Military Trauma Care’s Learning Health System and its Translation to the Civilian Sector
Advances in trauma care have accelerated over the past decade, spurred by the unprecedented burden of injury resulting from the wars in Afghanistan and Iraq. This is due in part to the military’s dedicated investment in trauma research through its Defense Health Program (DHP) and the development of the Department of Defense Joint Trauma System (JTS) and its associated trauma registry. By systematically identifying what works, what does not, and refining the approach over time, military medical providers and the JTS have enhanced outcomes through agile, evidence-based process improvement. As the JTS and the DHP mature in effectiveness, the military has worked toward what the National Academy of Medicine refers to as a “continuously learning health system” in which its trauma care experience is captured, integrated with its research program and systematically translated into more reliable care. As the war in Afghanistan ends and as individuals leave the military, there is concern that experience and knowledge pertaining to advances gained from the wars may be lost within the military itself. Intentional steps to codify and garner the lessons within the military’s learning health system and promote their translation to the civilian sector are needed to ensure a ready military medical force for future combat operations. More systematic efforts to translate military advances in trauma care to the civilian community has the additional purpose of improving the response to multiple casualty events in the civilian setting such as mass shootings, stabbings and improvised explosive devices. In this context, the National Academies of Sciences, Engineering, and Medicine convened an ad hoc committee to ensure lessons learned from the military’s knowledge-generating research investment are sustained and built upon for future combat operations, and translated into the U.S. civilian health system.
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