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Telemedicine & Advanced Technology
                     Research Center (TATRC)

                     1- Medical Simulation and
                     Training Technology
                     Research Portfolio
                     2- Armed Forces Simulation
                     Institute for Medicine (AFSIM)

                     Games for Health - 17 May 2011
COL Karl E. Friedl, Ph.D.          COL Ron K. Poropatich, M.D.
Director, TATRC                    Deputy Director, TATRC
Fort Detrick, Maryland             Fort Detrick, Maryland

                            UNCLASSIFIED
Presenter: J. Harvey Magee, Technical Director,
      Medical Simulation & Training Technology
• Financial Disclosures: None
• Organizational Disclosures: Employed by University
 of Maryland Med System, loaned to US Army under
 the Intragovernmental Personnel Mobilization Act
 (IPA)
• Disclaimer: I have no authority to negotiate for, or to
 obligate, the US Government.
• This is an informational brief and not intended to
 convey Department of Defense policy.

                            UNCLASSIFIED
TATRC MedSim Team

• Thomas B. Talbot, MAJ, USA, MC
      • Chair, JPC-1a Steering Committee
      • Director, Armed Forces Simulation Institute for Medicine
         (AFSIM)
•   Kevin Kunkler, MD, Interim Portfolio Manager
•   Hugh Connacher, Engineer
•   Harvey Magee, Hospital Administrator (Presenting in behalf
    of team), Technical Director
      • Harvey.magee@tatrc.org
•   Greg Wimsatt, JPC1 Facilitator
•   Adam Wyatt, Project Officer
•   Elton Edinborough, Project Officer


                                UNCLASSIFIED
Who TATRC is


• A US Army agency reporting to HQ US Army
  Medical Research Materiel Command
  (USAMRMC)
• We serve all of DOD




                      UNCLASSIFIED
Purposes

• Inform the Games for Health community of interest about:
      • “traditional” TATRC “MedSim” portfolio, 1999-2011-->>
      • a new funding source for medical simulation, through the
        Defense Health Program, managed by the Office of
        Secretary of Defense / Health Affairs (OSD/HA)
      • Armed Forces Institute for Medicine (AFSIM)
      • Joint Program Committee1a-MedSim (JPC1a-MedSim)
      • AFSIM strategic plan
•   Identify and describe major initiatives / areas of interest
•   Inform the public about Fiscal Year (FY) 10 investments
•   Request information / ideas for future AFSIM strategies



                                UNCLASSIFIED
Fulfilling the Vision Thru R&D

          Mission
          Explore science and engineering
          technologies ahead of programmed
          research, leveraging other
          programs to maximize benefits to
          military medicine


                Vision
                 Be the DoD model of
                 government enablement of
                 technology transfer to use



               UNCLASSIFIED
Strategic Partnerships
US Military Partners
USAMRMC HQs and Labs
Naval Health Research Center
Army & Navy Medical Centers


Extramural Partners
Pacific Telehealth & Technology Hui
Center for Integration of Medical &
   Innovative Technology (CIMIT)
Pain and Neuroscience Center
   Research (Conemaugh)                           TATRC WEST                                   TATRC office
                                                LOS ANGELES, CA          TATRC / BHSAI
UTHSC-Houston
                                                                       FORT DETRICK, MD     BRUSSELS, BELGIUM
Loma Linda University
Center for Advanced Surgical &
                                               TRIPLER
   Interventional Technology (CASIT)        HONOLULU, HI               TATRC South
Samueli Research Institute                                             AUGUSTA, GA
Center for Excellence for Remote & Medically
   Under-Served Areas (CERMUSA)
Windber Research Institute
Joslin Vision Network                                                                     Projects Supported
Center for Military Biomaterials Research (CeMBR)                                         Norway
Schepens Eye Research Institute                                                           Poland
University of Maryland                                                                    Macedonia
Ryder Trauma Center                                                                       Netherlands
                                                                                          Italy
International Medical Military Partners                                                   Austria
France, Germany, UK



                                                        UNCLASSIFIED
Sim-Game Based Research - TATRC
- Duke (Anesthesiology Team Training)
- Virtual Reality Med Cen
- Institute of Creative Technologies

- Higher Order Learning Skills to
Manage Blast / IED Events:
  - MYMIC LLC
  - SimQuest LLC

-Chem-Bio-Rad-Nuclear-Explosive
 - Forterra (bought by SAIC)
                                          TATRC WEST                                  TATRC office
                                        LOS ANGELES, CA           TATRC / BHSAI
                                                                FORT DETRICK, MD   BRUSSELS, BELGIUM
-Cog Motor Therapy / Console Game
 -Blue Marble                     TRIPLER
 -Kinetic Muscles               HONOLULU, HI                    TATRC South
                                                                AUGUSTA, GA

