UNCLASSIFIED

COL Karl E. Friedl, Ph.D.Director, TATRCFort Detrick, Maryland

COL Ron K. Poropatich, M.D.Deputy Director, TATRCFort Detrick, Maryland

Telemedicine & Advanced TechnologyResearch Center (TATRC)

1- Medical Simulation andTraining Technology Research Portfolio2- Armed Forces SimulationInstitute for Medicine (AFSIM)

Games for Health - 17 May 2011

UNCLASSIFIED

Presenter: J. Harvey Magee, Technical Director,Medical Simulation & Training Technology

• Financial Disclosures: None

• Organizational Disclosures: Employed by University of Maryland Med System, loaned to US Army under the Intragovernmental Personnel Mobilization Act (IPA)

• Disclaimer: I have no authority to negotiate for, or to obligate, the US Government.

• This is an informational brief and not intended to convey Department of Defense policy.

UNCLASSIFIED

• Thomas B. Talbot, MAJ, USA, MC• Chair, JPC-1a Steering Committee• Director, Armed Forces Simulation Institute for Medicine

(AFSIM)• Kevin Kunkler, MD, Interim Portfolio Manager• Hugh Connacher, Engineer• Harvey Magee, Hospital Administrator (Presenting in behalf

of team), Technical Director• Harvey.magee@tatrc.org

• Greg Wimsatt, JPC1 Facilitator• Adam Wyatt, Project Officer• Elton Edinborough, Project Officer

TATRC MedSim Team

UNCLASSIFIED

• A US Army agency reporting to HQ US Army Medical Research Materiel Command (USAMRMC)

• We serve all of DOD

Who TATRC is

UNCLASSIFIED

• Inform the Games for Health community of interest about:• “traditional” TATRC “MedSim” portfolio, 1999-2011-->>• a new funding source for medical simulation, through the

Defense Health Program, managed by the Office of Secretary of Defense / Health Affairs (OSD/HA)

• Armed Forces Institute for Medicine (AFSIM)• Joint Program Committee1a-MedSim (JPC1a-MedSim)• AFSIM strategic plan

• Identify and describe major initiatives / areas of interest• Inform the public about Fiscal Year (FY) 10 investments• Request information / ideas for future AFSIM strategies

Purposes

UNCLASSIFIED

Explore science and engineering technologies ahead of programmed research, leveraging other programs to maximize benefits to military medicine

Be the DoD model of government enablement of technology transfer to use

Mission

Vision

Fulfilling the Vision Thru R&D

UNCLASSIFIED

US Military PartnersUSAMRMC HQs and LabsNaval Health Research CenterArmy & Navy Medical Centers

Extramural PartnersPacific Telehealth & Technology HuiCenter for Integration of Medical &

Innovative Technology (CIMIT)Pain and Neuroscience Center

Research (Conemaugh) UTHSC-Houston Loma Linda University Center for Advanced Surgical &

Interventional Technology (CASIT)Samueli Research InstituteCenter for Excellence for Remote & Medically

Under-Served Areas (CERMUSA) Windber Research InstituteJoslin Vision Network Center for Military Biomaterials Research (CeMBR) Schepens Eye Research InstituteUniversity of MarylandRyder Trauma Center

International Medical Military PartnersFrance, Germany, UK

Strategic Partnerships

TRIPLERHONOLULU, HI

TATRC / BHSAIFORT DETRICK, MD

TATRC WESTLOS ANGELES, CA

TATRC officeBRUSSELS, BELGIUM

TATRC SouthAUGUSTA, GA

Projects SupportedNorwayPolandMacedoniaNetherlandsItalyAustria

UNCLASSIFIED

Sim-Game Based Research - TATRC

TRIPLERHONOLULU, HI

TATRC / BHSAIFORT DETRICK, MD

TATRC WESTLOS ANGELES, CA

TATRC officeBRUSSELS, BELGIUM

TATRC SouthAUGUSTA, GA

- Duke (Anesthesiology Team Training)- Virtual Reality Med Cen- Institute of Creative Technologies

- Higher Order Learning Skills to Manage Blast / IED Events:

- MYMIC LLC- SimQuest LLC

-Chem-Bio-Rad-Nuclear-Explosive- Forterra (bought by SAIC)

