Medical Simulation & Information Sciences Research Program (MSIS)

Mission

To responsively and responsibly coordinate emerging military medical simulation and health information technologies/informatics research across all stakeholder communities and transfer research solutions and knowledge to meet Military Health System goals.

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Background and Environment

The Joint Program Committee-1 (JPC-1), established in 2010, is part of the United States Army Medical Research and Materiel Command's (USAMRMC) research area directorate. The MSISRP is responsible for programming research in three distinct portfolio domains: Medical Simulation & Training, Health Information Technology/Informatics, and the Military Capabilities to Support Dispersed Operations. The MSISRP works with all the services and joint agencies to address gaps, threats, and requirements as identified by the Military Health System (MHS).

The MSISRP is tasked with planning, coordinating, and overseeing a tri-service science and technology program to improve strategic planning and process development related to research in three portfolio areas:

  • Improving military medical training through medical simulation, educational gaming, and objective training metrics
  • Improving health information sciences through increased interoperability and better health information technology applications
  • Improving military medical training military capabilities to support dispersed operations through robotics, unmanned autonomous systems and virtual health.

The establishment of the MSISRP has enabled a collaborative process to identify and validate the research initiatives pertaining to the military, thereby allowing USAMRMC to better align its research and development efforts with the needs of the MHS. This program assists in the identification of relevant emerging technologies, the assessment of technologies through a structured process, and the transition of technologies that are of value to the MHS.

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Goals and Objectives

The MSISRP seeks to improve patient safety and quality of care through strategic over-the-horizon research; by transitioning more capable healthcare information and medical simulation technologies and systems; by addressing stakeholder driven priorities to bridge existing and future capability gaps in the MHS, and through proactive integration and implementation of emerging technologies into military healthcare relevant applications.

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MSISRP JPC-1 Medical Simulation and Training

Research Programs

Joint Evacuation and Transport Simulation (JETS)

The JETS program provides the Department of Defense (DoD) with standardized Joint Patient Movement simulation training capabilities, by replicating the chain of evacuation. The objectives of the JETS system is to ensure patients receive the most effective medical care throughout the patient movement process within the DoD chain of evacuation, while decreasing overall DoD training costs and technology fielding timelines. The JETS program will link the operational needs of the Services and Combatant Commanders to standardized patient movement training platforms inside the Military Health System (MHS) continuum of care while sustaining and/or improving clinical standards of patient management.

Specific goals include:

  • Deliver effective continuum of care and patient hand-over training for improved patient care
  • Deliver usable patient movement training, with global 24/7/365 capability at the point of demand
  • Integrate the JETS training platform across the Department of Defense.

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Point of Injury Training System (POINTS)

The POINTS program provides a Point of Injury (PoI) training capabilities to sustain and improve first responders and combat medical skills to support a disbursed multi-domain battlefield. POINTS research will develop the next generation inter-professional, open source training platforms, toolkits, and models to the Role 1 care scenarios to improve the clinical outcomes of the warfighter. The POINTS program will link the operational needs of the Services and Combatant Commanders with highly trained warfighters that possess a high state of medical readiness and the capability to deliver PoI medical skills and enhance their ability to respond to prolonged care situations.

Specific goals include:

  • Adaptable, modular, and customizable training for the “platinum ten minutes”
  • Systems of systems to optimize efficiency/effectiveness
  • Predicting training needs in advance to assist the trainer

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Warfighter Performance, Resilience, Effectiveness, and Protection (WarPREP)

WarPREP is a future concept program to develop tools to deter skills degradation, enhance medical capabilities, and increase patient protection and pre-intervention rehearsal. The research efforts support studies that measures skill acquisition, maintenance, and minimize skill decay through simulation systems. WarPREP research centers on patient safety and improvement of clinical outcomes. This program will develop healthcare pre-intervention systems & proficiency assessment tools for sustained military medical readiness. Efforts in this domain are evidence-based driven with measurable outcomes that will lead to transference to clinical settings, hence patient safety and improved clinical outcomes throughout the continuum of care.

Specific goals include:

  • Provide accurate and appropriate cognitive and psychomotor predictive models of healthcare providers so the Warfighter receives the best care possible
  • Accurately and appropriately align effective and efficient training models vs. identified skills lost
  • Establishing evidence-based design and development requirements for pre-intervention rehearsal simulations for multiple and single-player serious games for medical team training.

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Theater Hospital Operations Replication (THOR)

One important concern faced by Medical Modeling & Simulation is how to train medical personnel in peace for the realities of war. THOR is a future concept program to develop in-theater, Role 2 and Role 3 simulation training capabilities; deliver rapid deployment of prepared and skilled medical teams, task forces and theater hospitals. THOR will link the operational needs of the Services and Combatant Commanders with highly trained warfighters that possess a high state of medical readiness and the capability to provide care at Role 2 and/or Role 3. THOR provides a wider range of medical interventions and enhanced laboratory and imaging capabilities. It is anticipated that the carry-over of lessons learned from previous medical contingency operations will influence how future forward surgical hospitals and personnel will operate. Training for these environments is vital to understand the field hospital operations and how hospital personnel work in that environment.

Specific goals include:

  • Start standardization of medical personnel level simulation in the operational environment
  • Increase the ability to have smooth team cohesion using Point of Demand simulation training regardless of location
  • Research on how medical scenarios should be assessed within the context of the capabilities present at a hospital and the cause, type and severity of the wounds

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Simulated Hospital Operations and Treatment System (SHOTS)

The SHOTS a future concept program that provides common Military Treatment Facility (MTF) based simulation capabilities for the training of medical providers and clinicians who are not operating within a MTF. The SHOTS program provides real time learning for specific medical environments, for example, surgical suites, inpatient wards, and other MTF operational environments. SHOTS program ensures patients receive the best care at the Role 4 environment by increasing the efficiency of the training platforms for medical personnel who operate in an out-patient clinic setting. The SHOTS program will link the operational needs of the Services and Combatant Commanders to standardized patient care training platforms inside the Military Health System (MHS) continuum of care while sustaining and/or improving clinical standards of patient management.

