Expanding Case Management Surge Capabilities of the Military Health System: A Scoping Review

INTRODUCTION: The Military Health System (MHS) provides essential case management services for ill and injured service members. Yet the MHS's capability to expand its current case management services in response to medical surge, as would be expected during a large-scale combat operation (LSCO), remains underexplored. MATERIALS AND METHODS: This study uses a scoping literature review to identify existing and required MHS case management capabilities necessary for such a surge event. Data were analyzed using the DOTmLPF-P framework (Doctrine, Organization, Training, Materiel, Leadership & Education, Personnel, Facilities, Policy) to assess current strengths and identify gaps for surge conditions. RESULTS: The literature review (n = 64 reports) revealed limited documentation of case management during a medical surge, with most focusing on steady state operations. Key findings indicated a lack of clear, standardized, and surge-specific doctrine and policy. Findings also highlighted fragmented organization, inadequate training for high-volume scenarios, and limitations in materiel, IT interoperability, personnel capacity, and facility adaptability for surge. CONCLUSIONS: Findings suggest the MHS currently lacks cohesive policy, doctrine, and standardization required to effectively manage a combat casualty surge during an LSCO. Recommendations include developing comprehensive medical surge doctrine, optimizing organizational structure, implementing LSCO-specific training, investing in software integration, and establishing new surge-enabling policies to enhance readiness.