Air Force Military Treatment Facilities pilot medical readiness Published Aug. 12, 2017 By Lt. Gen. Mark Ediger Air Force Surgeon General Office of Public Affairs FALLS CHURCH, Va. (AFNS) -- Air Force Medicine has a non-stop global readiness mission. Medical Airmen must be prepared to deploy on short notice to provide life-saving and performance-enhancing healthcare in diverse, austere and isolated locations, and all Airmen must be medically ready to deploy. To achieve this readiness mission, the Air Force Medical Service operates 76 military treatment facilities around the world, which serve as the primary readiness and training vehicles. The 12 hospitals and 64 clinics within the AFMS serve as dual readiness platforms, ensuring that all Airmen meet medical readiness standards to deploy, and that all medical Airmen have the training and skills necessary for deployment. The MTFs are the foundation of our expeditionary medical capabilities, providing a population of patients that drives the workload, case diversity and acuity necessary to maintain clinical currency that is essential for readiness. Every Air Force MTF is aligned with an operational wing to enhance the medical readiness of warfighters and their families. Medical group commanders tailor the care and training offered at their MTF, ensuring the medical readiness of the operational wing they support. No two air bases have exactly the same mission portfolio, so each has unique medical support requirements. An excellent example of how MTFs support the installation’s operational mission is the 19th Medical Group at Little Rock Air Force Base, Arkansas. The 19th Aerospace Medicine Squadron High Altitude Airdrop Mission Support Center is housed at Little Rock AFB, so medics from the 19th MDG are experts in the care of high-altitude operators. This includes unique oxygen monitoring and physiologic performance requirements for these Airmen. This type of expertise, like others organic to Air Force Medicine, isn’t required at every installation, nor would it be efficient to deploy it at all 76 AFMS facilities. The knowledge, skills, and abilities gained at these fixed facilities translate into outstanding care in a deployed environment. A valuable tool for the AFMS to extend this care downrange is our Expeditionary Medical Support Health Response Teams (EMEDS-HRT). EMEDS-HRT allows medical Airmen to rapidly deploy a mobile tent hospital that can provide emergency care within an hour of arrival on the scene of a disaster or other casualty situation. This gives us the capability to deliver surgery and critical care within six hours, and full hospital capability within 12 hours of arrival. Properly training medical Airmen to deploy and operate EMEDS-HRT requires a specialized MTF readiness platform. Four Air Force MTFs are presently staffed to deploy and train EMEDS personnel, including the 633rd Medical Group at Joint Base Langley-Eustis, Va., devoting time and resources to a critical deployment platform that other MTFs are not resourced to deliver. At the 633rd MDG, the Global Response Force coordinates with Air Combat Command to run annual training exercises on EMEDS-HRT. Medics from the 633rd MDG practice rapid deployment and simulated casualty care with a wide assortment of patient scenarios. These well-trained Airmen from the 633rd MDG deploy in support of a variety of mission types around the world, from combat operations support to humanitarian assistance and disaster relief. Once fully operational, EMEDS-HRT can provide surgical and trauma care, prevention, acute intervention, primary care and dental service to a population of more than 3,000. Our expert teams continue to find innovative ways to decrease the size and weight, while increasing the speed of deploying these mobile hospitals. They can also be tailored to a specific mission, adding specialty care such as obstetrics/gynecology and pediatrics for humanitarian assistance, disaster relief or other missions involving populations with special healthcare needs. Medics at most MTFs rotate through EMEDS training, but may not receive the in-depth training available to Airmen at JB Langley-Eustis. This tailored mission support is critical to building and sustaining an agile and flexible force, capable of completing a myriad of health-related missions around the globe at once. MTFs also serve as platforms to evolve and implement new ways of caring for patients. Most patients interact most often with their health teams in primary care clinics, so these are a key area for readiness and innovation. Air Force MTFs utilize the Air Force Medical Home (AFMH) model, a team-based approach to care that embeds specialty providers into primary care clinics. This removes barriers to care and drives efficiency. Mental health providers, physical therapists, clinical pharmacists, social workers, and others augment or deliver primary care appointments in close coordination with the primary provider and other members of the team. Our Behavioral Health Optimization Program, which embeds mental health providers in primary care clinics, has been particularly beneficial. Building a mentally resilient force is a key to readiness, but stigma can sometimes create a serious hurdle to seeking mental health care. BHOP is an effective way to initiate mental health care, starting informal conversations with mental health professionals. Brief meetings in the context of a primary care appointment can lead to earlier treatment of a mental health condition, preventing a more serious problem. The AFMH model also incorporates the Base Operational Medicine Clinic, an occupational medicine, flight medicine and deployment health focused clinic. BOMC is separate from primary and family care clinics at MTFs, focusing resources on the readiness mission. Previously, flight and occupational medicine clinics required patients to visit different departments to get their pre-placement exams and exposure assessments. BOMC, centralizes all exam components in one clinic, and use standardized procedures. This model is especially valuable at MTFs that host fighter wings, or other units that call for a high volume of aerospace medicine services. In our continuous efforts to provide a medically ready force of Airmen for our nation’s defense, the AFMS relies on the remarkable medical Airmen who are its providers, nurses, technicians and patients. The people I serve with, men and women of amazing compassion, skill, training and creativity, continually inspire me. My job is to build a system that allows them to succeed to the maximum extent of their abilities, and to create space for them to successfully innovate. The strength of the AFMS is undoubtedly our mighty medical Airmen. In any organization, once change has begun, the biggest challenge is to sustain the change and build on that initial momentum. Our readiness focus is not only for today’s requirements, but the new missions we may be called upon to execute tomorrow. As we support the increasingly in-demand, 24/7 mission of our globally engaged Air Force, some of these challenges will be small, while others will be immense. Our MTFs are the backbone of a flexible and resilient AFMS, helping us answer the call to meet any readiness mission we are called on to deliver in the future.