Dual Impact

How Medical Innovations Transformed Both Military and Civilian Sectors

By MAJ Lamanda Jackson

Article published on: July 1, 2025, in the July 2025 Issue of The Pulse of Army Medicine.

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ABSTRACT:

The U.S. Army Medical Department has been pivotal in advancing healthcare practices, pioneering innovations beyond civilian applications. From trauma care systems to logistic operations, many of the Army’s medical breakthroughs have been adapted by civilian industries, influencing fields such as public health, logistics, emergency response, and corporate management. The contributions of the Army Medical Department to both the medical community and various non-medical sectors demonstrate its broad impact on improving global systems of care, operations, and leadership.

With a long history of advanced medical practices, particularly within trauma care and emergency response, the U.S. Army Medical Department has extended its innovations far beyond healthcare. Over the years, concepts and systems developed for military medicine have found significant applications in civilian sectors, improving global healthcare systems, business practices, logistics, and even leadership training. The enduring influence of the Army Medical Department is evident in its contributions within medical communities and across a wide range of non-medical domains.

Trauma Care and Triage Systems

The Army Medical Department’s guidance to the development of modern emergency care has been invaluable and has allowed for evolutionary developments within the triage system and has also introduced the Advanced Trauma Life Support (ATLS) education program. With the knowledge gained through past conflict experiences dating as far back as the Civil War, a hierarchical system, similarly based off the military medical models, began to evolve in the civilian medical sectors. This integration of military medical models and practices continued after World War I, during which Emergency Medical Services (EMS) began including cardiopulmonary resuscitations (CPR), a cardiac or respiratory arrest lifesaving intervention procedure originally popularized by the U.S. military. Throughout the 1960’s, the civilian emergency services steadily increased their use of the triage organization systems when making patient care decisions. This approach was initially introduced by the military to help assist in the prioritization of Soldier treatments during wartime efforts. Today, triage care is adapted as a trauma response for routine emergency room operations, EMS services, and disaster relief efforts.

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As with the development of triage care, the Army’s understanding of the need to provide critical care closer to the front lines during War time efforts enabled the development of portable field hospitals. Initially tested during World War II, the intent of these mobile hospitals was to provide the maneuverability required to administer critical care. By the Korean War, Mobile Army Surgical Hospitals (MASH) units were formalized, after which Combat Support hospitals (CSH) became the standard. The significance of these military-driven advances in patient transport, trauma care, and healthcare infrastructure is that they have provided the civilian emergency medical systems with the same necessary knowledge.

These advancements saved lives in military settings and have been critical in civilian disaster response and emergency medical services. With innovations introduced by military healthcare, the development of civilian mobile health units followed. These mobile health units were instrumental to disaster response, changing how natural disasters and large-scale emergencies were handled and providing the ability to rapidly set up healthcare facilities during critical situations.

The continual evolution of these systems—shaped by lessons from past conflicts—has enhanced patient outcomes and the ability to respond quickly to crises, underlining the significant global influence of military-driven healthcare innovations.

Air Medical Transport

To enhance wartime efficiency and limit casualty rates among wounded soldiers, the French Army introduced the concept of using an aircraft to transport injured soldiers during World War I. The innovation of medical air transport during World War I saved numerous lives, and its advantages extended through World War II, helping to provide care for both military and civilian casualties.

Additionally, because of the success these military air ambulance services provided, civilian air medical transport services began to emerge. Non-profit organizations were especially crucial in providing accessible air medical transport services, particularly in remote areas with limited resources. The development and introduction of air ambulance helicopters enhanced patient transportation capabilities through its speed, versatility, and urban area accessibility. Due to its evolutionary growth, air ambulance helicopters also brought about the development of specialized training, advancements in technology, and quality in comprehensive patient care during transport.

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The military’s advancements in air ambulance services played a pivotal role in shaping the foundation for civilian air medical transport, paving the way for widespread emergency and critical care by air. As a result of various innovative specialized training and improved medical equipment, air medical transport services have transformed into an indispensable component of healthcare systems worldwide, ensuring rapid, high-quality care during critical transport.

Preventative Medicine and Technological Innovations

Since the founding of the United States, Army medicine has been the cornerstone to many groundbreaking contributions and innovations in preventative medicine. The influence and dedication of military personnel have profoundly impacted today’s modern medicine and public health systems. Such influence may be seen through the innovative contributions of Army Surgeon John Shaw Billings. Billings, known for his exemplary career, helped transform the Army Medical Library into one of the world’s premier medical resources by the end of his military service in 1895. His dedication toward the expansion of the Army Medical Library led to the development of the Index Catalogue and Index Medicus. This inevitably set the foundation to the modern medical information management system of today. Billing’s involvement in the development of the automated punch card system has helped revolutionize data processing, eventually leading to the configurations of the International Business Machines (IBM).

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Such commitment and contributions to the development of public health expanded during the Spanish-American war. The situational impact of the war revealed that American Soldiers perished from diseases such as yellow fever and malaria far more often than injuries sustained in combat. After the war, these illnesses continued to devastate both the Cuban population and the American forces. To combat these diseases, Army Surgeon General George M. Sternberg established the Walter Reed Yellow Fever Commission to investigate the disease’s causes and transmission in response to the ongoing health crisis. Led by Army Major Walter Reed, the groundbreaking research of the commission identified Aedes mosquitoes as the primary vectors of yellow fever and proposed a filterable virus as the etiological agent. This discovery enabled Colonel William C. Gorgas to implement mosquito control measures in the Panama Canal Zone, eventually eradicating yellow fever in the United States.

