Description:
OBJECTIVE: Per Army Medical Department Policy (AMEDD), adequate enroute care is required for casualty evacuation conducted on none MEDEVAC vehicles. Likewise, AMEDD policy prohibits unattended casualty evacuation on unmanned vehicles without enroute care capabilities normally provided by human attendants. The objective of this topic is to develop and demonstrate a handheld prototype system of systems that incrementally advances the state of the art in enroute combat casualty care assessment, monitoring, and intervention on attended casualty evacuation vehicles such that the final demonstration shows proof-of-concept feasibility for future casualty evacuation on unmanned vehicles. DESCRIPTION: This topic is designed to focus and address a wide-range of technical challenges in medical monitoring and intervention; information capture, storage and security; and communications integration with both civilian and military networks that requires a new direction in design and integration research. It is now technically possible and operationally feasible to combine most of the physiological monitoring, medical information exchange, imaging, and telemedicine technologies that are now in use, undergoing evaluation, or still in development; with emerging semi-autonomous, autonomous, or closed-loop treatment and intervention systems. In the past, DARPA worked on a project with this aim called the"Trauma Pod Program". It was overwhelmed by a host of technical and operational research challenges which were, at the time, infeasible to overcome. This topic focus down to a capability that can be used on any vehicle instead of DARPA"s wide range of initiatives; these specific areas: 1) Providing functional medical assessment, monitoring, or intervention application system modules that minimize size, weight, power consumption, and can be fit inside and run on host tactical medical ground vehicle or aircraft platforms; 2) Enabling within the same space, weight, and power constraints, either autonomous closed loop operation or securing access to sufficient bandwidth on the battlefield to enable tele-operated semi-autonomous operation, command and control on the move; 3) ruggedizing for shock, dust, sand, and water resistance to enable reliable, uninterrupted operation in combat vehicles on the move, to include operation and storage at extreme temperatures, and EMP hardening. The intent of this topic is to undertake research; aimed at developing a prototype capability that within said constraints which will integrate and incrementally advance the state of the art in enroute combat casualty care communications and automation of combat casualty assessment, monitoring, and intervention on attended casualty evacuation vehicles; such that the final demonstration will show a proof-of-concept feasibility for future casualty evacuation on unmanned vehicles. Size and weight are important factors; ultimate object of the medic attended system would be secure wireless connections between patient continuous medical monitoring sensors and military tactical radios to a handheld integrated processor, display, and communications device similar in size and weight to a mobile phone such that a soldier/medic could carry the device in a uniform pocket. To facilitate commercialization the hand-held device should incorporate embedded capabilities for connecting to both military common-user tactical radio networks and ubiquitous civilian communications networks. PHASE I: Research solutions for technical challenges on this topic as identified above for a capability that incorporates feasible solutions: physiological monitoring and telemetry; medical information exchange and analysis; imaging; and in semi-autonomous, autonomous, or closed-loop treatment. The intervention system should be designed as a ruggedized handheld prototype that integrates and will incrementally advance state of the art in enroute combat casualty care communications and automate combat casualty assessment, monitoring, and intervention on attended casualty evacuation vehicles. A final demonstration, after Phase II, will show proof-of-concept feasibility for future casualty evacuation on unmanned vehicles. Develop a Phase II proposal incorporating the proposed design into a work plan. Flesh out commercialization plans that were developed in the Phase I proposal for elaboration or modification to be incorporated in the Phase II proposal. Explore commercialization potential with civilian emergency medical service systems development and manufacturing companies. Seek partnerships within government and private industry for transition and commercialization of the production version of the product within government and civilian health care systems involved in combat casualty care, internal development and disaster response, emergency medical services, wilderness medicine or health care in extreme environments where ruggedized medical support systems are needed. PHASE II: From the Phase I design, develop a ruggedized handheld prototype system or system of systems to demonstrate incremental advances in enroute combat casualty care to include automation of casualty assessment, patient monitoring, and treatment intervention on attended casualty evacuation vehicles; such that the final demonstration shows proof-of-concept feasibility for future casualty evacuation on unmanned vehicles. In addition to demonstrating secure wireless connectivity to medical monitors and military tactical radios; the handheld device should demonstrate communications to ubiquitous civilian broadband wireless communications networks. The prototype should clearly demonstrate, for at least three prevalent combat casualty diagnoses: 1) integration; 2) feasible operation; and 3) semiautonomous or autonomous analysis, decision making, command, and control of subsystems for: 1) Physiological monitoring and telemetry 2) Diagnostic imaging 3) Treatment and intervention Some examples of prevalent combat casualty diagnoses are loss or near loss of limb, blocked air way, sucking chest wound, internal bleeding, or traumatic brain injury. Demonstrate the system with soldier medical attendants in a relevant environment; such as at a USA Army TRADOC Battle Lab. Flesh out commercialization plans contained in the Phase II proposal for elaboration or modification in Phase III. Firm up collaborative relationships and establish agreements with military and civilian health care networks to conduct proof-of-concept clinical trials in Phase III. Begin to execute transition to Phase III commercialization potential in accordance with the Phase II commercialization plan. PHASE III: Refine and execute the commercialization plan included in the Phase II Proposal. Execute proof-of-concept clinical trials as per research protocols developed during Phase II. Participate in appropriate advanced Warfighting experiments or Joint Capability Technology Demonstration(s) that demonstrate combat casualty care technologies. Present the prototype project, as a candidate for fielding, to applicable Army, Navy/Marine Corps, Air Force, Coast Guard, Department of Defense, Program Managers for Combat Casualty Care systems along with government and civilian program managers for emergency, remote, and wilderness medicine within state and civilian health care organizations, and the Departments of Justice, Homeland Security, Interior, and Veteran"s Administration. Execute further commercialization and manufacturing through collaborative relationships with partners identified in Phase II. REFERENCES: 1. Poropatich, COL Ronald, USAMRMC,"TATRC"s Strategy for the Research and Development of Mobile Health Applications", Presented to the FCC, 12 July 2010. http://reboot.fcc.gov/c/document_library/get_file?uuid=8ac18153-1b96-4e14-958c-9538a7fc272c & groupId=19001 2. Gilbert, Gary and COL R. Poropatich."TATRC"s Strategy for the Research and Development of Mobile Health Applications", Presented to the Korean Ubiquitous Healthcare Alliance, 30 July 2010. Provided upon request to authors. 3. Manemeit, Carl and G.R. Gilbert,"Joint Medical Distance Support and Evacuation JCTD, Joint Combat Casualty Care System Concept of Employment"NATO HFM-182-33 paper, 21 April 2010. http://ftp.rta.nato.int/public/PubFullText/RTO/MP/RTO-MP-HFM-182/MP-HFM-182-33.doc 4. Army TB 11-5825-298-10-3, Planner"s Manual Enhanced Position Location Reporting System (EPLRS), HQDA, 7 Jan 2008 (and 15 Jan 2009). http://www.disa.mil/jcss/documents/EPLRS_Models_UserGuide.pdf 5. Project Manager, Force XXI Battle Command Brigade and Below Website, http://peoc3t.monmouth.army.mil/fbcb2/fbcb2.html 6. US Special Operations Command,"Special Operations Medical Handbook", November 2008; ISBN 978-0-16-080896-8, cvbnmk, l. US Government Printing Office, Printed version: http://bookstore.gpo.gov/actions/GetPublication.do?stocknumber=008-070-00810-6 Digital version: stock number = 008-070-00816-5
