Q&A: Major General Eric B. Schoomaker
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Major General Eric B. Schoomaker
Commanding General
U.S. Army Medical Research and
Materiel Command and Fort Detrick
Commanding General
U.S. Army Medical Research and
Materiel Command and Fort Detrick
Major General Eric B. Schoomaker graduated from the University of Michigan in Ann Arbor, Mich., was commissioned a second lieutenant as a Distinguished Military Graduate, and was awarded a Bachelor of Science degree. He received his medical degree from the University of Michigan Medical School in 1975 and completed his Ph.D. in human genetics in 1979.
He completed his internship and residency in internal medicine at Duke University Medical Center in Durham, N.C., from 1976 to 1978, followed by a fellowship in hematology at Duke University Medical Center in 1979. He is certified by the American Board of Internal Medicine in both internal medicine and hematology. His military education includes completion of the combat care casualty course, medical management of chemical casualty care course, AMEDD officer advanced course, Command and General Staff College and the U.S. Army War College.
From 1979 to 1982 Schoomaker was a research hematologist at Walter Reed Army Institute of Research. He served as assistant chief and program director, Department of Medicine, Walter Reed Army Medical Center, 1982-1988; medical consultant to headquarters, 7th Medical Command, Heidelberg, Germany, 1988- 1990; deputy commander for clinical services, Landstuhl Army Regional Medical Center, Landstuhl, Germany, 1990-1992; chief and program director, Department of Medicine and director of primary care, Madigan Army Medical Center, Tacoma, Wash., 1992- 1995; director of medical education for the Office of the Surgeon General/HQ USAMEDCOM conducting a split operation between Washington, DC, and Fort Sam Houston, Texas, 1995-1997; and director of clinical operations at the HQ USAMEDCOM, February to July 1997. From July 1997 to July 1999, he commanded the USA MEDDAC (Evans Army Community Hospital) at Fort Carson, Colo. He attended the U.S. Army War College in Carlisle Barracks, Pa., from 1999 to 2000 followed by assignments as the command surgeon for the U.S. Army Forces Command (FORSCOM) from July 2000 to March 2001, and commander of the 30th Medical Brigade headquartered in Heidelberg, from April 2001 to June 2002. Prior to his current assignment as commanding general of the U.S. Army Medical Research and Materiel Command and Fort Detrick, Md., he was commanding general of the Southeast Regional Medical Command/Dwight David Eisenhower Army Medical Center from June 2002 to June 2005.
In August 2002, the Army Surgeon General appointed Schoomaker to the position of Chief of the Army Medical Corps.
His awards and decorations include the Distinguished Service Medal, the Legion of Merit with four oak leaf clusters, the Meritorious Service Medal with two oak leaf clusters, the Joint Service Commendation Medal, the Army Commendation Medal, the Army Achievement Medal and the Humanitarian Service Medal. He has been honored with the Order of Military Medical Merit and the “A” Proficiency Designator and holds the Expert Field Medical Badge.
Interviewed By MMT Editor Jeff McKaughan
Q: To get things started, can you give me a little background on MRMC and how it serves military health care?
A: We’re about translating concepts and doctrine into products that we put into the cargo pockets of our soldiers. We’re really judged, if you will, not only by the taxpayer but by the soldier, sailor, airman, Marine or Coast Guardsman who count on us to help protect their health and care for them if they are injured or become ill.
We really are about medical solutions. The solutions in many cases are final products—like bandages, tourniquets, vaccines and drugs—but they’re also about the expertise that we provide. One of our most important products recently is an orientation, a way of thinking about psychological stress—how it has affected deployed warriors and their families and how we can reorganize our thinking about their restoration and, if necessary, their care. The products of that program, quite frankly, are nothing more than a couple of trifolds and the training of leaders, but it’s the orientation and thinking that’s important.
In the military health care system, there’s been a real shift in moving away from just the delivery of health care for combatants and family members who are injured toward preventive medicine and toward timeliness and precision when health care is required. The command is very active in providing the enabling tools— whether they’re information technology, vaccines, or devices at the point of injury—that are part of the transformation of the military health care system. We’ve moved away from pure intervention to health promotion and preventive medicine.
