A scalable implementation framework for regional medical operations coordination centers: Lessons learned from San Antonio

Mass casualty events and public health emergencies consistently challenge regional healthcare systems, requiring integrated coordination to ensure patient care and resource management during surge conditions. Regional Medical Operations Coordination Centers (RMOCCs) serve as a critical, systems-level approach to managing medical surges. The San Antonio RMOCC, established by the Southwest Texas Regional Advisory Council (STRAC), offers a proven, sustained model, having successfully managed responses to natural disasters, civil unrest, and the COVID-19 pandemic. This paper details the historical, regulatory, and operational context of the San Antonio RMOCC and presents a scalable RMOCC framework, providing recommendations for development, implementation, and sustainment of RMOCCs across the United States. The framework emphasizes key components for success, including effective coalition integration, sustainable funding strategies, strong system leadership, and buy-in from diverse partners. Through implementation of this framework, other regions may develop similar response capabilities to improve regional surge preparedness and emergency response.