-Pandemic Event Mgt
  -SimQuest
  -Total Immersion Solutions

- Interactive Game-based system for
Psych Health Ed
  -Novonics
  -SOAR
  -Total Immersion Solutions



                                                 UNCLASSIFIED
Sim-Game Based Research – JPC1a
-Applied Research
Associate - Anesthesia and
Anaphylaxis for Physicians

-Blitz Games Studios
(Vitalize Game Based
Wellbeing [Kinect-based]
Physical Therapy Coach
                                   TATRC WEST                                     TATRC office
                                 LOS ANGELES, CA              TATRC / BHSAI
                                                            FORT DETRICK, MD   BRUSSELS, BELGIUM
-Blue Marble – TBI
Rehabilitation Surface          TRIPLER
                              HONOLULU, HI                  TATRC South
                                                            AUGUSTA, GA
-Breakaway Games –
Hospital Disaster Simulator
for CBRNE

-Institute for Creative
Technologies – SimCoach,
other projects




                                             UNCLASSIFIED
TATRC Funding History

                 Since FY98, $2.10B managed R&D projects
Millions
 400

 350

 300                         Demonstrations
                            & Field T-Med (P8)
 250

 200

 150

 100

   50                                          Congressional Special
                                              Appropriations – RDT&E
       0
           '98        '00          '02       '04        '06   '08


                                    FY 2009 Total
                                      $454.8M
                                         UNCLASSIFIED
TATRC Portfolios
      Medical Information & Training Technologies                           Military Operational Medicine
      Infectious Diseases                                                   Combat Casualty Care
                                                                            Clinical & Rehabilitative Medicine

                                                                                                                               Advanced
                                                                    Simulation                                                Prosthetics
                                           Resilience &              & Training                                Medical
                                                                                     Bio-Monitoring                            & Human
  Human                                    Reintegration            Technology                                 Robotics
                     Psych Health                                                    Technologies                             Performance
Performance
Optimization                                                        MAJ Talbot           Dr. Lai              Dr. Gilbert
                      Dr. Shore                                                                                                Mr. Turner
 Dr. Cardin



                                            Medical             Health
                                            Imaging          Information
     Genomics           International     Technologies      Technologies          Computational       Nano-Medicine &       Regenerative
   / Proteomics            Health                                                   Biology             Biomaterials         Medicine
                                                           LCDR Steffensen                                                     Dr. Lai
    Dr. Nisson          Ms. Barrigan                                               Dr. Reifman          Dr. Grundfest
                                           Dr. Pacifico




                         Medical
    Infectious          Logistics
                                        Blood Products         Trauma             Neurotrauma         Vision Research
      Disease                                                                                                                Acoustic
                                           & Safety                                                                          Trauma
                                                            Dr. Broderick         Dr. Golanov            Mr. Read
    Dr. Carney
                     Mr. DePasquale       Mr. Malloy                                                                         Dr. Holtel




    Slide 11 of 37
                                                                    UNCLASSIFIED
Download: http://www.tatrc.org/docs/TATRC_report_2009.pdf
                        UNCLASSIFIED
Opportunity-Driven Model - Examples

• Congressionals - a “Line Item” appears in DOD
 Authorization / Appropriation Bills
   • Opportunity / obligation: to shape it to maximize military &
     scientific relevance while honoring congressional language
• SBIR - Authoring of Small Business Innovative Research
 “topics”
   • Opportunity: proactively submit research topics to DOD /
     Army to “fill gaps”
• Augmentation funding - Someone submits a hot,
  innovative idea
• AAMTI - Army Med Dept Medical Training Initiative
• JPC1-MedSim - Joint Program Committee 1-MedSim


                                UNCLASSIFIED
Turning to medical
   simulation…


         UNCLASSIFIED
Why We Started – Reason #1
         To Improve Trauma Training

•100,000 military medical personnel must
practice battlefield trauma care skills*
(Source: GAO Rpt, NSIAD-98-75, DOD Training in Civilian
Trauma Centers)


  •Good News – not enough trauma patients
  •Bad News – not enough trauma patients,
  for they ARE a training opportunity

•Solution: Virtual patients
                          UNCLASSIFIED
Why we Started – Reason #2
                To Reduce the Errors
                                                         • IOM report - 1999:
                                                           >45,000 deaths due to
                                                           errors - Medical errors 7th
                                                           leading cause of U.S.
                                                           death…
                                                         • HealthGrades, 27 Jul
                                                           04: 195,000 deaths/yr,
                                                           $6B annual costs, 6th
                                                           most common death
                                                         • ENT: 45 % report errors
                                                           committed: 37%
“Classification and Consequences of Errors in
Otolaryngology “
                                                           serious harm, 9% fatal
-Rahul K. Shah, et al, The Laryngoscope, August 2004



                  Slide courtesy of Dr. Steve Dawson, CIMIT Simulation Group
                                                       UNCLASSIFIED                November 09
Long-Term Vision for
           Simulation-based Training

• To facilitate a paradigm shift in medical training, a Grand
 Challenge revolution…

• FROM subjective assessment of clinical skills

• TO a curriculum-aligned, metrics-driven, objective
 system of assessment based on demonstrated proficiency
 to perform skills for which health care personnel have been
 trained.