In addition to Reeds’ commission to investigate Yellow Fever, Surgeon General Sternberg quickly appointed Major Reed, Army Major Edward O. Shakespeare and Major Victor C. Vaughan to take part in a board directed at uncovering the cause of the Typhoid epidemic. The Reed-Vaughan-Shakespeare Typhoid Board conducted research which revealed that typhoid fever was spread by person-to-person contact and flies. This discovery led Major Frederic Russell to develop and introduce an antityphoid vaccine in 1909, which became compulsory for both the Army and Navy by 1911. The impact of this Army-directed initiative led to a widespread implementation of this vaccine. Its use would dramatically reduce hospital admissions and mortality rates from typhoid.

Veterinary science also contributed to innovative advances in medicine. Such contributions were brought forth by Army veterinarian Brigadier General Raymond Kelser, who while stationed in the Philippines in 1928, spearheaded the development of the rinderpest vaccine. This vaccine would become a major agricultural breakthrough in the treatment of rinderpest in cattle. His pioneering lab work also led to creating a test for detecting botulism in canned foods, improvements in rabies vaccines, advances in equine encephalomyelitis research, and the first “killed virus” vaccine using chloroform as an inactivating chemical.

Technology and Telehealth

Extending its reach beyond military application, Army medicine’s technological innovations have also led to advancements in both civilian healthcare and communications on a global scale. These innovations led to a significant increase in operational effectiveness across civilian applications, including telemedicine, healthcare technology, and communications.

One such example of this impact can be attributed to the invention of the wig-wag signaling system developed by Surgeon Albert J. Myer’s in the 1850s. Myer’s signaling system improved military communication and eventually contributed to the establishment of the U.S. Signal Corps. This signaling system’s technological innovation has assisted in the development of cutting-edge technologies, with one example in particular being telemedicine. This communication application assisted in improving healthcare delivery in remote and deployed environments.

The Army’s early adoption of telemedicine in remote and deployed environments laid the foundation for its civilian applications. One of the first examples of the civilian application of telemedicine was in 1970 when NASA directed researchers to explore the option of remote-controlled robots to operate on astronauts.

Since then, NASA and the U.S. Army have worked steadily to create reliable robots that can operate on human beings who are not in physical proximity to the operator of the surgical instruments, with an Anvari robot stitching a wound on an individual at the Aquarius underwater base to replicate the potential experience of performing telesurgery in space.

Today, telehealth now provides enhanced care by enabling patients to attend pre- and post-operative appointments from the convenience of their local clinics, reducing the need to travel to the hospital except for the scheduled procedure. Additionally, telehealth communication also supports various forms of patient needs, such as initial consultations, counseling, and educational sessions for surgical procedures. This approach improves access and convenience while creating the potential for further advances in delivering remote comprehensive care and enhancing patient satisfaction across various healthcare services.

The contributions of the Army have led to more accessible, efficient, and responsive healthcare solutions, benefiting military personnel and civilian populations.

Simulation and Training Systems

Similar to the contributions telehealth technology provided the civilian healthcare system, military medical training has also been a key driver of innovations in simulation technologies. Advancements of simulation technology in the 20th century have progressed from ancient models and animal training to advanced human patient simulators (HPS). These human patient simulator advancements are driven by biomedical and flight simulation innovations. The current military medical training simulators consist of high-fidelity simulations which are used to enhance training for medical personnel, emphasizing realistic, immersive environments to develop cognitive and psychomotor skills. These simulation-based training modules have proven to be instrumental in battlefield casualty survival as rates have shown a significant improvement from 80% in WWII to 90% in recent conflicts.

The Army’s use of simulation technology pioneered the use of virtual reality (VR) and augmented reality (AR) for training medical personnel in trauma care and surgery. Many civilian industries, such as aviation, nuclear energy, and engineering, have adopted a similar training system. Simulators allow civilian professionals to develop and practice work skills without the dangers of real-world scenarios, thus helping to increase worker safety.

Furthermore, the Army’s expertise in this area has influenced education, allowing schools to utilize simulation technologies to teach subjects like technical skills and medical procedures. The DoD supports a wide range of training through its medical modeling and simulation coordination, with ongoing improvements benefiting both military and civilian healthcare systems.

Lessons Learned

Over the past two and a half centuries, Army Medicine has continuously evolved, addressing the complex demands of military operations and civilian needs. The evolutionary growth of Army Medicine has not only revolutionized military healthcare but has also significantly influenced civilian industries and public health systems worldwide.

Today, many of these influences have shaped how healthcare is delivered. The innovations of trauma care, logistics, telemedicine, and simulation training technology have assisted in shaping the healthcare systems of today and have ensured greater efficiency, higher quality care, advanced training development, and a systematic organizational healthcare infrastructure.

With its pivotal role in advancing medical science and public health, Army Medicine will continue to influence and guide the public health care system through the development of new technologies, treatment protocols, and public health strategies. The influence of the Army Medical Department extends far beyond the battlefield, shaping the health and well-being of individuals worldwide. The ongoing research and innovation of Army Medicine will remain a cornerstone in meeting medical challenges, ensuring that its legacy of improving lives continues across generations.