Q: Has there been a need to transform the organizational structure of the command to meet the changes in environment and operational tempo?
A: All organizations are under pressure to be more agile and responsive to dynamic world situations and emerging threats. We’re always looking at ways to be more effective in engaging with partners and customers to take concepts to realized products.
This is a team sport! I would have to say that MRMC organizationally is much less into rearranging the wiring diagrams and organization charts and far more into the business of better synchronization and coordination internally and with external partners. I see this happening in several different ways. We’re coordinating and synchronizing the work of multiple laboratories and multiple agencies that conduct research and develop medical products with a goal of getting products into advanced development and out to the warfighter.
We have a superb relationship— a close collaborative and cooperative partnership— with the laboratories and materiel development centers of Major General Roger Nadeau’s Research, Development and Engineering Command and the Army Materiel Command. For every product that requires medical input or regulatory approval, we are there to work closely with our Army materiel developers.
We’re also coordinating across interagency boundaries with the Department of Homeland Security, the Department of Health and Human Services—including the National Institute of Allergy and Infectious Diseases and the Centers for Disease Control and Prevention—the Department of Agriculture and other non-DoD federal agencies. All of these non-DoD agencies and departments have expertise that may help us provide solutions for the warfighter.
A tangile, visible example of this is the National Interagency Biodefense Campus at Fort Detrick. This partnership among DHS, the CDC, NIAID and USDA is building a large and closely interactive set of research and development partnerships. The campus has gone from concept to its first buildings in less than three years. Two laboratories—NIAID’s and DHS’s—are currently under construction. The campus is also using the Army’s concept of enhanced use leases to provide conference space for the campus as well as utilities. The National Cancer Institute-Frederick, although not a partner in the campus, is contributing biotechnology expertise and support for those collaborative projects with which they can assist. It’s a clear example of the importance of interagency partnerships that will provide protection for combatants while also enhancing protection for the American public from biological threats and emerging infectious diseases.
We’re trying to do a better job of coordinating the spectrum for requirements- based approaches so we can provide solutions to enduring and rather resistant threats to the health of the warfighter, for example, with infectious diseases and combat care. We’re also very good at looking at emerging technologies to see how we can take advantage of them. For example, the Telemedicine and Advanced Technology Research Center was able to exploit the Battlefield Medical Information System-Telemedicine— the BMIST—which is a handheld PDA-like device that arose as a technical solution to solve a problem: the requirement for electronic medical records during deployment. It doesn’t solve all of the electronic health record problem, but it has become a portion of a larger, overarching enterprise solution. We were able to get a product out there that has been a real step forward in realizing that enterprise solution.
Q: How will the BRAC realignments affect MRMC?
A: From the science and engineering standpoint, there were six centers of excellence that were created as a result of the BRAC recommendations. MRMC was involved in five of them: the Joint Centers of Excellence for Chemical Defense, Biological Defense, Medical Research and Development and Acquisition, Infectious Diseases, and Battlefield Health and Trauma Research. So unequivocally, MRMC is affected by the recommendations. In the spirit of base realignment and closure, what it intends to do in the science community is to enable and co-locate like functions to better synchronize collaborations across the three services and prevent redundancies that harm the mission we’re given.
My predecessor, Major General Lester Martinez-Lopez had a slogan that I’ve kept: ‘duplication by design not default.’ I think the intent of base realignment and closure is exactly that.
I think we’re also mindful that multifunctional and multidisciplinary research arises sometimes out of necessity. Universities spring from colleges because of the need to get a broader perspective on a problem. To some degree some of the mixed functions that occur right now in the labs that are being realigned—like the biological defense research that will move to USAMRIID or trauma research at the Walter Reed Army Institute of Research that’s moving to the Institute of Surgical Research in San Antonio—they may have grown because they met a need over time.
We will fully execute the commission’s recommendations, but I want to sow the seed that what we’ve arrived at right now under BRAC might look like a good idea but, over time, may make our researchers less effective. Some of the best ideas in science and technology happen when people from different disciplines have a cup of coffee and share their problems and find out they have common solutions, and I’d hate to lose that.
