While relaxing at home on the evening before a long weekend, Lorinda Ferraiolo noticed an urgent message pop up on her work cellphone. She logged onto her laptop, read the message and learned her expertise was required in a life-or-death medical emergency at an Air Force base in Japan.
Ferraiolo isn’t a doctor, a nurse or a medic.
She’s a contracting officer at the Defense Logistics Agency and a vital cog in the Defense Department’s ability to take care of its patients anywhere on the globe.
“Our employees play a critical role in our support to the warfighter, especially in our response to overseas life-or-death requirements,” said Army Col. Alex Zotomayor, the director of DLA Troop Support’s Medical supply chain.
Ferraiolo serves with the supply chain’s Pharmaceutical Prime Vendor. She and her teammates connect more than 6,000 military healthcare providers with about 1,000 commercial manufacturers and distributors of more than 25,000 pharmaceuticals.
The division supports all military customers, regardless of location. But the level of support becomes much more sophisticated when working with customers outside U.S. borders.
In a stateside critical pharmaceutical emergency, the prime vendor can shift its massive distribution network to meet the demand. But when the emergency is overseas, thousands of miles from the prime vendor’s distribution hubs, getting the right drug to the military healthcare provider calls for a complex system. It’s a system that involves acquisition professionals, distributors, logisticians and transportation specialists from various government and commercial organizations.
This complex system is held together by the Pharmaceutical Prime Vendor division. Its people manage the contracts and processes that enable the flexibility to rapidly provide lifesaving emergency medications. And while a lot of planning and coordination goes into awarding effective contracts, life-or-death emergencies require more than just a set-it-and-forget-it approach.
Around the clock support
As Ferraiolo learned while supporting the customer in Japan, these emergencies take over the Pharmaceutical Prime Vendor division’s workday, or in her case, an entire long weekend.
As the contracting officer in charge of supporting customers in the Asia-Pacific region, which is about a half-day ahead of Philadelphia, she’s accustomed to receiving email while off duty. Most can be addressed briefly, but a life-or-death emergency requires her complete attention. So instead of kicking back for the weekend, Ferraiolo kicked it into high gear.
First, she coordinated with DLA’s Customer Pharmacy Operations Center to validate the emergency as life-or-death, meaning that if the patient did not receive the medication, the risk of death would increase significantly.
She then contacted the prime vendor to ensure it had the medication on hand. Next she coordinated with Army Maj. Christopher Splichal and Marie Boggs of the Medical supply chain’s customer support team, which is responsible for managing the coordination between the vendor, courier and customer.
“Maj. Splichal was running back and forth between the CPOC and transportation folks, coordinating the discussion between the vendor and the courier,” Ferraiolo said. “We communicated that whole entire weekend to make sure the customer got the medication.”
While Ferraiolo helps keep the Asia-Pacific region stocked with pharmaceuticals, her colleague Nicole Accardo handles military customers in Europe.
Since many military patients who are injured in Afghanistan are evacuated to Germany, Accardo has seen her share of pharmaceutical emergencies.
She said that during these emergencies, her other work grinds to a halt so she can focus on providing the best support.
“You have to ignore all the emails and other stuff you have going on and immediately contact the prime vendor,” Accardo said. “You need the right item, the right quantities and the right delivery location. Gathering all that information quickly is critical.”
“I think the process works well,” Accardo said. “Of course, if anything unexpected happens, we’re right on top of it to smooth out any issues.”
A team approach
“DLA’s Troop Support process of ensuring life-or-death pharmaceuticals are delivered on time has proved successful,” said Ruth Herman, chief of the Pharmaceutical Prime Vendor division.
The success, she said, is due to her division’s strong relationships and open communication inside and outside of Troop Support.
Internally, Herman said her division especially relies on the Medical supply chain’s customer support team.
“Without their knowledge and support, the program would not be as successful as it is,” she said.
Externally, Herman said her division is responsible for understanding the people and processes that drive their suppliers.
In one emergency, a military customer required an unusually large quantity of a medicine the prime vendor couldn’t supply through its usual processes.
