Joint Medical Asset Repository
by Commander David B. Stratton, USN, and Major Mark W. Dick

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Every day, combat forces across the globe train, mobilize, and deploy in response to world events. These movements produce unique needs for information, asset visibility, and technology. Without question, the successful deployment of our operating forces relies on countless factors, including force health protection and readiness; mobile, tailored, and flexible deployment planning; and force sustainment. In turn, these factors depend heavily on medical materiel to support the mission.

The emergence of near-real-time medical materiel asset visibility plays a pivotal role in saving lives. The Joint Medical Asset Repository (JMAR), which provides this Web-based visibility, keeps cadence with the daunting pace of force readiness by capturing, storing, and making medical asset data readily available. JMAR supports the missions of medical logisticians everywhere.

Medical logisticians use various communication methods to locate needed medical commodities and get them to the right place at the right time. JMAR is their tool of choice to accomplish this.

JMAR is the single authoritative source for acquiring, managing, and providing timely and accurate joint medical asset visibility information. It captures, integrates, and stores data in a central repository with Web-based access.

Designed by the Army Medical Materiel Agency in 1996, JMAR offers a unique view of critical military and commercial medical commodities. In December 2001, JMAR was fully integrated into the Defense Medical Logistics Standard Support (DMLSS) Program. JMAR is the component of the DMLSS automated information system that supports the military’s joint medical logistics information management effort and the Department of Defense (DOD) Military Health System (MHS).

JMAR supports the tenets of Joint Vision 2010 and Joint Vision 2020. It provides invaluable data for operations, medical logistics posture planning, and supply chain management for MHS operational forces and hospitals. The MHS uses new technologies and information provided by JMAR to decrease costs, improve logistics distribution management, refine business processes, and support the warfighter.

Joint Vision 2020—Focused Logistics

Beans, fuel, bullets, and bandages, known in the supply community as classes I, III, V, and VIII respectively, are precious commodities for our Armed Forces. Whether the supported activity is a deployed medical logistics supply operation, Naval fleet hospital, Air Force expeditionary medical system, or military hospital, focused logistics sustains our forces by providing total asset visibility of medical commodities.

Joint total asset visibility (JTAV), provides customers with timely and accurate information on the location, movement, status, and identity of units, personnel, equipment, and supplies. Without appropriate vaccines, medicines, or functional medical equipment on hand, the lives, health, and safety of our forces are at stake. JMAR sends data to the JTAV database daily, serving as the single authoritative source of medical asset data.

JMAR does not create new data; it captures and consolidates existing data from disparate legacy and replacement medical logistics sources. It provides asset visibility along all points of the medical logistics pipeline, including—

• In-storage materiel at unit and retail consumer sites, intermediate storage sites, disposal activities, and within wholesale inventories, including pre-positioned assets ashore and afloat and contractual and noncontractual assets stored at commercial sites.
• In-process materiel on order from DOD vendors but not yet shipped and assets in repair at depot-level organic or commercial repair facilities, intermediate repair facilities, and unit-level repair facilities. In-process also refers to blood or blood products that are pending quality certification testing.
• In-transit materiel within the transportation pipeline.
• In-theater materiel located within a theater of operations.

Medical logistics assets pass through multiple places during their journey from manufacturer to theater. JMAR offers an extensive array of easily accessible reports designed to provide essential asset visibility and create business intelligence products on assemblages (sets, kits, and outfits for medical units) and facilities. Command-level decisionmakers, as well as item managers, medical commodity managers, and clinicians, use JMAR to increase readiness and streamline acquisitions.

Types of Data Captured

JMAR is currently in Phase II—the Active component phase of its development cycle. Scheduled for completion by the end of fiscal year 2005, the goal of Phase II is to capture and integrate into JMAR relevant logistics data for all service-owned Active component medical materiel and secondary items. JMAR collects data on chemical defense materiel; vaccines; antibiotics pre-positioned for wartime use; blood and blood products for military use; prime vendor, medical, surgical, and pharmaceutical data; and vendor-managed exigency contract inventories. These data sources provide military medical materiel visibility, information on medical equipment in medical assemblages and hospitals, and facility management information.

The JMAR Web user interface offers assistance with informative pop-up logistics definitions, real-time notices, and “drill-down” reports. To further ease navigation, JMAR organizes data queries by data type, such as inventory management, quality assurance, prime vendor, and equipment. Future integrations will include facility management, medical assemblages, patient movement items, and, potentially, non-DOD Federal assets.

Architecture and Security

By providing total asset visibility of medical materiel, JMAR standardizes logistics data and reduces the time that healthcare professionals spend on logistics. The key features of the JMAR architecture include integration of asset databases; real-time connectivity for updates of information; and access to JMAR by any user, at any time, on any machine.