Q: What role does MRMC play in coordinating research with civilian counterparts to avoid duplicating work and funding on similar projects? Do you partner with any non-DoD facilities and in general how do you stay current with R&D in the civilian community?
A: We’re very much involved in collaborating and synchronizing elements of MRMC with our service partners, industry and academia to arrive at solutions for the warfighter. The people responsible for keeping abreast of all those opportunities are our research area directors— for military infectious diseases, combat casualty care, military operational medicine and chemical and biological defense. I lean heavily on this team, headed by our principal assistant for science and technology, Dr. Frazier Glenn, to stay current on who does the best science. They are the portfolio managers for what’s happening in the command and academia. Our laboratory commanders are experts in what’s happening in the realm of their laboratories, but they also keep up on opportunities to partner with industry, other services and academia to apply resources to whomever can get the work done most effectively.
The Telemedicine and Advanced Technology Research Center is always performing tech watch. It might not be always for every requirement we have for the warfighter, but they may be able to identify a new and emerging technology that the command can take from proof of concept to fielded solution.
Q: Will fiscal year 07 funding meet all your plans for projects?
A: It’s clear we won’t have enough money to meet all of our plans, but that’s why partnering is so important to the command. One of our core competencies is our ability to market our interests to academia, interagency and industry partners and leverage their funding to take products through advanced development for our customers.
Q: Are there any topics that you are focusing on now more so than others? Where do you see the greatest need for medical care advancement?
A: The military, in general, is reaping the benefits of applying information systems and knowledge networks in the conduct of war. It’s a fact that the Army is substituting knowledge for mass on the battlefield. Medical care in the 21st century is a very similar information-centered battle. In promoting health and providing health care, we have created a net-centric knowledge base on the battlefield and we are “substituting knowledge for mass.” From the medic to the first responder to higher echelons, the medical footprint has been reduced across space and time with advanced information systems.
We’re also optimizing human performance. Our researchers at the U.S. Army Research Institute of Environmental Medicine and the Walter Reed Army Institute of Research and its OCONUS labs are looking at how extremes in environment—like temperature, altitude, sleep deprivation and emotional and mental stress—affect the warfighter. That’s been a real important piece of research for the warfighter.
Thirdly, we’re advancing the care of severely injured soldiers and the victims of trauma. Wars have obvious, regrettable aspects: the carnage of battle. We’re making sure we take advantage of the opportunity to advance the care of soldiers, sailors, airmen, Marines and the Coast Guard by harvesting, in real time, lessons to help provide information and products to help combat lifesavers, medics, nurses and physicians.
A very busy trauma center in the United States sees as many cases in one year as our hospitals in Iraq see in one month. We’re taking this opportunity to learn as much as we can, as fast as we can, to help the warfighter and care providers. Just as the Army is taking full advantage to change its tactics, techniques and procedures to fight smarter and better, we’re applying the essential features of good science and good analysis by using tools like the Joint Theater Trauma Registry, a database that carefully monitors care from the point of injury through the forward surgical teams and combat support hospitals to rehabilitation centers in the States. We’re going to let evidence drive the decisions about what materiel works best and what organizational structure to deliver care works best.
Q: Is there much competition for the skilled and experienced scientists and engineers who are crucial for your work? What are some of the tools and resources you have to maintain your staff and attract new and bright people to you team?
A: Everybody in academia, as well as the government and industry, is competing for a shrinking pool of highly qualified people. We’re both a research and medical logistics command, so we’re not just recruiting scientists. Our various mission activities now add up to $1.6 billion and 38,000 business transactions annually, so we need contracting officers. We also need people who have experience with regulatory affairs and the acquisition process because we focus on the lifecycle management of products.
The U.S. Army Medical Acquisition Activity, as well as USAMRIID, both offer summer internships to give students an opportunity to work with the command. We also partner with the local academic communities—from elementary schools to universities— through our Gains in the Education of Math and Science, or GEMS, program. The program offers school-aged children a chance to spend a week of their summers working in a lab. The program is led by college-aged students who serve as near-peer mentors for the children to foster a love a science and possibly future careers as researchers or assistants.
