Telemedicine and Advanced Technology Research Center TATRC Cutting Edge Medical Technology

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TELEMEDICINE ADVANCED TECHNOLOGY RESEARCH
CENTER (TATRC) U.S. Army Medical Research and
Materiel Command Rapid Prototyping
Technology Transfer Strategy for Fiscal Year
2004 31 December 2009
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Telemedicine and Advanced
Medical Technology Program
Telemedicine Advanced Technology Research
Center Cutting Edge Medical Technology

• Mission
• Apply physiological and medical
  knowledge, advanced diagnostics, simulations,
  and effector systems integrated with information
  and telecommunications for the purposes of
  enhancing operational and medical
  decision-making, improving medical training, and
  delivering medical treatment across all
  barriers.
• The program scope is to identify,
  explore, and demonstrate key technologies and
  biomedical principles required to overcome
  technology barriers that are both medically and
  militarily unique.

Department of Defense, Joint Warfighting Science
and Technology Plan, Chapter IX, Joint Readiness
and Logistics, 1999
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5 Ps of Precision HealthcareScope of
TATRC Functional Objectives
Predictive - Leverage Emerging Developments
in Genetics, Bio-Informatics
Multi-Modality Imaging Preventive - Act
Proactively to Prevent Disease Point of Care -
Utilize Mobile Communications, Ubiquitous
Computing and Local intelligence Parametric
- Analyze Multi-Parametric Information
Referenced to Patient Baseline and Standard
Model Personalized - Individualize
Therapeutics to Each Patient
SATAVA 7 July, 1999 DARPA
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Examples of 5P Deliverables over the Last 12
Months
BMIS-T Chest
Tube Simulator Digital
X-ray
Dreams Digital Ambulance Smallpox
Inoculation Medical
Robotics Training Unit
BRSS
STAT-Care
Retinal Imaging
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Core Research Leads to .Transformational
Technologies
Decade of the 1950s
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5Ps Transition to Bio Intelligence!
Biosensors Biomaterials Biomimetic
BIOLOGICAL DOMAIN (science)
PHYSICAL DOMAIN (engineering)
FUTURE
Robotics MEMS/ Nanotech Microarray Molecular
Imaging
Genomics Proteomics Bioinformatics Biocomputation
INFORMATION DOMAIN (computers)
Richard M. Satava, MD U of Washington/ TATRC/DARPA
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We Are Not Alone, An International Perspective
European Union Framework Program 6
(2002-2005)
1.Medical Informatics (MI)citizen, patient and
population informatics
2.Bioinformatics/Genomics (BI)molecular
informatics
Medical Sciences
Biological Sciences

• Structural Genomics
• Functional Genomics
• Proteomics
• Biochip Technologies
• Advanced Data Clustering and Analysis Techniques
• Computational Biology
• Ethics
• etc.

• Electronic Health Record (EHR)
• Health Informatics/Telematics Standards
• Clinical Decision Support
• Intelligent Agent Systems for Health
• Telemedicine
• Safety and Security
• etc.

A
example Advancing into the molecular causes of
diseases Molecular Medicine example Exploiting
human genetics variation for individualized
health care Individualized Health Care
D
C
B
example Informatics in support of the next
generation of brain research Molecular
Neuroscience

• Biosignal Analysis and Pattern Recognition
  Systems
• Neuro Algorithms
• Neurocell Technology
• Human Computer Interfaces
• Machine Learning
• Knowledge Discovery
• etc.

example Gene expression imaging in the brain or
integration of genomic and neuroscience
databases Neurogenomics
example Modeling of structure and function of
molecules, cells, systems in disease Health
Knowledge Science
Behavioral Sciences Social Sciences
3.Neuroinformatics (NI)cell to organ informatics
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TATRC Science Technology Portfolio 250
Funded Projects
Telemedicine and Advanced Technology (www.tatrc.or
g)
Operational Capability Areas
Joint Medical Readiness
Battlespace Medical Awareness
Effective Employment of Medical Forces
Care Management Trauma Care Medical
Care Evacuation
Real-Time Health Monitoring,
Measurement,Management
Pre-Deployment Wellness, Training, Planning,
Assessment
Wireless Medical Systems Teleconsultation
Systems Global Grid Telemed System Predictive
Diagnostics 3D Medical Image Analysis Minimally
Invasive Therapies Image Guided
Therapies Robotics - Biomaterials
Physiological Sensors Microelectromechanical
Systems Digital Image Acquisition Devices Medical
Data Processing Medical Image Data
Displays Medical Situational Analysis
Computer Aided Instruction 3D Surgical
Simulations Joint Medical Simulations Force
Feedback - Virtual Reality Health Care Complex
Modeling Computerized Patient Records Medical
Data Mining Intelligent Decision Systems
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TATRC Develops Internal Prototype Solutions