Data from multiple DOD-, service-, and unit-level databases populate the JMAR database. By using file transfers, JMAR obtains data from selected systems and loads them into its database. This makes the data available to JTAV and agency requests through output feeds or the World Wide Web. This strategy provides data visibility to all users and meets the Web-based standard of Defense Reform Initiative Directive 54.

The JMAR program manager maintains access security and can limit data accessibility when necessary. At the network level, firewall security is provided for communications into the JMAR server. A staging server isolates data being transferred into JMAR and checks data and files for viruses. Virtual Database Mediator provides its own security for JTAV access to the JMAR database server. User security for JMAR is maintained through individual user identifications and passwords. Secure Sockets Layer encryption serves to protect passwords and data transmitted through the Web browser. [The Secure Sockets Layer is a protocol commonly used to manage the security of a message transmission on the Internet.]

Business Practices

JMAR’s vision also embraces the goals of reduced DOD inventory investments, improved supply chain management, and increased use of business intelligence to capture and help manage MHS expenditures. Over $2.3 billion in annual purchases and over $19 billion in annual operating costs are required to maintain the MHS infrastructure. JMAR captures legacy data and produces business intelligence solutions to streamline and encourage refinement of business processes for decision support.

JMAR’s prime vendor report is an initial proof of concept that summarizes expenditure data compiled from the Prime Vendor Program and other sources when medical commodities are ordered. At some facilities, most of the orders are placed with vendors other than the prime vendor supporting that facility. JMAR’s prime vendor reports identify efficiencies and unplanned or increased expenditures for supplies that are available at contracted, fixed costs.

Executive Dashboard Initiative

The JMAR team is ambitiously researching and designing for the future. It continues to enhance real-time snapshots of medical asset data to make JMAR responsive to JTAV and to medical logisticians worldwide. The DMLSS JMAR leaders recently completed a review of responses to a request for proposal (RFP) submitted for an executive dashboard for use in business intelligence and decision support initiatives. [An executive dashboard is a Web-based information system that provides executives with a dashboard view of a company’s performance goals compared to actual results.] The RFP was submitted under the Small Business Innovation Research (SBIR) Fast Track program sponsored by DOD, which provides funding for research, development, and testing of DOD-specific or commercially usable products.

The executive dashboard will capture internal and external metrics and important requirements in a user-friendly graphic user interface. Using the SBIR program has allowed the JMAR team to pursue research and development funding from DOD programs while conserving and applying scarce resources for continued integration of over 55 development efforts. This type of innovative and collaborative initiative makes use of the full spectrum of defense funding. Using business intelligence tools also provides trend analysis and reveals areas for improvement. Through these targeted and powerful reporting capabilities, JMAR improves overall supply chain management.

Operation Noble Eagle

Immediately following the 11 September 2001 attacks on the World Trade Center and the Pentagon, JMAR processed requests for medical asset information. In support of Operation Noble Eagle, the JMAR staff provided data on vaccines, burn dressings, intravenous solution bags, facemasks, eye care solutions, and other medical necessities. This lifesaving information was sent to Army, Air Force, and Navy emergency operations centers.

JMAR provided medical logistics agencies with listings of materiel potentially needed to meet requirements created by mass casualties and future attacks and for force protection at DOD installations. With the support of JMAR, medical logisticians in the Army operations centers were able to use asset data to inform leaders about on-hand assets to support homeland defense and plan for future worldwide operations.

JMAR is a robust Web application that uses leading-edge technology to store medical logistics asset information for medical logistics units, planners, hospitals, and deployed forces around the globe. JMAR provides precise information on medical assets during both wartime and peacetime, meeting the DOD Joint Vision 2020 goals for focused medical logistics, information superiority, and full-spectrum dominance.

When complete, JMAR will be the central hub for joint visibility of all medical materiel and equipment and will serve as the single, recognized, authoritative source for all military medical materiel assets. JMAR achieves its mission by providing global access to joint medical asset information for anyone, anytime, and on any machine. More information about JMAR can be found at http://jmar.detrick.army.mil. ALOG

Commander David B. Stratton, USN, is the Director for Readiness at the Defense Medical Logistics Standard Support Program Office at Falls Church, Virginia, and Fort Detrick, Maryland. He has a bachelor’s degree in rehabilitation services from Syracuse University and a master’s degree in health services administration from George Washington University.

Major Mark W. Dick is the Chief of the Materiel Management Division in the Directorate of Logistics at Walter Reed Army Medical Center in Washington, D.C. He has a bachelor’s degree from Virginia Military Institute and a master’s degree from the Florida Institute of Technology.