# Improvements in cold chain management reinforce Medical’s joint role, processes

/ Published May 10, 2019
PHILADELPHIA, 
Thanks to revised guidance applicable across all Defense agencies, Dana Dallas no longer has to worry about which season it is to decide if a military treatment facility can receive certain medical materiel to treat its patients.The Defense Logistics Agency Troop Support Medical supply chain’s cold chain program manager said there were times when she had to wait until the spring or fall to send certain products due to delivery requirements that included controlled room temperature ranges.For Dallas and others in the military medical logistics community, an outdated policy with some vague packaging details left room for interpretation that could compromise the quality of temperature-sensitive pharmaceuticals or laboratory supplies.“Right now we are shipping influenza antivirals for the Defense Health Agency, which are controlled room temperature products, but we are only able to do it seasonally,” Dallas said. “Meaning we can only ship the vaccine when the ambient temperatures outside are within the controlled room temperature range of 15 to 30 degrees Celsius.”It was not until November 2018, after five years of rewriting and coordinating the policy, identifying weaknesses and modernizing the cold chain management process that Dallas’ work came to fruition.Dallas was co-author of DLA’s updated joint military service regulation enabling year-round deliveries. Because the updated regulation was finalized during flu season, Medical had to wait until the season was over to implement new changes.“We’ve been working on it since 2013 and we wanted our customers and vendors to know what our capabilities are,” Dallas said. “We wrote it in a very specific way to remove assumptions and prepare our distribution sites for new missions.”Medical is the Department of Defense’s executive agent for medical supplies, with Dallas overseeing the cold chain management for Medical’s customers.Dallas said it was important to encourage program efficiency and accountability, as the previous regulation dated back to 2008 and lacked information on current protocols. The new joint regulation incorporates updated cold chain management protocols, and establishes Medical as the subject matter expert organization.“The new joint regulation will now support the way Medical does business,” Dallas said. “It formalizes Medical’s role in the joint environment, and provides consistency in cold chain management protocols across all of the services.”Dallas worked alongside Jennifer Smith, DLA Logistics Operations packaging specialist, throughout the process. Smith relied on Dallas’ input to ensure customers were benefitting from Medical’s capabilities.“Joint regulations are required to be updated every five years,” Smith said. “In the case of this particular regulation, there were new protocols developed to expand our capabilities [that] will greatly enhance our ability to [ensure] product quality.”A key element was not only updating information on current protocols, but also introducing new ones based on research and development updates and consideration for the capabilities of DLA Distribution depots, prime vendors and other distributors.  By formally including the protocols already in use, Dallas said the updated regulation would help hold agencies accountable and prepare them for audit readiness.“We updated the verbiage for the refrigeration protocol because the last regulation was old, and we formalized the hybrid protocol even though we’ve been using it for years,” Dallas said. “But by projecting the direction of the cold chain management industry, we also added a control room temperature protocol and a frozen non-dry ice protocol to account for potentially new missions and the possible expansion of our distributor’s capabilities.”The updated and new protocols will not only maximize distributors’ current capabilities, but also their potential based on where DLA sees the direction of the cold chain management industry’s future, according to Dallas.“There are currently Air Force and Navy customers in Guam that can’t receive certain frozen medical material items because the previous regulation only allowed us to ship frozen products using dry ice, which is prohibited on commercial carriers flying into Guam,” Dallas said. “Our only option was using military airlift, which takes longer to get to the customers. But our new frozen non-dry ice packaging protocol will allow us to move frozen medical material to Guam through commercial carriers because the packaging is based off of inert water-based gel packs, and it will help us reach the customer faster.”Theresa Rucci, Medical’s pharmaceutical distributor integrated supply team chief, said there will also be a positive impact on contracts and shipping methods so customers around the world can get the temperature-sensitive supplies any time throughout the year.“With the update on protocols, the new joint regulation will allow for the option of medical contracts to include the new shipping protocols and shipping initiatives, and provide additional shipping material capabilities,” Rucci said.The job is not over for Dallas and Smith, as they need to make sure everyone knows the new protocols.“DLA Distribution will see the biggest impact and present the greatest challenge because each Distribution site is different and will use various protocols,” Dallas said. “Troop Support and Distribution headquarters are hoping to visit the different sites soon to conduct site surveys, determine which portions of the updated regulation directly affect them and ensure they are trained on how to use the new protocols properly.”The joint regulation will need to be updated again with an industry that is constantly growing. But for now, DLA is optimistic that it will have a lasting effect.“With the updated regulation published, training and process development can begin,” Smith said. “This will take a good amount of time, but the end result will put DOD at the front of the industry in cold chain management.”