint policy guidance and doctrine
• Patient Movement Requirement Centers (PMRCs)
• Develop an Automated Information System (AIS) to
  support global patient movement TRAC2ES

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PATIENT MOVEMENT
Directives

• DODD 6000.12 - Health Services Operations And
  Readiness (Jan 98)
• DODI 6000.11 Patient Movement (Sep 98)
• Joint PUB 4-02.2 Joint Tactics, Techniques And
  Procedures For Patient Movement in Joint
  Operations (Dec 96)

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PATIENT MOVEMENT
TRAC2ES

• TRANSPORTATION COMMAND
• REGULATING
• AND
• C2 COMMAND AND CONTROL
• EVACUATION
• SYSTEM

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PATIENT MOVEMENT
TRAC2ES MISSION STATEMENT Combine
transportation, logistics and clinical decision
support elements into a seamless patient movement
information management system which is capable of
visualizing, assessing and prioritizing patient
movement requirements, assigning proper
resources and distributing relevant data to
efficiently deliver patients.In other
wordsGather requirements, match with available
lift and facility capability. All data will be
in an electronic format.
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PATIENT MOVEMENT

• TRAC2ES Vision
• Manage patient movement with total visibility and
  worldwide responsiveness.

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PATIENT MOVEMENT
What is TRAC2ES?

• AIS that supports global patient movement
• Initial Operating Capability (IOC) - Jul 01
• Primary user interface is web-based
• Used by PMRCs, Medical Treatment Facilities
  (MTF) fixed and deployed and Command and Control
  (C2) Units

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PATIENT MOVEMENT
What is TRAC2ES? - Cont.

• Available data consists of
• Patient Movement Requests (PMRs)
• Mission data (routes, timings, patient loads,
  etc)
• Patient tracking data (itinerary, last reported
  location, etc)
• Facility data (locations, capabilities, contact
  numbers, etc.)

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PATIENT MOVEMENT
What TRAC2ES is NOT!
TRAC2ES is not an Air Force systemIt is a
Department of Defense system.USTRANSCOM is the
primary agent for the management of the patient
movement requirements.TRAC2ES does not own any
lift capability. Lift information is input into
the system.TRAC2ES only tracks patients while
they are in the patient movement system. Once
they are delivered to final destination, tracking
ceases. Does NOT provide In-transit visibility
(ITV) of patients while receiving treatment.
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TRAC2ES Users Are The Key Patient Movement
requires the effort of multiple services and
disciplines.
PATIENT MOVEMENT
2. PMRC Regulators/PMCC Validate PMR/Edit
PMR Error Check PMR/Approve PMR
3. PMRC Duty Officers Create Missions Create
Lift Bed Plan Edit Lift Bed Plan Approve Plan
1. MTF PM Clerks Submit PMR Edit PMR View
Itinerary View Manifest Submit ITV
TRAC2ES Database
4. PMRC Duty Controllers Monitor Missions
Monitor Move In-Transit Visibility
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Patient Movement

USTRANSCOM
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PATIENT MOVEMENT
Medical Treatment Facilities Any Service

• Patient Movement Clerks
• Prepare patients and documents for movement
• Coordinate ground movement to airfield
• Coordinate directly with PMRC for urgent,
  priority and any special moves
• Receive patients regulated to their facility
• Enter ITV events for patients leaving and
  arriving at their facility
• Bed reporting and medical capabilities
• Update facility contact info in TRAC2ES

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PMRC LOCATIONS
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PATIENT MOVEMENT
Patient Movement Requirements Centers

• Global Patient Movement Requirements Center
  USTRANSCOM
• Theater Patient Movement Requirements Centers
  EUCOM/PACOM
• Joint Patient Movement Requirements Centers
  CENTCOM/ Notional in Korea
• Responsibilities
• Validate requests for movement within their
  theater
• Pass validated requirements to lift agencies
• Monitor clinical status/trends of patients being
  moved
• Coordinate special requirements for patient
  movement
• TRAC2ES Subject Matter Experts
• Control access to TRAC2ES servers
• Exercise participation

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PATIENT MOVEMENT
How do you access TRAC2ES?
PMRCs Responsible for the area where you are
located. Issue User Logins and Passwords to
access their server.EUCOM, PACOM and CENTCOM
users routed thru GPMRC server
Back Up server up and
running in CONUSUser Logins issued to
individual users. No office logins permitted.
No sharing Logins or Passwords.
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PATIENT MOVEMENT
Logging on to TRAC2ES
Must be from .mil or .gov computerRecommended
browsers Mozilla 1.7.3 or Internet Explorer
6.0 Will work with other versions but
performance may be sub-optimalURLhttps//www.t
rac2es.transcom.milExercise Servierhttps//www
.exercise.trac2es.transcom.mil/etdbs2
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PATIENT MOVEMENT
TRAC2ES Security Features

• Handles unclassified information to provide
  patient and mission information- Security
  features include the following Safeguards
  Sensitive But Unclassified (SBU)
  information Creates a permanent record
  Provides an audit trail of all dataThere is a
  High Side TRAC2ES One way Guard to
  transfer data low to high

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PATIENT MOVEMENT
TRAC2ES User roles
What you see in TRAC2ES will depend on the role
you are assigned by the system administrator.Rol
es are assigned based on your job description and
requirement to access the database.Possible to
assign C2 leadership access to track their
soldiers without revealing personal medical
information.Users are expected to access only
information required to perform their duties.
Violation of patients confidential information
using information acquired thru TRAC2ES is an
offense.
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PATIENT MOVEMENT
TRAC2ES Tidbits
-Will not accept a PMR for the same person, based
on ID number, from the same originating facility
with the same ready date. Prevents duplication of
requests to move a patient.-Has a Time Out
feature of 20 minutes after inactivity. Make sure
you save often or you will lose work.-Primary
and back up servers replicate to each other.
Replication normally takes between 5-10 minutes.
Ability to see all move requests worldwide. -
Archive server maintains record of PMRs forever.
Records are moved from active to the archive
server 60 days after they are placed in the
COMPLETED state.
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PATIENT MOVEMENT
TRAC2ES Tidbits, cont.

• -Has a download file that takes data from TRAC2ES
  and imports it into an Excel spreadsheet. Data
  can then be manipulated to suit user
  requirements.
• -Download file only available to Surgeon General
  offices and only contains data on that services
  movement.
• -Has capability to generate reports on movement
  data such as aircraft usage and inter/intra
  theater moves.

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PATIENT MOVEMENT
TRAC2ES Limitations
-Users have access to a vast amount of
information contained in the database and can
modify the dataSolution Users must only access
and edit records that are from their MTF-When
the server goes down at one location, this
affects replication and records that are in the
system. These records may not be visible to users
looking at the system from another
server.Solution Call the PMRC. They may have
visibility that you do not have access to.
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PATIENT MOVEMENT
TRAC2ES Limitations, cont.
-If bandwidth is narrow, TRAC2ES is very slow and
can take HOURS to submit a single PMRSolution
The PMRC has a form you can email or fax to them
and they will input the record.TRAC2ES
Mobile(T-mobile) is designed to work offline with
connection to the internet only required to send
and receive data. T-mobile also allows users to
save data to a disk.
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The Bottom Line
Timely, customer-focused global mobility in
peace and war through efficient, effective, and
integrated transportation from origin to
destination. RIGHT TIME RIGHT MODE
RIGHT CARE
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• Questions?
• mark.mahar_at_hq.transcom.mil
• [phone]
• DSN 779-7172