Medical Situational Awareness Advanced Concept Technology Demonstration: leading the acquisition culture change.

There is a recognized need to make the defense acquisition process more effective and efficient and to deliver quality products to warfighters at lower costs in the shortest amount of time. The Department of Defense is undertaking several initiatives to improve the acquisition process, including a top-to-bottom review of acquisition programs through the Defense Acquisition Performance Assessment; however, more is needed. Deputy Defense Secretary Gordon England recently told the Senate Armed Services Committee, "This is just hard work."

In a speech to the International Test and Evaluation Association Symposium in October 1995, Paul G. Kaminski, then under secretary of defense for acquisition and technology, spoke to attendees about the need for an acquisition culture change. He used the example of Team New Zealand (the America's Cup sailing team that defeated Team Dennis Connor, five races to zero in 1995): The New Zealand team, from a smaller country with a smaller budget and limited resources, used repeated testing and evaluation throughout the development life cycle of the boat Black Magic, integrating the designers, testers, and sailing crew into a cohesive team. According to Kaminski, that example could easily translate to the defense acquisition process.

"We must shift our outlook and approach from one of oversight and report, to early insight," said Kaminski. "We need to make sure test and evaluation expertise is made available to the program manager early on so that we prevent problems, rather than try to identify them in a 'gotcha' fashion when we write a test report or at the Defense Acquisition Board review itself. We should be building in quality and excellence from the start, not trying to inspect it two weeks before the test program begins or the DAB meeting occurs."

Medical Situational Awareness in the Theater Advanced Concept Technology Demonstration is one of the programs within the Department of Defense striving to make this cultural change a reality. Building on lessons learned from previous acquisition programs, the MSAT ACTD program office has been integrating, from the beginning, both the Operational Test Agent and the Transition Manager into the development process to help make the program a success.

"We are doing it the best I have ever seen," says Dr. Dan Gower, interim president of the U.S. Army Medical Department Board and the Operational Test Agent for the MSAT ACTD. "First, we have the Operational Test Agent working for the Operational Manager. Second, we have demonstrated trust in the operational tester, and he is an accepted part of the team. He is not just the guy in the black hat that walks in to give you a report card."

Bob Foster, the program executive officer for the Joint Medical Information System and the MSAT ACTD Transition Manager agrees: "We are already working with [the technical manager] and the rest of the executive team as an integral part. Most ACTDs do not consider transition until late in the program and that is why they fail. Success means incorporating transition from the beginning."

Test to Learn

For any project, success and utility must be defined as precisely and early as possible. For the MSAT ACTD, success means a Military Utility Assessment that will result in a recommendation to transition to a program of record. To ensure a successful Military Utility Assessment, the MSAT ACTD Joint Program Office held a requirements conference just two months after the MSAT Implementation Directive was signed.

"The Military Utility Assessment requires a clear definition of what utility is as seen through the eyes of the ultimate users of the proposed system," says Gower. "That is why I pushed so hard for the requirements conference early. This started the process of defining success and utility from the users' perspective. The requirements conference ensured that we can build the product to what the users value." According to Gower, some ACTDs failed because they did not involve the users early enough in the process.

"Further, you need to test early and test often during development of complex systems. Our mantra is that we test to learn and we evaluate to understand," Gower says. This means integrating the operational test agent into all planning processes, not just in the execution of test events.

"The value of bringing me into the process early is that the development team needs to understand the basis of the report card that will be written," says Gower. The first real test of the MSAT Medical Support Enhanced (MSE) tool--the first spiral in the MSAT ACTD development--will be at Exercise Cobra Gold 06 in May 2006. In preparation, Gower and his team have been actively engaged in writing an event design plan and working with the MSAT ACTD Operational Manager in developing the Major Scenario Events List (MSEL).

"We are working with the Operational Manager to figure out how we are going to exercise the MSAT MSE in the context of Cobra Gold," says Gower. "We are working with the White Cells in both Thailand and at the Pacific Command's Simulation Center in Hawaii to ensure the MSELs happen and to ensure the MSELs take on the right parameters. We will also put data collectors with the users to get immediate feedback on the MSAT MSE tool as each problem occurs."

Transition for Success

The MSAT ACTD will be successful only if it transitions to a program of record, which can be a very difficult task because of all the standards that information technology systems must meet (for example, Technology Readiness Level standards and the Defense Information Technology Security Certification and Accreditation Process).

"One of the great things about MSAT," says Foster, "is that we are looking at mature technologies that have already gone through a lot of the transition documentation, so it is already done."

The targeted program of record for the MSAT ACTD is the Theater Medical Information Program, commonly called TMIP, which is part of the Joint Medical Information Systems Program Executive Office. Members of the program of record office have already begun working closely with the MSAT ACTD transition manager to develop a measured transition plan. According to Foster the program of record is already requesting funding through the budgeting process for full operational capability and further development.

The next steps toward transition are further refinement of the transition plan to address user evaluations and preplanned product improvement.

"Medical planners are salivating to get actionable information," says Foster. "If MSAT is successful, it will give us a multi-generational leap over what the program of record can do. This equates to a three, maybe four, generation leap ahead in a medical area program that we have never been able to see before."

Kratzer is a member of the MSAT ACTD Joint Program Office and works as a contractor for the deputy assistant secretary of defense for force health protection & readiness. She can be contacted at nicole.kratzer@deploy menthealth.osd.mil. For more information on the MSAT ACTD, visit <http://fhp.osd.mil/msat/index.jsp>.

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