-Cog Motor Therapy / Console Game-Blue Marble-Kinetic Muscles

-Pandemic Event Mgt-SimQuest-Total Immersion Solutions

- Interactive Game-based system for Psych Health Ed

-Novonics-SOAR-Total Immersion Solutions

UNCLASSIFIED

Sim-Game Based Research – JPC1a

TRIPLERHONOLULU, HI

TATRC / BHSAIFORT DETRICK, MD

TATRC WESTLOS ANGELES, CA

TATRC officeBRUSSELS, BELGIUM

TATRC SouthAUGUSTA, GA

-Applied Research Associate - Anesthesia and Anaphylaxis for Physicians

-Blitz Games Studios (Vitalize Game Based Wellbeing [Kinect-based] Physical Therapy Coach

-Blue Marble – TBI Rehabilitation Surface

-Breakaway Games –Hospital Disaster Simulator for CBRNE

-Institute for Creative Technologies – SimCoach, other projects

UNCLASSIFIED

0

50

100

150

200

250

300

350

400

Millions

'98 '00 '02 '04 '06 '08

Demonstrations & Field T-Med (P8)

Congressional Special Appropriations – RDT&E

FY 2009 Total $454.8M

Since FY98, $2.10B managed R&D projects

TATRC Funding History

UNCLASSIFIED

TATRC Portfolios

Resilience & ReintegrationHuman

Performance Optimization

Dr. Cardin

Psych Health

Dr. Shore

Simulation& Training

Technology

MAJ Talbot

Bio-MonitoringTechnologies

Dr. Lai

MedicalRobotics

Dr. Gilbert

AdvancedProsthetics & Human

Performance

Mr. Turner

Genomics/ Proteomics

Dr. Nisson

InternationalHealth

Ms. Barrigan

MedicalImaging

Technologies

Dr. Pacifico

HealthInformation

Technologies

LCDR Steffensen

ComputationalBiology

Dr. Reifman

Nano-Medicine &Biomaterials

Dr. Grundfest

RegenerativeMedicine

Dr. Lai

InfectiousDisease

Dr. Carney

MedicalLogistics

Mr. DePasquale

Blood Products & Safety

Mr. Malloy

Trauma

Dr. Broderick

Vision Research

Mr. Read

Acoustic Trauma

Dr. Holtel

Neurotrauma

Dr. Golanov

Medical Information & Training TechnologiesInfectious Diseases

Military Operational MedicineCombat Casualty CareClinical & Rehabilitative Medicine

Slide 11 of 37

UNCLASSIFIED

Download: http://www.tatrc.org/docs/TATRC_report_2009.pdf

UNCLASSIFIED

• Congressionals - a “Line Item” appears in DOD Authorization / Appropriation Bills

• Opportunity / obligation: to shape it to maximize military & scientific relevance while honoring congressional language

• SBIR - Authoring of Small Business Innovative Research “topics”

• Opportunity: proactively submit research topics to DOD / Army to “fill gaps”

• Augmentation funding - Someone submits a hot, innovative idea

• AAMTI - Army Med Dept Medical Training Initiative• JPC1-MedSim - Joint Program Committee 1-MedSim

Opportunity-Driven Model - Examples

UNCLASSIFIED

Turning to medical simulation…

UNCLASSIFIED

Why We Started – Reason #1To Improve Trauma Training

•100,000 military medical personnel must practice battlefield trauma care skills*(Source: GAO Rpt, NSIAD-98-75, DOD Training in Civilian Trauma Centers)

•Good News – not enough trauma patients•Bad News – not enough trauma patients, for they ARE a training opportunity

•Solution: Virtual patients

November 09UNCLASSIFIED

Why we Started – Reason #2To Reduce the Errors

• IOM report - 1999:>45,000 deaths due to errors - Medical errors 7th leading cause of U.S. death…

• HealthGrades, 27 Jul 04: 195,000 deaths/yr, $6B annual costs, 6th

most common death• ENT: 45 % report errors

committed: 37% serious harm, 9% fatal“Classification and Consequences of Errors in

Otolaryngology “

-Rahul K. Shah, et al, The Laryngoscope, August 2004

Slide courtesy of Dr. Steve Dawson, CIMIT Simulation Group

UNCLASSIFIED

Long-Term Vision forSimulation-based Training

• To facilitate a paradigm shift in medical training, a Grand Challenge revolution…

• FROM subjective assessment of clinical skills

• TO a curriculum-aligned, metrics-driven, objectivesystem of assessment based on demonstrated proficiency to perform skills for which health care personnel have been trained.