                              UNCLASSIFIED
Integrated Research Team – Feb 00




•70-person IRT (government, academia, & industry)
• Strategic ROAD MAP resulted
• 4 general areas for research identified
• Became basis of TATRC portfolio to this day
                         UNCLASSIFIED
Basis for Road Map:
   Multiple Needs, Multiple Technologies

                          PC-based Interactive Multimedia

                                         Digitally Enhanced
                                         Mannequins

                                                       Part-
                                                  Task
                                                  Trainers /
                                                  Virtual
                                                  Workbench
                                                  es

Total Immersion Virtual
Reality                   UNCLASSIFIED
PC-Based Interactive Multimedia



                                                                                  Maintenance of Certification
       Social Behavior –                Combat Casualty – Chemical War            - SimQuest
       AVESSS / Second Life             - Forterra (now SAIC) CBRNE




Interactive Psychological Health Education Cognitive Learning & Logistics -   Patient Interactions & Logistics
- Total Immersive Software, Inc (JESSEY) Office of Naval                      – Applied Research Associates, Inc,
                                           Research (PULSE)                   Virtual Heroes Division (HumanSim)




                                                         UNCLASSIFIED
Digitally Enhanced Mannequins



                                                             Next Generation Injury Creation
                                                             -
                                                             The Virtual Reality Medical
                                                             Center
Combat Medic Training System
– Center for Integration of
Medicine & Innovative
Technologies (CIMIT) -
(COMETS)

                               Compartment Syndrome Task
                               Trainer
                               - Operative Experience




                                              UNCLASSIFIED
Part-Task Trainers / Virtual Reality
                         Systems

                                                                                Burr Hole Simulator -
                                                                                SimQuest




Virtual Cricothyroidotomy -
National Capital Area Medical Simulation Center




3-D Anatomical Model -
ArchieMD, Inc.
                                                                 Compartment Syndrome Sim & Didactics
                                                                 - Touch of Life (ToLTECH)



                                                  UNCLASSIFIED
Total Immersive Virtual Reality System




                       Wide Area Virtual Environment (WAVE)-
                       National Capital Area Medical Simulation
                       Image from
                       www.simcen.org/VME%20Lab/projects/wave/index.html               iGlove Robotic Controller
                                                                                       - AnthroTronix




                                              Tactical Digital Holograms: technology
Ultra High Resolution Display                 matured under contract with the Army
- eMagin                                      -Zebra Imaging


                                                          UNCLASSIFIED
Technical Strategy

• Identify Enabling Technologies
• R&D them into components that can be…
• Integrated into…
• Systems of simulation-based training that can be…
• Validated to determine their training effectiveness, so
    OTHER military organizations can…
•   Transition / sustain them for military health care, from the
    foxhole to the operating room and beyond




                                 UNCLASSIFIED
Enabling Technologies
•Real-time in vivo tissue property measurement
•Haptics
•Tissue-tool interactions
•Graphics, visualization
•Augmented Reality
•Learning systems
•Metrics development
•Learning transfer & assessment
•Open source architecture
•Olfactory technologies
•Gaming Technologies




                          UNCLASSIFIED
AFSIM:
    Introduction to the
Armed Forces Simulation
  Institute for Medicine

 Director: Thomas B. Talbot, MAJ, USA, MC
   Telemedicine and Advanced Technology Research Center (TATRC)
       United States Army Medical Research & Materiel Command
                            (USAMRMC)




                             UNCLASSIFIED
AFSIM ORIGINS
• Department of Defense Health Affairs Initiative
     • Defense Health Program Dollars ~$30-45M/year
       (contingent on receipt of funding)
         • Improve medical education & readiness for all services
         • ULAMET – JAT Report
     • ASBREM Committee
     • JTCG-1
     • JPC-1

•   Initial Mandate
      1. Live Tissue/Sim Research,
      2. Curricula and Standards,
      3. Virtual Human Coaching for OIF/OEF Veterans,
      4. Ophthalmology & Anesthesia, and
      5. Medical Simulation Systems.