Specific goals include:

  • Research the need for clinical and MTF wide exercises to increase medical capabilities
  • Standardized MTF exercises to support a Joint training requirement, Inter-Governmental, and an Allied and Coalition Partner training capability
  • Research dedicated to requirement priorities for MedSim training that focus on specialized procedures within the SHOTS environment

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MSISRP JPC-1 Health Informatics Technology Research

Research Programs

Theater/Operational Medicine

Since FY16, guidance has prioritized Theater/Operational Medicine/military relevant research to develop timely, clinically relevant and secure health information technology (HIT) solutions that close significant asymmetric information and medical situational awareness gaps and challenges at the point of care in-theater and far forward environments. Enhance efficiency of healthcare operations in combat and operational environments through multi-faceted, novel technology-based research that advances the state of the art in military medicine for 24/7 globally integrated operations.

Specific goals include:

  • Model Use of Innovative Technologies and Industry Best Practices to Support Defense Medical Logistics Data Capabilities
  • Virtual Health/ Teleconsultations: Demonstration of Joint synchronous/ asynchronous Teleconsultation/Virtual Health for deployed healthcare professionals at all levels of care
  • Hands-Free Clinical Documentation and Medical Data Access and Data Integration for Improved Care In-Theater for Casualty Response and Patient Movement Situational Awareness.

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Military Healthcare Services

Research to enhance the efficiency of health care operations; ensure the delivery of high-quality healthcare services by improving information accessibility and by providing better decision support for clinicians to include big data analytics, patient engagement, medical device information, end user usability and the mobile environment.

Specific goals include:

  • Research to Improve the medical providers’ ability to treat patients and promote health through readiness-centric patient engagement and patient safety-driven medical device interoperability;
  • Research to improve clinical decision-making/data availability and connected healthcare services.

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MSISRP Military Capabilities to Support Dispersed Operations Research

Research Programs

Autonomous and Unmanned Systems

Research, design, and prototype autonomous and unmanned capabilities to deliver high quality combat casualty care in dispersed operations with limited or absent medical care personnel in support of the Army Multi-Domain Battle concept and the Army Force 2025 and Beyond vision.

Specific goals included:

  • Research, design and prototype autonomous and unmanned capabilities to address current and future capability gaps in the areas of autonomous critical care such as hemorrhage control, traumatic brain injury management, autonomous damage control surgery and resuscitation, autonomous vascular and surgical control approaches of combat casualties, and autonomous transport for critical care patients (multi-trauma).
  • Research, design, and prototype interfaces between emerging unmanned systems platforms to enable them to be utilized for medical missions including emergency medical resupply and patient evacuation. This includes the development and integration of medical robotics modules, payloads, automated patient management systems, or other medical equipment with general purpose robotics systems.
  • Leverage emerging small prototype man-transportable UAS to provide a cost-effective UAS research platform for conducting 1) operational evaluation of UAS just-in-time unit-level medical emergency resupply and 2) in-flight testing of enroute care research prototype capabilities to include remote patient monitoring, closed-loop patient support systems, and robotic-enabled interventions. Research methods to address safe ride standards for patient transport for emerging UAS platforms. Design and Implement a data acquisition system to monitor in-flight environmental factors of the interior space of a UAS pertinent to medical missions.

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Medical Robotics

Research, design, and prototype future medical robotic systems capable of providing or supporting combat casualty care while optimizing the medical logistic footprint in far-forward and dispersed geographic environments in support of the Army Multi-Domain Battle concept and the Army Force 2025 and Beyond vision.

Specific goals included:

  • Research, design and prototype hard and soft robotic solutions to facilitate medical stabilization of patients, control application of sensors, and enable automated physical (pressure controlled, palpable, tactile) diagnostics and therapeutics for Roles 1-3 during pre-hospital enroute care and prolonged field care.
  • Research concepts and approaches to develop semi-autonomous/autonomous robotic surgical capabilities to improve the safety profile and efficacy of tele-robotic surgery in austere and combat environments.
  • Research, design and prototype robotic intelligence and robotic perception capabilities for accurate detection, mapping, and modeling of the human body to enable applied research in semi-autonomous and autonomous casualty extraction and enroute care systems. Semi-autonomous & autonomous systems for these applications require high fidelity three dimensional mapping of the human body and any external injuries in near-real time for safe physical contact with the casualty.

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Virtual Health

To develop future Virtual Health enterprise process architectures, approaches for delivery of care, and integrated physical solutions capable to supporting prolonged field care and dispersed operations in conditions with limited or lacking traditional field communications and extended enroute care scenarios.

Specific goals included:

  • Enable prolonged field care and deciding faster by exploiting emerging communications and information technologies to enable remote telemonitoring, hands free documentation, secure medical information exchange, and teleconsultation.
  • Focus on mid and long-term enabling technologies to assist in the delivery of care by virtual means through a wide range of networked and stand-alone capabilities aimed at providing better information to the consulting provider, improved guidance mechanisms to the deployed medical forces and improved clinical outcomes for the wounded.
  • Close the gap of distance by improving the experience and improving clinical outcomes on both ends of a virtual health encounter.

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Last Modified Date: 13-Feb-2018