UNCLASSIFIED

•70-person IRT (government, academia, & industry)• Strategic ROAD MAP resulted• 4 general areas for research identified• Became basis of TATRC portfolio to this day

Integrated Research Team – Feb 00

UNCLASSIFIED

PC-based Interactive Multimedia

Basis for Road Map:Multiple Needs, Multiple Technologies

Digitally EnhancedMannequins

Part-Task Trainers / VirtualWorkbenches

Total Immersion Virtual Reality

UNCLASSIFIED

PC-Based Interactive Multimedia

Social Behavior –AVESSS / Second Life

Combat Casualty – Chemical War- Forterra (now SAIC) CBRNE

Maintenance of Certification - SimQuest

Interactive Psychological Health Education - Total Immersive Software, Inc (JESSEY)

Cognitive Learning & Logistics -Office of Naval Research (PULSE)

Patient Interactions & Logistics – Applied Research Associates, Inc, Virtual Heroes Division (HumanSim)

UNCLASSIFIED

Digitally Enhanced Mannequins

Combat Medic Training System – Center for Integration of Medicine & Innovative Technologies (CIMIT) -(COMETS)

Compartment Syndrome Task Trainer - Operative Experience

Next Generation Injury Creation -The Virtual Reality Medical Center

UNCLASSIFIED

Part-Task Trainers / Virtual Reality Systems

Virtual Cricothyroidotomy -National Capital Area Medical Simulation Center

Burr Hole Simulator -SimQuest

3-D Anatomical Model -ArchieMD, Inc.

Compartment Syndrome Sim & Didactics - Touch of Life (ToLTECH)

UNCLASSIFIED

Total Immersive Virtual Reality System

Wide Area Virtual Environment (WAVE)-National Capital Area Medical Simulation Image from www.simcen.org/VME%20Lab/projects/wave/index.html

Tactical Digital Holograms: technology matured under contract with the Army-Zebra Imaging

Ultra High Resolution Display - eMagin

iGlove Robotic Controller - AnthroTronix

UNCLASSIFIED

Technical Strategy

• Identify Enabling Technologies• R&D them into components that can be…• Integrated into…• Systems of simulation-based training that can be…• Validated to determine their training effectiveness, so

OTHER military organizations can… • Transition / sustain them for military health care, from the

foxhole to the operating room and beyond

UNCLASSIFIED

•Real-time in vivo tissue property measurement•Haptics•Tissue-tool interactions•Graphics, visualization•Augmented Reality•Learning systems•Metrics development•Learning transfer & assessment•Open source architecture•Olfactory technologies•Gaming Technologies

Enabling Technologies

UNCLASSIFIED

AFSIM:Introduction to the

Armed Forces Simulation Institute for Medicine

Director: Thomas B. Talbot, MAJ, USA, MCTelemedicine and Advanced Technology Research Center (TATRC)

United States Army Medical Research & Materiel Command(USAMRMC)

UNCLASSIFIED

AFSIM ORIGINS• Department of Defense Health Affairs Initiative

• Defense Health Program Dollars ~$30-45M/year (contingent on receipt of funding)

• Improve medical education & readiness for all services• ULAMET – JAT Report

• ASBREM Committee• JTCG-1• JPC-1

• Initial Mandate1. Live Tissue/Sim Research,2. Curricula and Standards,3. Virtual Human Coaching for OIF/OEF Veterans,4. Ophthalmology & Anesthesia, and5. Medical Simulation Systems.

UNCLASSIFIED

Joint Program Committee 1

• JPC-1• Chair: COL Karl Friedl, PhD• Tri-Service Programmatic Committee• TATRC is primary execution agent

• JPC-1a Medical Simulation & Training• Chair: MAJ Thomas B. Talbot, MD• Efforts spawned AFSIM

• JPC-1b Health Information Technology• Chair: Steve Steffensen, MD (Former Navy)

• JPC-1c Decision Support Tools & Modeling • Chair: Jaques Reifman, PhD

Tri-Service

Transparent

Ethical

Visionary

Collaborative

Responsive

Strategic

UNCLASSIFIED

JPC-1a Voting Members

US Army - PEOSTRI

US Air Force - Air Education Training Command

US Army - Central Simulation Committee

USUHS - Natl Capital Area Med Sim Cen

AMEDD C&S - Directorate, Combat Medic Training

AMEDD C&S - US Army EMS Office

US Navy - Office of Naval Research

US Air Force - Air Education Training Command

US Army - RDECOM / STTC

DARPA

Medical Education and Training Campus (METC)