                                UNCLASSIFIED
Joint Program Committee 1

• JPC-1                                                        Tri-Service
      • Chair: COL Karl Friedl, PhD
      • Tri-Service Programmatic Committee                     Transparent
      • TATRC is primary execution agent
                                                               Ethical
•   JPC-1a Medical Simulation & Training
      •   Chair: MAJ Thomas B. Talbot, MD                      Visionary
      •   Efforts spawned AFSIM


•   JPC-1b Health Information Technology                       Collaborative
      •   Chair: Steve Steffensen, MD   (Former Navy)
                                                               Responsive
•   JPC-1c Decision Support Tools & Modeling
      •   Chair: Jaques Reifman, PhD
                                                               Strategic




                                                UNCLASSIFIED
JPC-1a Voting Members


           US Army - PEOSTRI

           US Air Force - Air Education Training Command

           US Army - Central Simulation Committee

           USUHS - Natl Capital Area Med Sim Cen

           AMEDD C&S - Directorate, Combat Medic Training

           AMEDD C&S - US Army EMS Office

           US Navy - Office of Naval Research

           US Air Force - Air Education Training Command

           US Army - RDECOM / STTC

           DARPA

           Medical Education and Training Campus (METC)

           Office of Naval Research




          UNCLASSIFIED
JPC-1a Advisors


       US Navy - Naval Postgraduate School Monterey

       Dept of Homeland Security

       DOD; USA OTSG

       DOD Patient Safety Office

       TATRC / Brussels Belgium

       USUHS - Natl Capital Area Med Sim Cen

       Defense Center of Excellence for Psych Health & TBI

       DOD Patient Safety Office

       HQ USAMRMC

       OASD (HA)




      UNCLASSIFIED
Ground Rules
• NO PROMISES
   • We cannot obligate the US Government to anything based
     upon discussions during this event
   • Decisions, plans and budgets are subject to approval and
     changes by headquarters at any time
   • The steering committee can and will change plans
• Pending Awards
   • We cannot provide details on programs under review for
     selection or projects pending award
• We want your input
   • We shall inform industry and academia of our efforts and
     wish to glean your insights on how you think we can
     accomplish our strategic objectives


                            UNCLASSIFIED
JPC-1a Structure

Combat Casualty             Medical Practice
Training Initiative            Initiative


                 AFSIM

Developer Tools
                            Patient Focused
  for Medical
                                Initiative
   Education

                      UNCLASSIFIED
Combat Casualty Training Initiative
Strategic Building Blocks (CCTI)
Systems & research to improve
pre-hospital trauma training and
maintain lifesaver resilience
                                                                                  Superior
                                                                                 Battlefield
Integrate very advanced training technology                                      Lifesaving                      DTME
                                                                                 Capability
into medical training & simulation facilities of                                                                 PFI
all services
                                                                                 Advanced
                                                                                  Training
Virtual Reality individual and team training to
                                                   MPI                           Systems
replicate chaotic and mass casualty
scenarios in a safe environment
                                                                  Tri- Service                 Resilience
                                                                  Compatible                   Research &
                                                                   Curricula                   Integration
Real world benefits:
-Pre-hospital assets continuously in a
high state of readiness                                            Simulator
                                                                                               Olfaction &
                                                                  Gap R&D to
-Potential to replace animal training                             equal animal
                                                                                                 PTSD
                                                                                               Research
                                                                    efficacy

-Training geared towards psychological
                                                      Animal /                   Improved
resilience during and after deployments               Simulator                    Task
                                                                                                             Improved
                                                                                                             Learning
-Improved safety by statistically valid              Comparison
                                                       (CCTC)
                                                                                 Trainers &
                                                                                  Manikins
                                                                                                              Metrics
recognition of lost skills




                                                          UNCLASSIFIED
FY11 Combat Casualty Training Initiative

• Combat Casualty Training Consortium Program Announcement - $15.2M
   • Timeline
       Released Summer 2010
       Closed November 19th, 2010
       Scientific Review Complete
       Programmatic Review Underway
       Selection Board February 24th, 2011
       Award(s) Anticipated Late Summer 2011
   • Critical Research Areas
       • Trauma Airway
       • Hemorrhage
       • Emergency Medical Skills (Nerve Agent Casualty)
   • Goals
       • Live Animal / Simulator Comparative Research
       • Curriculum Development
       • Simulator System Gap Analysis




                                            UNCLASSIFIED
FY10 Combat Casualty Training Initiative

 Combat Casualty Training Initiative Project              Perfomer               Budget

Live tissue / sim - metrics research           NAVAIR                              $ 369,835

BCT-3 live tissue / sim study                  Brooke Army Medical Center          $ 250,000