We partner with industry as well, especially small businesses to help them realize their opportunities to partner with us as future contractors to further our science goals.
Q: How user friendly is MRMC for large and small companies to either participate in the bidding process for existing programs and separately to showcase their latest product or technology that they think will fill a need you have?
A: In the final analysis it’s for the companies who want to participate with us to tell us how easy or difficult it is to work with us! We certainly make every effort to develop partnerships where it’s profitable for them and us. We have small business partnerships with veterans-owned and disabled veterans-owned businesses. Here at Fort Detrick we have the Fort Detrick Business Development Office that has created a single portal of entry for the entire installation for any businesses who want to work with us. Those businesses have visibility of upcoming contracts and have an opportunity to participate in workshops and get personalized support from that office. Bill Howell, my deputy for acquisition, is always looking at companies to partner with, and Jerome Maltsby and Archie Cardwell have gone out of their way to reach potential partners in small businesses.
Q: What do you consider MRMC’s success stories within the past few years?
A: We have many success stories. People are most familiar with our products: devices, drugs and vaccines that we have fielded or are in the process of improving. It’s important to note, though, that MRMC is important to the military health care system for its expertise and its intellectual orientation in solving problems. Trauma care, to the command, is not just about providing devices. It’s about how we think about casualties: what care to provide at each echelon of care and how to organize care.
One of MRMC’s greatest success stories is with the behavioral health support we’ve provided. As I said at the beginning, though the products are information on trifolds and DVDs, what’s important are the intellectual framework and the approach that’s been taken toward combatants and ensuring emerging symptoms are rapidly identified. Those initiatives have concentrated on thinking about the soldiers who are serving in defense of the country and ensuring they are fully focused. And once they are ready to return to civilian life, we want healthy, fully capable citizens and intact, resilient families.
As for products, one of our success stories is the improved first aid kit. It’s the first real modification of the first aid kit since the Korean War. The Army Combat Helmet is providing enhanced protection for the warfighters. The HemCon or chitosan dressing is a great example of being able to go from concept to fielding to the medic and combat lifesaver in the theater of operations in less than two years because we were able to expedite its approval with the Food and Drug Administration. The Combat Application Tourniquet is another example of how the command has made a difference. The civilian medical community hadn’t felt that tourniquets offered an advantage, but we found that they’ve been lifesaving against the most common cause of death, battlefield hemorrhage. The need for the hypothermia prevention kit came out of data collected in the Joint Theater Combat Registry that said the theater needed a device to maintain a casualty’s body temperature because that was a predictor of survival. The BMIST, which I talked about earlier, is also a success story.
It’s a real source of pride for all of us that in the past three years, the MRMC has claimed six of the Army’s 30 greatest inventions: the Golden Hour Blood Box, the Virgil Chest Tube Insertion Simulator, the BMIST, the Electronic Information Carrier, the chitosan bandage and the Combat Application Tourniquet. That’s quite an achievement: 20 percent of the Army’s greatest inventions from the MRMC!
In the medical logistics arena, we have effected a very successful partnership with the Defense Logistics Agency that permits us to leverage the medical purchasing power of the Defense Working Capital Fund. This partnership ensures financial visibility and inventory accountability to the DLA resource managers while ensuring our medical logisticians have continuous supply chain management and timely, efficient medical assembly of field hospitals and medical sets and kits. This has occurred in part through a successful fielding of the Theatre Enterprise Wide Logistics System, or TEWLS, a unique commercial product that will bring that same “information dominance” and knowledge network technology to the logistics community that I described for the health care delivery community.
As a life cycle management command, we are attentive to and successful in intermediate supply chain management of medical supplies, equipment, and devices from factory to foxhole, foc’sle, flight line and mud. We are as successful in this arena as we are in concept development, science and technology, and advanced development of new products in the MRMC.
It is with great pride and a deep sense of humility that I lead and serve this talented MRMC team. ♦
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