Office of Naval Research

UNCLASSIFIED

JPC-1a Advisors

US Navy - Naval Postgraduate School Monterey

Dept of Homeland Security

DOD; USA OTSG

DOD Patient Safety Office

TATRC / Brussels Belgium

USUHS - Natl Capital Area Med Sim Cen

Defense Center of Excellence for Psych Health & TBI

DOD Patient Safety Office

HQ USAMRMC

OASD (HA)

UNCLASSIFIED

Ground Rules

• NO PROMISES• We cannot obligate the US Government to anything based

upon discussions during this event• Decisions, plans and budgets are subject to approval and

changes by headquarters at any time• The steering committee can and will change plans

• Pending Awards• We cannot provide details on programs under review for

selection or projects pending award• We want your input

• We shall inform industry and academia of our efforts and wish to glean your insights on how you think we can accomplish our strategic objectives

UNCLASSIFIED

JPC-1a Structure

Combat Casualty Training Initiative

Medical Practice Initiative

Developer Tools for Medical Education

Patient Focused Initiative

AFSIM

UNCLASSIFIED

Combat Casualty Training Initiative Strategic Building Blocks (CCTI)

Superior Battlefield Lifesaving Capability

Tri- Service Compatible Curricula

Advanced Training Systems

Resilience Research & Integration

Animal / Simulator

Comparison (CCTC)

Simulator Gap R&D to equal animal

efficacy

Improved Task

Trainers & Manikins

Olfaction & PTSD

Research

Improved Learning Metrics

Systems & research to improve pre-hospital trauma training and maintain lifesaver resilience

Integrate very advanced training technology into medical training & simulation facilities of all services

Virtual Reality individual and team training to replicate chaotic and mass casualty scenarios in a safe environment

Real world benefits:-Pre-hospital assets continuously in a high state of readiness-Potential to replace animal training

-Training geared towards psychological resilience during and after deployments-Improved safety by statistically valid recognition of lost skills

DTMEPFI

MPI

UNCLASSIFIED

FY11 Combat Casualty Training Initiative

• Combat Casualty Training Consortium Program Announcement - $15.2M• Timeline

Released Summer 2010Closed November 19th, 2010Scientific Review CompleteProgrammatic Review UnderwaySelection Board February 24th, 2011Award(s) Anticipated Late Summer 2011

• Critical Research Areas• Trauma Airway• Hemorrhage• Emergency Medical Skills (Nerve Agent Casualty)

• Goals• Live Animal / Simulator Comparative Research• Curriculum Development• Simulator System Gap Analysis

UNCLASSIFIED

FY10 Combat Casualty Training Initiative

Combat Casualty Training Initiative Project Perfomer Budget

Live tissue / sim - metrics research NAVAIR $ 369,835

BCT-3 live tissue / sim study Brooke Army Medical Center $ 250,000

Multiple Amputee Trauma Trainer STTC Orlando $ 756,000

Rapid trauma skills training Operative Experience $ 497,750

COMETS improved capabilities for combat medics CIMIT Sim Group $ 449,901 Maxillofacial & Ophthalmology Trauma Trainer Pending Extramural Award Pending Award

TOTAL: ~$ 5,550,000

UNCLASSIFIED

CCTI FY11 Plans

• CTCC PA Award $15.2 M• Extend BCT-3 research efforts ($1.8M)

~$17 Million

UNCLASSIFIED

CCTI FY12 Plans

• No Program Announcement Plans for FY12• Consider PA in FY13

• CTCC is just starting and will not produce feedback by FY12 to know where to add additional funding to CTCC

• Should we start a new advanced training platform in FY12?• Advanced open architecture manikin

• Possible, but we don’t have research data to know everything it will need• Advanced talking task trainers

• It is a stronger possibility. What would we do?

UNCLASSIFIED

Medical Practice Initiative Strategic Building Blocks (MPI)

Advanced Doctor

Education System

(COMRADE)

JPC-1b EHR Education & Reference Integration

Virtual Human

Standardized Patients

JPC-1c Decision Support

Integration

Loss of Skills.