Multiple Amputee Trauma Trainer                STTC Orlando                        $ 756,000

Rapid trauma skills training                   Operative Experience                $ 497,750
COMETS improved capabilities for combat
medics                                         CIMIT Sim Group                     $ 449,901
Maxillofacial & Ophthalmology Trauma
Trainer                                        Pending Extramural Award        Pending Award



                                                                      TOTAL:    ~$ 5,550,000




                                                UNCLASSIFIED
CCTI FY11 Plans

• CTCC PA Award $15.2 M
• Extend BCT-3 research efforts ($1.8M)




~$17 Million



                             UNCLASSIFIED
CCTI FY12 Plans

• No Program Announcement Plans for FY12
• Consider PA in FY13

   • CTCC is just starting and will not produce feedback by FY12 to
     know where to add additional funding to CTCC
   • Should we start a new advanced training platform in FY12?
       • Advanced open architecture manikin
           • Possible, but we don’t have research data to know everything it will need
       • Advanced talking task trainers
           • It is a stronger possibility. What would we do?




                                        UNCLASSIFIED
Medical Practice Initiative
Strategic Building Blocks (MPI)
Development of medical training
systems & competency
assessment for sustained military
medical readiness.                                                      Advanced
                                                                         Doctor
                                                                        Education
                                                                                                        PFI
Continuous Observation of Medical
                                                                         System
                                                                       (COMRADE
                                                                                                        DTME
Records for Advanced Doctor Education                                       )
(COMRADE)
                                                                          Virtual
                                                                         Human
                                                                       Standardize
Real-time specialty specific evaluation for                             d Patients
loss of skills & knowledge
                                                        JPC-1b EHR                      JPC-1c
                                                        Education &                    Decision
Real world benefits:                 CCTI                Reference                      Support
                                                         Integration                  Integration
-Reduced cost for training                                             Educational
-Reduced liability                                                      Content        Military
                                                          Serious                      Medical
-Cost savings by replacing expensive                     Games for                    Lifecycle
standardized live patient teaching                        Training                    Counselor
cases with reusable virtual human                                                      (DKO)
patients                                    Loss of                     Common
                                                                       Curricula &                   Military
                                             Skills.
-Improved Tri-Service medical              Retraining                    Metrics                     Medical
                                                                                                    Simulation
interoperability                               &                       (Tri Service                  Masters
                                          Competence                   Consortium)
-Leverages Electronic Health Record
system as training portal
      -Can use AHLTA or another EHR



                                                UNCLASSIFIED
Continuous Observation
of Medical Records for Advanced
Doctor Education (COMRADE)

                                  Medical Record EHR Development
                                      Extensive hyper-linking and floating reference info
                                      Meaningful visual formats
            Advanced                  Clinical practice guideline based formats when appropriate
             Doctor                   Intelligent summarization of data
            Education
             System                   Health records that communicate
           (COMRADE)                  Visual decision support tools



                                  Intelligent Assessment & Tutoring
                                      System tracks procedures, CME, findings & assessments
                                         to determine physician exposures against list of
                                         expected knowledge by their specialty board
                                      System determines if lack of exposure is sufficient for a
                                         refresher in a certain area
                                      System schedules a teaching case or a virtual patient into
                                         the physicians patient schedule
                                      System recommends periodic procedure observed training
                                      Automatic & documented maintenance of certification




                                    UNCLASSIFIED
FY10 Medical Practice Initiative

      Medical Practice Initiative Project              Perfomer             Budget
Medical Training Evaluation and Review
(MeTER)                                     RDECOM / STTC                     $515,000

Training Outcomes Research Metrics          UCLA / CRESST                     $450,000

Hospital disaster simulator - CBRNE Based   Breakaway Games                  $2,671,322

Redeployment skills evaluation              Madigan Army Medical Center       $800,000
Tri Service Medical Simulation Training
Consortium                                  Air Force / ONR / USUHS          $2,500,000
Anesthesia and Anaphylaxis for Physicians   Applied Research Associates      $1,900,000
Virtual Sick Call                           RDECOM / STTC                     $773,000

                                                                   TOTAL:   $ 9,609,322




                                             UNCLASSIFIED
MPI FY11 Plans

•   Navy Redeployment Skills Degradation
•   Multiple Amputee Trainer (MATT) final year
•   Olfaction training device & study
•   Medical Simulation Training Consortium Years 2-3
•   Simulation for Futuristic Surgery (VR Urology)
•   CBRNE Hospital Incident Management Radiological Scenarios
•   Ocular Craniofacial Manikin Advanced Development
•   Medical Simulation Master’s Degree Program
•   Student Innovations in Medical Simulation (Skunk Works)

• Unfunded request for large web portal hosted by Air Force


~$13.5 Million


                                       UNCLASSIFIED
MPI FY12 Plans

• We would like a program announcement for FY12
• PA would be major effort for AFSIM for the year

•   Things we are thinking about:
      • How can electronic health record data be used to discern a physician’s
         educational needs?
      • Military Medical Career Training Guidance
      • How can we deliver training content with all the things we want to do on
         government computer systems?
      • For what applications are Virtual Reality & networked training appropriate
         and efficacious?
      • Are there things going on in the civilian world that we can leverage?




