The US military has been developing and evolving models to improve combat casualty care since the Civil War. However, over the past quarter century, military medicine dramatically improved combat survival by organizing care into a coordinated echelon system, where every role was clearly defined, rapid frontline response was prioritized, and clinical information moved quickly across a unified network.
Goldie applies that same “Golden Hour” logic to the opioid crisis by giving hospitals, peers, providers, community organizations, and civic agencies a secure, compliant platform to coordinate referrals, communicate in real time, close feedback loops, and operate as one synchronized system of health for people ready to pursue recovery.
This will take a little explanation, so bear with me.
And we will get to Goldie.
During the last Gulf War, the US Military Medical System exercised a tiered model of care that resulted in the lowest combat casualty fatality rate in history, despite the increased lethality of the wounds inflicted. In World War II, 30% of combat wounded U.S. soldiers died from their wounds. In Vietnam it was 24%. But in Iraq and Afghanistan (2001-2014), only 10% of those wounded succumbed. Ninety percent of combat wounded service members survived.
Much can be said about the improvements in personal protective equipment (e.g. Kevlar helmets, body army, ballistic glasses). But the biggest difference was the system.
During my military career, tiered levels of care (“Roles” or “Echelons of Care”) were clearly defined in the military medical system as were the standards for the definitive care delivered at each level, (table 1). I was assigned (part time) to a Medical Company of the 25th Infantry Division (Echelon II) and trained with them for six years in the 90’s before 9/11. Later, I deployed with the 8th Army Medical Brigade, responsible for care delivery in Operation Iraqi Freedom’s (OIF) Southern Theater, including Kuwait, Qatar as well as Afghanistan, (2004). Continue reading