“Committed to the health of our forces”


The NATO Near Real Time Surveillance Tool performs excellently on two exercises within 2 weeks

What is near real time surveillance?

The near real time surveillance provides an overview of the state of health of our troops in NATO Missions. The tool helps us to identify possible outbreaks of diseases, implement protective measures very quickly and stop the spread of the diseases as soon as possible. The system is based on sign and symptoms not on laboratory-confirmed diagnoses. If there are a certain number of patients with a specific set of signs and symptoms, then an alert is generated. This can be for a single or multiple MTFs or across the whole Mission with the system sending an automated alert to pre-defined email addresses. This enables a very quick reaction and the enactment of preventive measures, like the isolation of patients, curfews, or investigation of the source of the infection. The tool is capable of collecting data from national medical information systems or from its custom-built data-entry interface, that can run on anything that can launch a web browser.

The CWIX exercise series is NATO’s primary virtual exercise, aiming to test the limits of interoperability of a myriad of capabilities, and where the NATO MILMED COE is a valued participant in the Medical Focus Area. The exercise’s medical play focused on the interoperability of various medical information systems, the testing of medical message standards and the trial of novel technologies, such as the NRTS tool or the use of data from wearable biomedical sensors. The NRTS successfully collected data from these sensors and national systems and generated the appropriate alerts for the MTFs.

Ex CLEAN CARE is the NATO CBRN Medical Exercise and consisted of three R1 MTFs (CZE, FRA and MN) and a R2B (MN) augmented by a Mobile Hospital Isolation Unit (CZE). The scenarios were based on a variety of biological, radiological, and chemical exposures with additional capabilities delivering reconnaissance and decontamination capabilities. Each MTF including the R2B was expected to record patient symptoms using the NRTS. They were provided with a tablet with the NRTS app allowing them to enter relevant data offline. This could then be transmitted to the online tool when internet connection was available – enabling an alert to be generated based on pre-set parameters. Training was provided on data entry in advance of the LIVEX by one of the FHPB team from Munich.

The following were the objectives for the NRTS Experimentation on Ex CLEAN CARE 22:

  1. To understand whether NRTS can be used in an austere environment with limited internet connectivity.
  2. To review data entry into NRTS by staff from the MTFs of different Nations
  3. To evaluate whether alerts can be generated from the data received.
  4. To understand what medical staff, do with the alerts generated from NRTS

Ex CLEAN CARE 22 provided important information for advancing the NATO NRTS tool towards FOC. It enabled NRTS to be tested in an Exercise environment with a training audience from different Nations using a range of symptoms and signs. Their feedback is important to ensure that the tool reflects specific requirements and is useful and usable.

Both exercises have provided us with key findings on the further development of the tool and we expect to see it deployed into a NATO mission soon.


08-10 October 2024
Budapest (HUN)
Military Psychosocial Incident Management
02-06 June 2025
Budapest (HUN)
Emergency Management of Battlefield Injuries


NATO Standardization Office
Future Forces Forum
Military Medicine Forum
Semmelweis Egyetem
MH Egészszégügyi Központ
École du Val-de-Grâce