Retraining &

Competence

Serious Games for Training

Common Curricula &

Metrics (Tri Service Consortium)

Military Medical Lifecycle

Counselor (DKO)

Military Medical

Simulation Masters

Development of medical training systems & competency assessment for sustained military medical readiness.

Continuous Observation of Medical Records for Advanced Doctor Education (COMRADE)

Real-time specialty specific evaluation for loss of skills & knowledge

Real world benefits:-Reduced cost for training-Reduced liability-Cost savings by replacing expensive standardized live patient teaching cases with reusable virtual human patients-Improved Tri-Service medical interoperability-Leverages Electronic Health Record system as training portal

-Can use AHLTA or another EHR

PFIDTME

CCTIEducational

Content

UNCLASSIFIED

Continuous Observation of Medical Records for Advanced Doctor Education (COMRADE)

Medical Record EHR DevelopmentExtensive hyper-linking and floating reference infoMeaningful visual formatsClinical practice guideline based formats when appropriateIntelligent summarization of dataHealth records that communicateVisual decision support tools

Intelligent Assessment & TutoringSystem tracks procedures, CME, findings & assessments

to determine physician exposures against list of expected knowledge by their specialty board

System determines if lack of exposure is sufficient for a refresher in a certain area

System schedules a teaching case or a virtual patient into the physicians patient schedule

System recommends periodic procedure observed trainingAutomatic & documented maintenance of certification

Advanced Doctor

Education System

(COMRADE)

UNCLASSIFIED

FY10 Medical Practice Initiative

Medical Practice Initiative Project Perfomer Budget

Medical Training Evaluation and Review (MeTER) RDECOM / STTC $515,000

Training Outcomes Research Metrics UCLA / CRESST $450,000

Hospital disaster simulator - CBRNE Based Breakaway Games $2,671,322

Redeployment skills evaluation Madigan Army Medical Center $800,000

Tri Service Medical Simulation Training Consortium Air Force / ONR / USUHS $2,500,000 Anesthesia and Anaphylaxis for Physicians Applied Research Associates $1,900,000 Virtual Sick Call RDECOM / STTC $773,000

TOTAL: $ 9,609,322

UNCLASSIFIED

MPI FY11 Plans

• Navy Redeployment Skills Degradation• Multiple Amputee Trainer (MATT) final year• Olfaction training device & study• Medical Simulation Training Consortium Years 2-3• Simulation for Futuristic Surgery (VR Urology)• CBRNE Hospital Incident Management Radiological Scenarios• Ocular Craniofacial Manikin Advanced Development• Medical Simulation Master’s Degree Program• Student Innovations in Medical Simulation (Skunk Works)

• Unfunded request for large web portal hosted by Air Force

~$13.5 Million

UNCLASSIFIED

MPI FY12 Plans

• We would like a program announcement for FY12• PA would be major effort for AFSIM for the year

• Things we are thinking about:• How can electronic health record data be used to discern a physician’s

educational needs?• Military Medical Career Training Guidance• How can we deliver training content with all the things we want to do on

government computer systems?• For what applications are Virtual Reality & networked training appropriate

and efficacious?• Are there things going on in the civilian world that we can leverage?

UNCLASSIFIED

Patient Focused Initiative Strategic Building Blocks (PFI)

Advanced Virtual Reality &

Augmented Reality Training

Technology

Mobile Technology

Integration for Health & Training

Virtual Human Patients & Coaches

Physical & Neurocognitive

Therapy Applications

DARPA –Healing Heroes

NIH – Virtual Reality for Obesity & Diabetes

Game Industry Technology

JPC-8 Rehabilitation, Physical and

Neurocognitive Rehabilitation

ICT simCoach& Emotionally

Expressive Characters

Advanced user interface and interactive technologies for healthy living, medical practice , patient rehabilitation & training

Advanced technology for training applications leveraging investments of DoD and Government Partners

Adapts therapeutic technology targeting warfighter readiness and mental health

Real world benefits:-High impact development at reduced costs, especially for VR-based training-Technology highly adaptable to training-Direct injured warfighter benefit

-Traumatic Brain Injury-Psychological Health (PTSD, Suicide)-Physical Therapy

-Adaptation of mobile and tele-health technology

MPICCTI

PARTNERSHIPS

UNCLASSIFIED

FY10 Patient Focused Initiative

Patient Focused Initiative Project Perfomer Budget

Vitalize Game Based Wellbeing (Kinect-basedPhysical Therapy Coach) Blitz Games Studios $4,325,024

