Modernizing Casualty Tracking in Large-Scale Combat Operations

A Division-Level Approach Using MEDSTAT

By SPC Lance Lee, MAJ Danielle Ivenz, and LTC Aaron Griffin (Co-Authors: LTC Zach Booms, SGM John Wilkerson, LTC Bryan Lee, MAJ(P) Jason Anthes, MAJ Alivia Stehlik, CPT Guinelle Chipchase, MSG Lawrence Roe, SFC Ceserae Hoover)

Article published on: August 1st, 2025, in the August 2025 Issue of The Pulse of Army Medicine

Read Time: < 5 mins

ABSTRACT:

Coordinating casualty tracking at the Division level during LSCO is a complex operational task marked by unpredictability, breadth, and speed. In the past, LSCO’s fast-paced environment made manual, Excel-based data collection inefficient, leading to delays and errors. To overcome these constraints, the 101st Airborne Division (Air Assault) partnered with EagleWerx to develop and implement an improved Medical Status (MEDSTAT) reporting system. Built on a Microsoft Teams and Power BI framework, the MEDSTAT system enables real-time, synchronized patient monitoring and injury trend analysis across all levels of care. This article outlines the system’s development, applications in both training and operational settings, and its strategic role in strengthening force health protection. MEDSTAT represents a critical evolution in medical readiness, transforming reactive reporting into predictive analytics that preserve combat power. Its flexibility, scalability, and analytic depth represent a major advancement in how the U.S. Army conducts medical operations in complex, large-scale environments.

Rapid, precise, and integrated medical data are essential for Large-Scale Combat Operations (LSCO) to support long-term operations in unstable and dispersed environments. Tracking patient movement, comprehending injury trends, and maintaining situational awareness is critical for individual care and the maintenance of unit effectiveness and operational tempo.

Historically, the Division Surgeon (DIVSURG) section of the 101st Airborne Division (Air Assault) employed a decentralized, Excel-based casualty tracking method. This legacy process relied heavily on manual entry at the Role 1 level, with datasets compiled and transmitted using tools like email, Microsoft Teams, and shared portals on the NIPRNet. Brigade and division medical officers manually curated and interpreted the data. This method proved inefficient, introduced significant latency, and failed to detect or analyze disease and non-battle injuries (DNBI) trends—a critical need in high-tempo LSCO scenarios.

IDENTIFYING THE GAPS

Notional example of a modern MEDSTAT dashboard

The legacy approach to casualty tracking was reactive and labor-intensive. It required significant time for each Role 1 and 2 to complete before sending to their respective brigade Surgeon section to consolidate. Finally, the division surgeon would consolidate six reports into one to provide a holistic understanding of what injuries and illnesses were most negatively impacting the units. It was not scaled to meet the demands of LSCO and failed to support injury prevention or rapid decision-making. Recognizing these shortcomings, the DIVSURG section partnered with EagleWerx—the Soldier-led innovation cell at Fort Campbell—to develop a modernized solution: the Medical Status (MEDSTAT) reporting system.

A system was needed that could:

1. Provide real-time visibility of casualties
2. Integrate horizontally (across units) and vertically (across echelons)
3. Support injury trend identification and strategic medical planning

MEDSTAT DESIGN

The MEDSTAT framework was developed as a collaborative environment housed in Microsoft Teams. This architecture allowed concurrent data entry and live updates from Role 1 and 2 medical teams. Data feeds were structured to flow into a custom-built Power BI dashboard, which offered visualized casualty and DNBI trends in near real-time.

The system’s intuitive design reduced the administrative burden on medical personnel, enabling them to shift focus from data compilation to anticipatory medical planning and support.

OPERATIONAL USE CASES AND INSIGHTS

COMPARATIVE ANALYSIS DURING TRAINING EXERCISES

MEDSTAT has been employed across multiple training exercises, including Operation Lethal Eagle 24 and Operation Lethal Eagle 25. The platform enabled comparative analysis of DNBI trends over time, environment, and training intensity during these events

For instance, during dismounted maneuver phases, the system detected increased musculoskeletal injuries among Infantry (11B) soldiers. After cross-referencing with local weather data, heat and humidity were identified as major contributing factors. Command teams responded by implementing mitigation measures like load-bearing tasks, hydration enforcement, and staggered training schedules, which led to quantifiable decreases in repeat injuries in operations that followed.

DEPLOYMENT AND JRTC ROTATIONS

The MEDSTAT system has demonstrated consistent effectiveness during operational deployments and training center rotations. The system’s greatest strength is its depth of analytical capabilities. Data on casualties can be broken down by age, rank, deployability status, return-to-duty dates, Military Occupational Specialty (MOS), and other critical variables. These insights directly informed focused preventative measures, such as equipment modifications for particular roles and conditioning regimens for high-risk age groups.

STRATEGIC IMPLICATIONS AND SCALABILITY

The strategic value of the MEDSTAT system lies in its ability to bridge tactical data collection and strategic readiness planning. By allowing commanders to monitor casualty recovery velocity and identify bottlenecks in return to duty processes, MEDSTAT supports triage and overall force health posture.

The four key strategic advantages of MEDSTAT include:

1. Predictive Analytics: The ability to anticipate injury trends allows medical planners to shift from reactive to proactive interventions.
2. Scalability: Using existing platforms like Microsoft Teams and Power BI ensures ease of adoption across other Divisions, Corps, or Joint Task Forces.
3. Low Technical Overhead: Minimal training and infrastructure are needed, increasing adaptability in digitally mature and austere environments.
4. Rapid Insights: Dashboards convert hours of manual compilation into seconds of visual analysis.

These features make MEDSTAT an ideal solution for dynamic and unpredictable LSCO environments, especially where rapid decisions must be made with incomplete or decentralized information.

FUTURE DEVELOPMENT AND APPLICATION

Future iterations of the MEDSTAT system aim to integrate with broader platforms such as the MAVEN Smart System and Vantage Dashboards. Enhancements will include:

1. Reduction of data entry errors through automated dropdowns and validation logic
2. Geographic visualization of injuries on a common operating picture (COP), allowing location-based trend identification
3. Enhanced interoperability with other Army and Joint systems to support coalition operations
4. AI-assisted injury prediction models based on historical and environmental variables

These developments will transform casualty reporting into actionable medical intelligence—empowering leaders to preserve combat power through precision health interventions.

CONCLUSION

The MEDSTAT system represents a paradigm shift in casualty tracking during LSCO, enabling real-time insight, proactive intervention, and strategic readiness. Its adoption across formations could significantly reduce non-combat attrition and enhance combat power in dynamic operational environments.

In LSCO environments, the MEDSTAT system significantly advances operational health intelligence and casualty tracking. MEDSTAT gives commanders the means to protect force readiness and stop preventable attrition by removing antiquated manual procedures and facilitating real-time, data-driven decision-making.

The 101st Airborne Division’s (Air Assault) successful deployment demonstrates the necessity and feasibility of digital transformation in battlefield medicine. MEDSTAT is an example of how military medical systems should develop to satisfy the demands of contemporary warfare because it is scalable, user-friendly, and operationally relevant.

In a future fight shaped by speed, complexity, and distributed operations, medical data is a form of combat intelligence. The key to successful application of MEDSTAT in an adaptive environment is ensuring it’s not just a tool, but an embedded part of how units plan, fight, and recover across all echelons.