• DARPA
• TACOM
• RDECOM
• Signal Battle Lab
• CECOM
• ARL

Emerging Technologies
Government off the Shelf technologies

• I Robots, Inc
• Alion, Inc
• RTI
• Kurzweil Tech, Inc
• ATT
• GE

Commercial off the shelf technologies
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Telemedicine Advanced Technology Research
Center Cutting Edge Medical Technology
Uses DoD Federal Partnerships for Non-Medical
and Supporting Technologies

• RD Panels and Commands Partnerships
• U.S. Army Research Laboratory
• Los Alamos National Laboratory
• Sandia National Laboratory
• U.S. Army, Signal Battle Laboratory
• Commo Electronic Command
• Oak Ridge National Laboratory
• Veterans Administration
• NASA
• DARPA
• National Library of Medicine (NIH)
• Agency for Health Research Quality (HHS)

Distributed, Synchronized Databases Advanced,
Adaptive Multilevel Security Data Mining of
Disparate Databases Secure Global Positioning
System Network Management Tools Info Warfare
Surveillance Defense Tools Artificial
Intelligence - Expert Systems Fault Avoidance
and Recovery Systems Hands Free, Wireless
Telecom Wireless Networking Data
Compression High Bandwidth Datalinks Low
Power Electronics Multi-platform, Interoperable
Software Complex Modeling and Simulation

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Leverages Academic Partnerships For Basic
and Applied Research
Telemedicine Advanced Technology Research
Center Cutting Edge Medical Technology

• Georgetown University (CA-Medical Vangaurd)
• Howard University (CRDA-Urban Telemed)
• Harvard University (CA-CIMIT)
• Mass Institute of Technology (CA-CIMIT)
• University of Maryland (IPA/CA ORF)
• Rutgers University (CA-CeMBR)
• University of Utah (Contract-Teleopth)
• Saint Francis University (CRDA-CERMUSA)
• Loma Linda University (CA-NMTB/Proton Beam)
• Drexel University (CA-CIMERC)
• University of Tex - Houston HSC (CA-DREAMS)
• University South Florida (CA-Telerad/Adv
  Cancer Detect)
• University of Hawaii (CA-Telemed Curriclm)
• University of Pittsburgh (Contract-GGTS)
• Stanford University (Contract-Affiliates Prog)
• Yale University (IPA-Adv Tech Watch)
• Texas A M (CA-DREAMS)
• Johns Hopkins University (CA-Periscopic MIS)
• University of Southern Calfornia (CA-NGI)

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TATRC can draw from a network of existing
advanced medical technology RD public private
partnerships.
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Leverages International
Partnerships to Accelerate Development

• US/Norway Telemedicine (Wireless, Handheld)
• European Union Collaboration
• NATO Telemedicine Standardization Committee
• South African Military Health Service
  (Peacekeeping)
• International Global Satellite System Poland
  (CME)
• Landmine Victim Assistance Central America gt
  Afghanistan
• Partnership for Peace Romanian Needs Assessment
• Pakistani Exchange Program
• Yuma Proving Ground - Panama Telemedicine
• South Korean Exchange Program
• ATA Symposiums EU (2001) Africa (2002) - Latin
  America (2003)

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Core Business Processes I C M E O
Advanced Technology Watch
Mechanisms
Execution
Outputs
Inputs
Controls
Project Management Regulatory Compliance Technol
ogy Review
Functional Scientific Review Prioritization
Prototypes Patents Royalties Articles Products Dem
os
RDTE, Congressional Defense Health DUST -
SBIR STTR- ACT II CEP - ACTD WRAP -
AWE Interagency Partnerships
Proposals Taskers
TATRC
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Triple Helix RD Strategies
High Risk, High Payoff
New Ideas, Knowledge
Link to the Warfighter
DARPA
Stryker Brigade Deployed Forces
Academia
Academia Government Industry (Maximum Bang
for Buck)
Innovation, Transition
Expanded Resource Base
Industry
Service Labs
International Coalitions
Interagency Partners
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Center for Integration of Medicine and Innovative
Technology
SOLUTION RICH ENVIRONMENT
PROBLEM RICH ENVIRONMENT
CIMIT
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CIMIT Assumptions re Health Care

