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U.S. Department of Health and Human Services

Medical Utilization and Response Integration Branch

Division of Medical Countermeasures Strategy and Requirements

End-user tools must be in place to enable the effective use of medical countermeasures (MCMs) in a public health incident or emergency medical response.  The Medical Utilization and Response Integration (MURI) branch works closely with end-users and stakeholders to develop medical countermeasure response strategies, concepts of operations, and clinical utilization guidance.  Through the development of these products, MURI ensures return on investment and promotes the effective use of resources in a response.

Figure: Return on Investments

Maximizing return on upstream investments is represented by a cyclical process with two main entities and two sub processes between the two.  On the left is the end-users and stakeholders entity which encompasses State, tribal, territorial governments, regional coordination, local government, the public, health care professionals and first responders.  A process of Stakeholder Engagement, which includes meetings, workshops and reviews leads from the end-users and stakeholders to end-user input which leads to the second main entity on the right, response integration tools, which included MCM response strategy, conops and plans, and clinical utilization guidance.  The MCM response strategy is created from a partnership of CDC, FDA MURI and Office of Emergency Management (OEM).  The conops and plans are created from a partnership of CDC, MURI and OEM.  The clinical utilization guidance is created from a partnership of CDC, FDA and MURI.  The process of MCM Capability Enhancement leads from the entity Response in


MURI’s mission is to maximize the return on upstream PHEMCE-partner medical countermeasure investments (e.g., research, development, acquisition) by enhancing end-user capabilities and preparedness in leveraging Federal medical countermeasures during a large-scale public health emergency.  The figure above illustrates the dynamic planning process among end-users and MURI. 

In close collaboration with interagency partners, MURI leads the development and tracking of medical countermeasure response integration tools such as MCM-related response strategies, concepts of operations, and clinical utilization guidance for products available to states through the Strategic National Stockpile program at the CDC.  End-user input early on in the MCM Enterprise is a key component for ensuring end-user goals, capabilities, and planning activities are closely aligned with best evidence and availability of Federal assets.  MURI engages stakeholders through meetings, workshops, and the document review process to gather end-user perspectives, facilitating incorporation of their questions and needs into Federal response integration tools.

In the past year, MURI successfully partnered with the CDC in developing clinical utilization guidance for Botulism Antitoxin-Heptavalent (BAT®) for use in a botulism incident, and for hematopoietic ARS medical countermeasures for use in a nuclear detonation.  Additionally, MURI recently successfully partnered with OEM to develop a capabilities assessment of the Federal Medical Stations (FMS) program to determine the optimal number and size of FMS assets for Federal stockpiling. The analysis assessed the ability of the health care system to use the FMS assets as part of state, regional or local emergency planning.

  • This page last reviewed: September 24, 2014