"The medical system in the United States is comprised of many different agencies and organizations that need coordination in order to provide optimal care for individual patients created by a mass-casualty incident or public-health emergency. This coordination of all the medical system components has been a challenge in the past, and the medical operations center (MOC) has been one relatively new concept utilized by some jurisdictions to address that challenge. The public-health system, in contrast to the medical system, focuses on the care provided to the entire community or large population group. Are the two systems different? Are they mutually exclusive? Can the medical operations center meet the coordination needs of the medical community? This thesis uses surveys of medical system leaders and a qualitative analysis of focus group discussion from jurisdictions currently using an MOC. The thesis begins with a description of the medical system and the challenges that currently exist for coordination and response. Collaboration barriers and facilitators are discussed along with the difference between the two systems. A section of the thesis examines the origins and current functions of four existing medical operations centers in Oklahoma City, Tulsa, Houston, and San Antonio. The findings support the argument that the two systems are indeed different, but not mutually exclusive. The data also strongly support the MOC as a means of coordinating the medical system if done in concert with public-health agencies. The thesis concludes with a proposal, conceptual design, and argument to build a national network of medical operations centers in order to enhance the medical system response to a mass-casualty incident or public-health emergency."
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