                                          UNCLASSIFIED
Patient Focused Initiative
Strategic Building Blocks (PFI)
Advanced user interface and
interactive technologies for
healthy living, medical practice ,                                                                                       MPI
patient rehabilitation & training                                                  Advanced                              CCTI
                                                                                Virtual Reality &
                                                                                  Augmented
                                                                                Reality Training
Advanced technology for training                                                  Technology
applications leveraging investments of
DoD and Government Partners
                                                                                Virtual Human
                                                                                  Patients &
                                                                                   Coaches
Adapts therapeutic technology targeting
warfighter readiness and mental health
                                                                  Mobile
                                                                                                      Physical &
                                                               Technology
                                                                                                    Neurocognitive
                                                              Integration for
                                                                                                       Therapy
Real world benefits:                                             Health &
                                                                                                     Applications
                                                                 Training
-High impact development at reduced
costs, especially for VR-based training                                                                JPC-8
                                                              NIH – Virtual
                                                                                                    Rehabilitation,
-Technology highly adaptable to                                Reality for
                                                               Obesity &
                                                                                                     Physical and
                                                                                                    Neurocognitive
training                                                       Diabetes
                                                                                                    Rehabilitation
-Direct injured warfighter benefit
     -Traumatic Brain Injury                                                                                          ICT simCoach
     -Psychological Health (PTSD, Suicide)     DARPA –                          Game Industry                         & Emotionally
                                             Healing Heroes                      Technology                             Expressive
     -Physical Therapy                                                                                                  Characters

-Adaptation of mobile and tele-health
technology                                                                PARTNERSHIPS




                                                    UNCLASSIFIED
FY10 Patient Focused Initiative

        Patient Focused Initiative Project                   Perfomer            Budget
Vitalize Game Based Wellbeing (Kinect-based
Physical Therapy Coach)                        Blitz Games Studios                $4,325,024

Refining medical outcomes deployment:          Naval Health Research Center        $500,055

TBI Rehabilitation Surface                     Blue Marble                        $1,374,447

Olfaction & Resilience Research (10 studies 6.1) Monell Chemical Senses Center    $4,000,000


                                                                        TOTAL:   $10,199,526




                                               UNCLASSIFIED
PFI FY11 Plans

• Natural Language Processing for Virtual Humans
• 3D motion tracking for rehabilitation
• DARPA: Healing Heroes




~$5 Million



                            UNCLASSIFIED
PFI FY12 Plans

• We want to consider a program announcement in FY12

• Things we are thinking about:
    • Virtual Humans for Coaching
    • Assessment of off the shelf and easily hacked technology for the
      rehabilitation, assessment and therapy environments
    • Mobile Technology
        • Constantly proposing SBIR topics in this area




                                       UNCLASSIFIED
Developer Tools for Medical Education
Strategic Building Blocks (DTME)
Transformational open source
advanced developer tools to reduce                                                                     MPI
development costs and democratize
access to technology.
                                                                                                       CCTI
                                                                        Affordable
                                                                         Training
Based on the need to greatly reduce the                                  Content
                                                                         Creation
burden to develop interactive medical &   CCTI
surgical training content.
                                                                       Character AI
Open Source (OS) promotes low cost and
innovation
                                                        Surgical VR
                                                                                      Advanced
                                                          Training
Real world benefits:                                      System
                                                                                      Displays &
                                                                                      Interfaces
-Greatly reduced development costs                       Standards
                                                                         Online
-Saves development time                                                  Portal
-Facilitates content creation                           OS Practical
                                                        Physiology
                                                                                      OS Speech
                                                                                       & Motion
     -Greatest need as program matures                    Engine                      Recognition
-Opens development to a more diverse
and wider community                                                     OS VR
                                           OS Natural                                               OS Medical
-Reduced system procurement costs          Language
                                                                       Anatomy &
                                                                         Haptic
                                                                                                      Asset
                                           Processing                                                Library
-Reduces redundant development                                          Platform




                                                UNCLASSIFIED
FY10 Developer Tools for Medical Education

Developer Tools For Medical Education      Perfomer                  Budget
Dynamic Holographic Displays & 3D in
medical education                          RDECOM & PEOSTRI          $ 3,000,039

