Group Links Health Care Providers to VA, Academia

By Jacob Boyer
U.S. Joint Forces Command

April 30, 2010 - The U.S. Joint Forces Command surgeon's office is sponsoring a working group here May 3 and 4 to bring military health care providers together with representatives of the Veterans Affairs Department academic institutions researching cutting-edge medical techniques.

The Restorative Medicine Working Group seeks to examine ways to partner in developing medical technology to further care for wounded warriors, said Navy Rear Adm. (Dr.) Michael H. Mittelman, command surgeon for Joint Forces Command.

The institutions are members of a consortium working with the Armed Forces Institute of Regenerative Medicine, a partnership between the Defense Department and academic institutions set up in 2008 to fund advanced research in rebuilding human muscle and tissue.

"We're attempting to ensure that returning wounded warriors have access to cutting-edge, controlled medical research and development," Mittleman said. "[Joint Forces Command] is providing a forum so that these academic institutions will be able to present to the services, the VA, and the Tricare Management Activity what they can provide for our wounded warriors.

"It's my goal to set up the active communication between these different groups," he continued, "so that military health care providers will be aware of what's available and feel comfortable to appropriately refer patients to these institutions."

Impetus for the working group came when Marine Corps Gen. James N. Mattis, commander of Joint Forces Command, visited the University of Pittsburgh's McGowan Institute, one of the Armed Forces Institute of Regenerative Medicine partners, Mittelman said. While Mattis was there, he added, researchers demonstrated some emerging care techniques and Mattis met Marine Corps Cpl. Josh Maloney, recipient of an experimental hand transplant made possible by the partnership.

Defense Department representatives at the forum will meet researchers from partners that include Rutgers University, the University of Pittsburgh's McGowan Institute, Wake Forest University, the Mayo Clinic, Case Western Reserve University's Cleveland Clinic, Johns Hopkins University and Dartmouth College. Military attendees will receive information on which procedures Armed Forces Institute of Regenerative Medicine partners currently are researching. The Defense Department representatives then will brief the academic attendees on current initiatives, expectations, and prospective processes for assuring appropriate access to this rapidly growing medical technology.

"There appears to be a lack of awareness in our [Defense Department] medical treatment facilities about these initiatives," Mittelman said. "What we're attempting to accomplish is the establishment of relationships, so the services can educate the academic institutions on the ground rules and the academic institutions will educate us on what they can provide to our wounded warriors and their families.

"Ideally," he continued, "I'd like to see consensus on the development of a clearing house or approval board that would review cases and direct them accordingly."

Mittelman said the Armed Forces Institute of Regenerative Medicine is doing great work, and it is important that eligible warfighters have access to controlled research protocols.

"We're bringing in military physicians who have the opportunity to refer patients to let them know what's out there and what processes they need to follow," he said. "We can leverage this great science that's out there for our wounded warriors."

Conversely, it is important for the institutions to be aware of what the services expect for patients and their families, Mittelman said.

"We want to ensure the patient will get taken care of," he said. "There has to be outpatient care for many of these cases for months on end. They need a place to put up the patient and his family and have all the necessary support mechanisms, because when we're treating a wounded warrior, we're not just treating them, we're treating their families. It's a total package."

Mittelman said the working group's effectiveness is predicated on spreading awareness on both sides to ensure warfighters get the care they need and cutting-edge techniques develop more rapidly.

"We are here to be the agent for our warfighter to ensure they are getting the best medical care possible, so if I need to be the facilitator for this for a while, I certainly will be," he said. "It all came out of the one meeting at the University of Pittsburgh, but there are other universities doing great work in different venues.

"We want to raise the benchmark for medical treatment," he added. "It's unfortunate that war drives these medical advances, but that's a silver lining of battle medicine. It really drives people to develop new technologies and skill sets."