She could have accepted the circumstances, but that would have put military patients in greater jeopardy. So Herman, who has built a network of relationships with her prime vendor counterparts, reached out to identify alternative methods to meet her customer’s needs.
Through that collaboration, Herman said they solved the logistics puzzle by rerouting an order intended for another customer.
“If they had put it into stock, it would’ve gone out to their regular commercial customers, and we would never have caught it in time.”
When Herman talks about the importance of open and frequent communication, she means it.
“From about 11 a.m. on a Friday to 8:30 Tuesday morning, I had 125 emails related to one emergency,” she said.
One large customer the Pharmaceutical Prime Vendor team communicates with frequently is the U.S. Army Medical Materiel Center, Europe — especially in life-or-death emergencies.
“With DLA Troop Support’s assistance, USAMMCE routinely makes the impossible possible, enabling our medical providers to give our service members and beneficiaries top-notch medical care,” said Army Maj. Derek Stranton, the chief of USAMMCE’s clinical advisory branch.
Stranton said USAMMCE relies on DLA’s support during medical emergencies that are uncommon and difficult to forecast.
Earlier this year, healthcare providers deployed overseas encountered a military patient with a life-threatening bacterial infection that was resistant to common antibiotics. The providers looked to USAMMCE for a rarely used antibiotic, but it wasn’t available in Europe.
So they placed a life-or-death emergency order.
“We reached out to DLA Troop Support for assistance. And within a few hours on a Friday night, they were able to locate and purchase the medication from a vendor in Maryland,” Stranton said. “They coordinated with a commercial carrier to ensure the product was delivered to USAMMCE in Pirmasens, Germany, the very next day.”
The event made an impression on Stranton.
“I have 100-percent confidence in DLA Troop Support’s ability to respond to a medical crisis anywhere in the world,” he said.
Stranton said it takes a team effort of military medical professionals from DLA, USAMMCE and other military and civilian agencies to ensure service members receive the best emergency care available in deployed environments.
Ensuring warfighters and their families are taken care of
The idea of providing lifesaving medications to service members overseas may conjure visions of battle-hardened warriors wounded in action. But some patients are as harmless as infants in the womb.
This was the exactly the case for Ferraiolo, who spent a weekend coordinating the acquisition and delivery of emergency pharmaceuticals to help save the lives of unborn infants of military service members in Japan.
Air Force Maj. Rohin Kasudia, the pharmacy flight commander for the 35th Medical Group at Misawa Air Base, Japan, said the base was experiencing a shortage of a medication that lowers the risk of pre-term birth and infant mortality. Demand for the drug was quickly out-pacing supply, so Kasudia reached out to Ferraiolo to help expedite the delivery.
He said he was pleased with how quickly DLA responded to the request and how their continuous communication benefited healthcare planning at Misawa Air Base.
“This was very nice because we usually don’t have eyes on shipments and movements,” he said. “This gave our staff and providers confidence that the drug will be coming and the ability to plan for any contingency strategies if a new pre-term risk mother was identified.”
Kasudia said that DLA’s Pharmaceutical Prime Vendor team does more than help save lives; its members also enable the overall mission of their military customers.
“If we can’t get drugs to our overseas bases, then it affects our ability to project air power, deploy forces and meet the trusted care mission of the Air Force surgeon general,” he said. “The fact that they have the ability to push our vendors to make things happen is critical to the warfighting mission, because it ensures our warfighters and their families are taken care of.”
The warfighter can continue to count on DLA Troop Support’s Medical supply chain to provide excellent support for life-or-death requirements, Zotomayor said.
“Medical employees are committed to their jobs and take pride in their support to the warfighter — moreso if that support involves a life-or-death requirement,” he said. “They will go the extra mile to make sure a medication is delivered as quickly as possible.”
Ferraiolo’s weekend support was just one example of Medical supply chain employees going the extra mile to ensure success.
Within a few days of placing the emergency order, Kasudia received the shipment, and mothers-to-be received the medication they needed, boosting the chance of a healthy birth for the sons and daughters of American service members at Misawa Air Base.
“I was very happy, extremely happy. We did our job and we got the customer the product they needed,” Ferraiolo said. “It almost feels like we save lives.”