Tri-Service Open Platform for Simulation   USUHS                     $ 2,000,000




                                                              TOTAL: $ 5,000,039




                                            UNCLASSIFIED
DTME FY11 Plans

• Advanced VR Eyewear Display




~$4 Million



                          UNCLASSIFIED
DTME FY12 Plans

• We want to consider a program announcement in FY12

• Things we are thinking about in the near term:
   • Open Source Practical Physiology Engines
   • Open Source Visual Human toolkit for VR surgical applications


• Things we are thinking about down the road
   •   Open Source Virtual Character Behavior Engine
   •   Medical Asset Exchange (Radiographs, sounds, slides, etc.)
   •   Character emotional display, speech & movement tools
   •   Natural Interface Tools, Facial Recognition for Emotion, etc.




                                     UNCLASSIFIED
Summary

• Many thanks to the Games for Health community. You are
 part of an unprecedented opportunity to shape the future of
 medical training

• We welcome your input

• Make the most of the week!

• Harvey.magee@tatrc.org



                               UNCLASSIFIED
Opportunity-Driven Model - Examples

• Congressionals - a “Line Item” appears in DOD
 Authorization / Appropriation Bills
   • Opportunity / obligation: to shape it to maximize military &
     scientific relevance while honoring congressional language
• SBIR - Authoring of Small Business Innovative Research
 “topics”
   • Opportunity: proactively submit research topics to DOD /
     Army to “fill gaps”
• Augmentation funding - Someone submits a hot,
  innovative idea
• AAMTI - Army Med Dept Medical Training Initiative
• JPC1-MedSim - Joint Program Committee 1-MedSim


                                UNCLASSIFIED
Congressional Process

• Our role is to manage congressionally supported
research as directed.

• Constituents’ opportunity is to educate and inform
your congressional representative . Government
officials are prohibited from involvement with
constituents in seeking to influence Congress.

•If you have questions, contract Mr Tony Story,
TATRC’s congressional liaison.
     •301-619-7033
     •tony.story@tatrc.org


                          UNCLASSIFIED
Locate the USAMRMC
           Broad Agency Announcement
                   (the “BAA”)
• http://www.tatrc.org
• Click “Funding” at top-line menu.
• On Funding Opportunity page, click “USAMRMC BAA 10-1”.
• Click “Click here to visit the USAMRMC Broad Agency
 Announcements (BAA) Website”.
• Or just go here:
       http://www.usamraa.army.mil/pages/baa_forms/index.cfm
• READ and UNDERSTAND IT!
• You can take it from there.

                            UNCLASSIFIED
Questions ?




     UNCLASSIFIED

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Gfh 17 may-tatrc, afsim-magee

