U.S. ARMY MEDICAL RESEARCH

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U.S. ARMY MEDICAL RESEARCH MATERIEL COMMAND
Telemedicine Advanced Technology
Cutting Edge Medical Technology
Broadband Medical Networks

iGRID 27 September 2005 Mr. Jan
Patterson Director, TATRC West Coast Field
Office Telemedicine Advanced Technology
Research Center (TATRC) Ms. Mary Kratz Special
Advisor to the Director, Broadband Medical
Networks Telemedicine Advanced Technology
Research Center (TATRC)
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U.S. Army Medical Research and Materiel
CommandCore Medical ST Program Areas
1.5bn
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Mission
Telemedicine Advanced Technology Research
Center Cutting Edge Medical Technology

• 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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Total Funding
Telemedicine Advanced Technology Research
Center Cutting Edge Medical Technology
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TATRC Funding Programs

• Congressional Special Interest
• Dual Use Science Technology
• Small Business Innovative Research
• Defense Health
• Small Business Technology Transfer
• Federal Partnerships

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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)
• University of Utah (Contract-Teleopth)
• Rutgers University (CA-CEMBR)
• Saint Francis University (CRDA-CERMUSA)
• Drexel University (CA-CIMERC)
• Loma Linda University (CA-NMTB/Proton Beam)
• 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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Telemedicine Advanced Technology Research
Center Cutting Edge Medical Technology
Uses DoD Federal Partnerships for
Non-Medical and Supporting Technologies
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

• 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
• Food Drug Administration
• Centers for Disease Control Prevention

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TATRC is a network of Best of Breed
public/private advanced medical technology
partnerships.
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Leverages International Partnerships to
Accelerate Development

• US/Norway Telemedicine (Wireless, Handheld)
• European Union Collaboration
• NATO Telemedicine Standardization Committee
• Canada International Space Station (Telesurgery)
• South African Military Health Service
  (Peacekeeping)
• International Global Satellite System Poland
  (CME)
• Landmine Victim Assistance Central America gt
  Bosnia gt Afghanistan
• Partnership for Peace Romanian Needs Assessment
• Fellowship Programs Pakistani, Polish
• Yuma Proving Ground - Panama Telepathology
  Hyperspectral Imaging
• Argentina Civilian Medical Emergency Response
• Israeli Trauma Simulator
• South Korean Exchange Program
• ATA Symposiums
• EU (2001) Africa (2002) - Latin America (2003)
  - E.Europe (2004) Asia (2005) W. Europe (2006)

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Doing Business with TATRC

• MRMC Broad Agency Announcement (BAA 05-1)
• http//www.usamraa.army.mil/pages/index.cfm
• General process
• Submit pre- proposal to MRMC/TATRC
• Review for scientific and programmatic merit
• Award funding
• Project monitoring and accountability

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Eschatological Approach of Health Paradigms
G O D
T R U T H Genes, molecules, virus
GLOBAL INFORMATION SOCIETY
R E C O V E R Y
F A U L T / P U N I S H M E N T
R E C O N C I L I A T I O N
E R R O R S
Slide Courtesy Jean-Claude Healy, WHO
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LambdaGRID Challenges

• Federation of databases
• Content-based knowledge
• Management of personal data
• Security
• Social Anthropology
• Ethical and legal
• Regulatory compliance
• What is a GRID ?
• HealthGRID http//www.healthgrid.org
• What is a LambdaGRID??

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TATRC Broadband Medical Networking State-Based
Initiatives

• Linking regional TeleHealth programs
• National Health Information Infrastructure
• Regional Health Information Organizations (RHIO)
• Regional Optical Network (RON)
• Disaster Relief /Preparedness
• Advanced Distributed Learning
• Simulation Environments
• Advanced Visualizations
• Gaming industry
• Entertainment industry
• Ubiquitous Broadband (urban/rural)

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TATRC Broadband Medical NetworksPatterns of
Content

• Computational Models of the Human Body
• Advanced Distributed Learning
• Modeling and Simulation
• Epidemiological Networks
• Public Health sector
• SensorNets
• Predictive modeling
• Biomedical Informatics
• Medical Imaging
• PharmaGRID (RxNorm)
• Life Sciences GRID
• Veterinary Medical
• Agriculture
• Animal to human vectors
• National Health Information Infrastructure

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6 s approach in e-Health
Healthcare Systems (Hospital, Patient Treatment,
Doctors, etc.)
Patient
Citizen
1 s
3 s
Professional Risk Management
Home care monitoringContinuity of Care
Personal RiskManagement
Early detection
Public Health Risk Management
GeneticcsBiomedic Risk Manag.
Policies
Slide courtesy of Dr.Jean-Claude Healy, WHO
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TATRC Broadband Medical Networks GRID

• Computing GRID
• Bio-patterning
• Resources such as TeraGRID/Supercomputers
• Data GRID
• Biomedical Informatics (storage?)
• Terminology mediation
• Knowledge GRID
• Semantic Mining
• Business intelligence
• Collaboration GRID
• Teleconsultation
• Telementoring

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TATRC Broadband Medical Networks Current TATRC
Activities

• Developing networks for sharing medical data
• Funding projects for planning, implementing, and
  demonstrating the value of health IT
• Providing technical assistance to solve problems
  and identify lessons learned
• Regional Optical Networks
• Regional Health Information Organizations
• Global Collaborations
• European HealthGRID
• Pacific Rim PRAGMA Life Sciences GRID
• Africa PEPFAR program
• WHO/ITU MoU
• Latin America/Caribbean/Canadian in discussion

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TATRC Advanced Distributed Learning
To meet multiple training needs, TATRC is
actively developing computer imaging technologies
telecommunications to achieve the most
effective training possible.
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TATRC Homeland Defense
Chemical/Biological/Nuclear Threat Detection

• MEMS Sensor System
• High Sensitivity
• Nanoliter Samples
• Short Analysis Time
• High-density Information
• Low Cost

Typical of TATRC programs for threat detection is
the MicroElectroMechanical sensor for detection
of anthrax, developed through the Harvard Medical
School Center for Integrating Medicine and
Innovative Technology, the Draper Research
Laboratory and MIT.
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TATRC Life Cycle Health Care Management
Telemedicine is the cornerstone of TATRC
geriatric care, such as the home monitoring
equipment being developed in collaboration with
the Mercy Health System to improve the management
of congestive heart failure.
Home Health Congestive Heart Failure Protocol
base data collection.
Parameters Blood Pressure Heart
Rate Respirations Oral Temperature Heart and Lung
Assessment with Stethoscope ECG Oxygen Saturation
Assessment of general appearance, pedal edema and
mental status will be obtained through the video
camera, as well as questions presented by the
telemed nurse.
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TATRC Broadband Medical Networking Next Steps

• TATRC Integrated Research Team
• Seek advice for setting BMN priorities
• Develop a program for supporting development and
  adoption
• Spring 2006
• Dont wait for IRT
• http//www.usamraa.army.mil/pages/index.cfm
• Help answer what is a LambdaGRID?

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Questions? More information?

• http//www.tatrc.org
• Points of Contact
• Mary Kratz
• 734-763-5505
• mkratz_at_tatrc.org
• (mkratz_at_umich.edu)
• Jan M. Patterson
• 310-574-8401
• patterson_at_tatrc.org