• Major advances in next 10-15 years
• - Devices, Minimally Invasive Procedures,
  Imaging, Drug Delivery Systems
• Good News
• - Enabling technology already exists
• Bad News
• - Major barriers to capturing technology
• Clinical Insertion
• Economic /Regulatory
• Industrial Involvement
• These barriers can be rapidly overcome by
• - Systematic Culture Blending
• - Committed Experts
• - Individualized Facilitation

Dr John Parrish Institute of Medicine Director,
CIMIT
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CIMIT Technology Implementation Process
EDUCATION
Communications Site Mining Convening
Doing Good
Technology Assessment Regulatory/Reimbursement Sec
ond Round Funding Technology Implementation Indust
ry Liaison (CSRL)
FACILITATION
RFPs, Peer Review Project Funding Management
Specific Innovations
TECHNOLOGY DEVELOPMENT
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CIMITIndustry Liaison Group

• General Electric Medical Systems
• Johnson Johnson
• Cordis
• Ethicon Endosurgery
• COSAT
• Karl Storz Endoscopy
• Omnicell, Inc
• Pentax Precision Instrument Corp
• Radianse, Inc
• 10 Blade, Inc
• Ascension Technology, Corp
• AstraZeneca
• Baxter Healthcare, Corp
• B-K Medical Systems, Inc.
• Boston Scientific, Corp
• Olympus America, Inc.
• OmniGuide Communications, Inc.
• Pharmacia, Inc.
• Physical Sciences, Inc.

• Medtronic, Inc.
• Bristol Myers Squibb Co.
• Terumo Medical Corp
• Draeger Medical, Inc.
• Foster-Miller, Inc.
• Foxfire Interactive Corp
• Getinge-Castle, Inc.
• Harvard Clinical Technologies, Inc
• HydroCision, Inc.
• IDEO
• Instrumentarium, Corp
• Granite Peak Technology
• Hewlett Packard Company
• Guidant Corporation
• Mobile Aspects, Inc.
• Motorola, Inc.
• Percadia, Inc.
• Pfizer, Inc.
• TYCO

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Cleveland Clinic FoundationComputer Assisted
Minimally Invasive Surgery (CAMIS)
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Cleveland Clinic Foundation (CCF)
Innovations gtNew Technology Transfer
Centerlt 2003 Medical Innovation Summit
Participants

 
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CeMBR The Center for Military Biomaterials
Research Biomaterials Solutions to Acute
Trauma Bringing the Full Power of Materials
Science to Combat Casualty Care
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Initial Technical Focus Areas
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CEMBR Industrial Members 2003A Diverse Group of
Synergistic Companies

• Major Corporations
• Avon Products
• Boston Scientific
• Cordis, a JJ Company
• Dupont
• Medtronic
• Unilever
• Associated Research Centers
• Center for Biomaterials Advanced Technologies,
  Medical Products Group (Ethicon, Inc.)

• Production and Fabrication
• The MedTech Group
• Corium
• Supporting Law Firm
• Norris, McLaughlin and Marcus
• Participating Venture Capital Groups
• The Vertical Group

• Medical Device
• Start-ups
• Advanced Materials Design
• BioCure
• REVA Medical
• Vectramed
• Vyteris
• Midsize Medical Device Companies
• Enzon
• Integra Lifesciences
• Hydro Med Sciences
• LifeCell
• Osteotech
• Stratec

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National Medical Technology Testbed
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Evolution of an IdeaDistributed Network for
Advanced Medical Technology Transfer (DISNET
AMTT)
Seeking a new, distributed approach to technology
transfer, thus we anticipate initial

• Indignant rejection
• Reasoned objection
• Qualified opposition
• Tentative acceptance
• Qualified endorsement
• Judicious modification
• Cautious adoption
• Impassioned espousal
• Proud parenthood
• Dogmatic propagation
• HK Silver, 1965