Semi-Markovian Planning to Coordinate Aerial and Maritime Medical Evacuation Platforms

TL;DR

This paper introduces a semi-Markov decision process model for optimizing patient transfer in maritime medical evacuations, demonstrating significant response time improvements through watercraft exchange points and validating the approach with real-world military deployment.

Contribution

It presents a novel semi-Markovian planning approach for coordinating aerial and maritime evacuation platforms, incorporating watercraft exchange points and Monte Carlo tree search for decision optimization.

Findings

Watercraft exchange points reduce incident response times by up to 40%.

Optimal policies outperform greedy and non-exchange policies significantly.

First deployment of watercraft exchange points in military medical evacuation scenarios.

Abstract

The transfer of patients between two aircraft using an underway watercraft increases medical evacuation reach and flexibility in maritime environments. The selection of any one of multiple underway watercraft for patient exchange is complicated by participating aircraft utilization history and a participating watercraft position and velocity. The selection problem is modeled as a semi-Markov decision process with an action space including both fixed land and moving watercraft exchange points. Monte Carlo tree search with root parallelization is used to select optimal exchange points and determine aircraft dispatch times. Model parameters are varied in simulation to identify representative scenarios where watercraft exchange points reduce incident response times. We find that an optimal policy with watercraft exchange points outperforms an optimal policy without watercraft exchange points and a greedy policy by 35% and 40%, respectively. In partnership with the United States Army, we deploy for the first time the watercraft exchange point by executing a mock patient transfer with a manikin between two HH-60M medical evacuation helicopters and an underway Army Logistic Support Vessel south of the Hawaiian island of Oahu. Both helicopters were dispatched in accordance with our optimized decision strategy.