Refining medical outcomes deployment: Naval Health Research Center $500,055

TBI Rehabilitation Surface Blue Marble $1,374,447

Olfaction & Resilience Research (10 studies 6.1) Monell Chemical Senses Center $4,000,000

TOTAL: $10,199,526

UNCLASSIFIED

PFI FY11 Plans

• Natural Language Processing for Virtual Humans• 3D motion tracking for rehabilitation• DARPA: Healing Heroes

~$5 Million

UNCLASSIFIED

PFI FY12 Plans

• We want to consider a program announcement in FY12

• Things we are thinking about:• Virtual Humans for Coaching• Assessment of off the shelf and easily hacked technology for the

rehabilitation, assessment and therapy environments• Mobile Technology

• Constantly proposing SBIR topics in this area

UNCLASSIFIED

Developer Tools for Medical Education Strategic Building Blocks (DTME)

Affordable Training Content Creation

Surgical VR Training System

Standards

Character AI

Advanced Displays & Interfaces

OS Natural Language Processing

OS Practical Physiology

Engine

OS VR Anatomy &

Haptic Platform

OS Speech & Motion

Recognition

OS Medical Asset Library

Transformational open source advanced developer tools to reduce development costs and democratize access to technology.

Based on the need to greatly reduce the burden to develop interactive medical & surgical training content.

Open Source (OS) promotes low cost and innovation

Real world benefits:-Greatly reduced development costs-Saves development time-Facilitates content creation

-Greatest need as program matures-Opens development to a more diverse and wider community-Reduced system procurement costs-Reduces redundant development

CCTI

MPICCTI

OnlinePortal

UNCLASSIFIED

FY10 Developer Tools for Medical Education

Developer Tools For Medical Education Perfomer Budget

Dynamic Holographic Displays & 3D in medical education RDECOM & PEOSTRI $ 3,000,039

Tri-Service Open Platform for Simulation USUHS $ 2,000,000

TOTAL: $ 5,000,039

UNCLASSIFIED

DTME FY11 Plans

• Advanced VR Eyewear Display

~$4 Million

UNCLASSIFIED

DTME FY12 Plans

• We want to consider a program announcement in FY12

• Things we are thinking about in the near term:• Open Source Practical Physiology Engines• Open Source Visual Human toolkit for VR surgical applications

• Things we are thinking about down the road• Open Source Virtual Character Behavior Engine• Medical Asset Exchange (Radiographs, sounds, slides, etc.)• Character emotional display, speech & movement tools• Natural Interface Tools, Facial Recognition for Emotion, etc.

UNCLASSIFIED

Summary

• Many thanks to the Games for Health community. You are part of an unprecedented opportunity to shape the future of medical training

• We welcome your input

• Make the most of the week!

• Harvey.magee@tatrc.org

UNCLASSIFIED

• Congressionals - a “Line Item” appears in DOD Authorization / Appropriation Bills

• Opportunity / obligation: to shape it to maximize military & scientific relevance while honoring congressional language

• SBIR - Authoring of Small Business Innovative Research “topics”

• Opportunity: proactively submit research topics to DOD / Army to “fill gaps”

• Augmentation funding - Someone submits a hot, innovative idea

• AAMTI - Army Med Dept Medical Training Initiative• JPC1-MedSim - Joint Program Committee 1-MedSim

Opportunity-Driven Model - Examples

UNCLASSIFIED

• Our role is to manage congressionally supported research as directed.

• Constituents’ opportunity is to educate and inform your congressional representative . Government officials are prohibited from involvement with constituents in seeking to influence Congress.

•If you have questions, contract Mr Tony Story, TATRC’s congressional liaison.

•301-619-7033•tony.story@tatrc.org

Congressional Process

UNCLASSIFIED

• http://www.tatrc.org

• Click “Funding” at top-line menu.

• On Funding Opportunity page, click “USAMRMC BAA 10-1”.

• Click “Click here to visit the USAMRMC Broad Agency Announcements (BAA) Website”.

• Or just go here: http://www.usamraa.army.mil/pages/baa_forms/index.cfm

• READ and UNDERSTAND IT!

• You can take it from there.

Locate the USAMRMCBroad Agency Announcement

(the “BAA”)

UNCLASSIFIED

Questions ?