Combat & Casualty Care

Summer 2017

Military Magazines in the United States and Canada, Covering Combat and Casualty Care, first responders, rescue and medical products programs and news\Tactical Defense Media

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Evacuation (MEDEVAC) aircraft may return with more patients than they were called out for in the initial mission request which makes it difficult to plan for MEDEVAC patient arrival. Forwarding the accurate patient count, nature of injuries and vitals well ahead of arrival allow the gaining medical unit to alert and form the reception litter teams, anticipate the triage, and assemble the right providers. The hospital staff can take appropriate action when several MEDEVACs are inbound and non-Personally Identifiable Information (PII) information is displayed on a big screen where all can see. "Currently, a limited voice message is passed with line-of-sight tactical radios," said Wang. "With improved technology, we can provide better patient outcomes. "A faster flow of data will help the field hospitals better prepare immediate treatment plans," said Wang. "By shortening the time it takes for an injured service member to receive critical care, we may be able to increase that patient's chance of survival." Faster transitioning of patients may also allow MEDEVAC ground and air teams to quickly return to mission and continue the evacuation of wounded warriors from the battlefield. Onboard Gateway to Additional Smart Tools for the Medic Wang explained, "MEDHUB will automatically measure the patient's weight, perform the calculations, and provide the medic the exact dosage seamlessly. The tool could also support Food and Drug Administration (FDA) approved medical decision support tools such as Compensatory Reserve Index (CRI), which assist clinicians in quickly identifying and appropriately managing the most severely ill and injured patients. Wang offered, however, that it is also important to understand what MEDHUB is not designed to do. MEDHUB is not being designed to replace the medic or to direct clinical decisions. Rather, it is about data and time. More time for the medic to spend on the patient vice calculating or documenting care. More time for the hospital to treat the patient because it is already prepared for the patient. The Evolution of Transport Telemedicine The Transport Telemedicine Program, under which the MEDHUB project is being developed, began in 2012. Earlier projects, such as the Transport Telemedicine System Rotary-Wing (T2RW) project, validated the capability of pre-hospital documentation and transmission during a medical evacuation (MEDEVAC). This was demonstrated in a formal proof of military utility held in Reno Nevada. T2RW provided a medical data transport infrastructure that collects data from Combat Medics and existing medical devices. This information was transmitted through the existing military single-channel satellite communications network from one evacuation platform to one gaining medical facility. A related follow-on project focused on the development of enabling technologies to support and enhance the functionality of T2RW. The Nett Warrior Electronic Life-Saving Line Equipment (NOELLE) and Close Area Medical Integration Technology (CAMIT) developed the capability to wirelessly collect and share medical data through an Ultra Wide Band (UWB) connection and then pass that data to the ground station. Through these efforts, the current system has brought the capability to a Technology Readiness Level (TRL) 6, supporting a system that has been tested in relevant or simulated operational environments. In January of 2017, following a user assessment of NOELLE and CAMIT prototypes, the program changed focus to automating medic tasks, patient-care focus, and providing critical situational awareness to the receiving medical facility. The medics are task saturated with up to six patients aboard a medical evacuation aircraft and reported handheld devices with voice and data entry were distractions that hindered patient care. It was determined the combat medics needed an automatic system to capture, store and forward data in order for them to perform lifesaving treatment. The MEDHUB concept was developed from user feedback from Flight Paramedics of all Army Components, including flight paramedics stationed at the U.S. Army School of Aviation Medicine (USASAM). MEDHUB leveraged the networking and software components of NOELLE and CAMIT to provide the medic with a device to autonomously capture, store, and forward data from onboard medical devices, without adding any administrative burden to the medic. The MEDHUB concept more adequately meets the requirement of pre-hospital documentation, while providing needed situational awareness to improve patient outcomes, according to Wang. Integrating Technologies According to LTC Christian Cook, USAMMA's MEDEVAC Mission Equipment Project Manager, there are more than 5,000 Army medical ground ambulances and 585 Army air ambulances that could provide timely medical data to field hospital to prepare for better care and outcomes for the patient. The medic needs to hand-off patient data but does not need to be burdened during the evacuation creating the documentation. MEDHUB is uniquely positioned to integrate with legacy and future medical devices. In addition, the MEDHUB development team is partnering with Program Executive Offices (PEOs) to fully integrate with existing systems where possible. For example, the team is working to leverage the PEO Soldier NETT WARRIOR program for handheld technology and the Joint Battle Command Platform (JBC-P) Joint Variable Messaging Format (JVMF) for data transfer to facilitate simultaneous MEDEVAC mission communications. In later phases of the project MEDHUB could work seamlessly with Medical Communications for Combat Casualty Care (MC4) and Joint Operational Medicine Information System (JOMIS), providing direct data upload to the Electronic Health Record. Cook added, "By providing state of the art medical and Information Technology (IT) equipment and leveraging existing and planned Army communication infrastructure, we can improve the timeliness and quality of care. MEDHUB's Next Steps The MEDHUB team at USAMMA is continuing to move forward with its accelerated development of MEDHUB with the goal of fielding a system by 2020. COMPLIMENTARY SUBSCRIPTION | scan the code to sign up now! 18 | Combat & Casualty Care | Summer 2017 MEDICAL COMMUNICATIONS DATA FROM POINT OF TRAUMA

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