  • 1. Telemedicine & Advanced Technology Research Center (TATRC) 1- Medical Simulation and Training Technology Research Portfolio 2- Armed Forces Simulation Institute for Medicine (AFSIM) Games for Health - 17 May 2011 COL Karl E. Friedl, Ph.D. COL Ron K. Poropatich, M.D. Director, TATRC Deputy Director, TATRC Fort Detrick, Maryland Fort Detrick, Maryland UNCLASSIFIED
  • 2. Presenter: J. Harvey Magee, Technical Director, Medical Simulation & Training Technology • Financial Disclosures: None • Organizational Disclosures: Employed by University of Maryland Med System, loaned to US Army under the Intragovernmental Personnel Mobilization Act (IPA) • Disclaimer: I have no authority to negotiate for, or to obligate, the US Government. • This is an informational brief and not intended to convey Department of Defense policy. UNCLASSIFIED
  • 3. TATRC MedSim Team • Thomas B. Talbot, MAJ, USA, MC • Chair, JPC-1a Steering Committee • Director, Armed Forces Simulation Institute for Medicine (AFSIM) • Kevin Kunkler, MD, Interim Portfolio Manager • Hugh Connacher, Engineer • Harvey Magee, Hospital Administrator (Presenting in behalf of team), Technical Director • Harvey.magee@tatrc.org • Greg Wimsatt, JPC1 Facilitator • Adam Wyatt, Project Officer • Elton Edinborough, Project Officer UNCLASSIFIED
  • 4. Who TATRC is • A US Army agency reporting to HQ US Army Medical Research Materiel Command (USAMRMC) • We serve all of DOD UNCLASSIFIED
  • 5. Purposes • Inform the Games for Health community of interest about: • “traditional” TATRC “MedSim” portfolio, 1999-2011-->> • a new funding source for medical simulation, through the Defense Health Program, managed by the Office of Secretary of Defense / Health Affairs (OSD/HA) • Armed Forces Institute for Medicine (AFSIM) • Joint Program Committee1a-MedSim (JPC1a-MedSim) • AFSIM strategic plan • Identify and describe major initiatives / areas of interest • Inform the public about Fiscal Year (FY) 10 investments • Request information / ideas for future AFSIM strategies UNCLASSIFIED
  • 6. Fulfilling the Vision Thru R&D Mission Explore science and engineering technologies ahead of programmed research, leveraging other programs to maximize benefits to military medicine Vision Be the DoD model of government enablement of technology transfer to use UNCLASSIFIED
  • 7. Strategic Partnerships US Military Partners USAMRMC HQs and Labs Naval Health Research Center Army & Navy Medical Centers Extramural Partners Pacific Telehealth & Technology Hui Center for Integration of Medical & Innovative Technology (CIMIT) Pain and Neuroscience Center Research (Conemaugh) TATRC WEST TATRC office LOS ANGELES, CA TATRC / BHSAI UTHSC-Houston FORT DETRICK, MD BRUSSELS, BELGIUM Loma Linda University Center for Advanced Surgical & TRIPLER Interventional Technology (CASIT) HONOLULU, HI TATRC South Samueli Research Institute AUGUSTA, GA Center for Excellence for Remote & Medically Under-Served Areas (CERMUSA) Windber Research Institute Joslin Vision Network Projects Supported Center for Military Biomaterials Research (CeMBR) Norway Schepens Eye Research Institute Poland University of Maryland Macedonia Ryder Trauma Center Netherlands Italy International Medical Military Partners Austria France, Germany, UK UNCLASSIFIED
  • 8. Sim-Game Based Research - TATRC - Duke (Anesthesiology Team Training) - Virtual Reality Med Cen - Institute of Creative Technologies - Higher Order Learning Skills to Manage Blast / IED Events: - MYMIC LLC - SimQuest LLC -Chem-Bio-Rad-Nuclear-Explosive - Forterra (bought by SAIC) TATRC WEST TATRC office LOS ANGELES, CA TATRC / BHSAI FORT DETRICK, MD BRUSSELS, BELGIUM -Cog Motor Therapy / Console Game -Blue Marble TRIPLER -Kinetic Muscles HONOLULU, HI TATRC South AUGUSTA, GA -Pandemic Event Mgt -SimQuest -Total Immersion Solutions - Interactive Game-based system for Psych Health Ed -Novonics -SOAR -Total Immersion Solutions UNCLASSIFIED
  • 9. Sim-Game Based Research – JPC1a -Applied Research Associate - Anesthesia and Anaphylaxis for Physicians -Blitz Games Studios (Vitalize Game Based Wellbeing [Kinect-based] Physical Therapy Coach TATRC WEST TATRC office LOS ANGELES, CA TATRC / BHSAI FORT DETRICK, MD BRUSSELS, BELGIUM -Blue Marble – TBI Rehabilitation Surface TRIPLER HONOLULU, HI TATRC South AUGUSTA, GA -Breakaway Games – Hospital Disaster Simulator for CBRNE -Institute for Creative Technologies – SimCoach, other projects UNCLASSIFIED
  • 10. TATRC Funding History Since FY98, $2.10B managed R&D projects Millions 400 350 300 Demonstrations & Field T-Med (P8) 250 200 150 100 50 Congressional Special Appropriations – RDT&E 0 '98 '00 '02 '04 '06 '08 FY 2009 Total $454.8M UNCLASSIFIED
  • 11. TATRC Portfolios Medical Information & Training Technologies Military Operational Medicine Infectious Diseases Combat Casualty Care Clinical & Rehabilitative Medicine Advanced Simulation Prosthetics Resilience & & Training Medical Bio-Monitoring & Human Human Reintegration Technology Robotics Psych Health Technologies Performance Performance Optimization MAJ Talbot Dr. Lai Dr. Gilbert Dr. Shore Mr. Turner Dr. Cardin Medical Health Imaging Information Genomics International Technologies Technologies Computational Nano-Medicine & Regenerative / Proteomics Health Biology Biomaterials Medicine LCDR Steffensen Dr. Lai Dr. Nisson Ms. Barrigan Dr. Reifman Dr. Grundfest Dr. Pacifico Medical Infectious Logistics Blood Products Trauma Neurotrauma Vision Research Disease Acoustic & Safety Trauma Dr. Broderick Dr. Golanov Mr. Read Dr. Carney Mr. DePasquale Mr. Malloy Dr. Holtel Slide 11 of 37 UNCLASSIFIED
  • 13. Opportunity-Driven Model - Examples • Congressionals - a “Line Item” appears in DOD Authorization / Appropriation Bills • Opportunity / obligation: to shape it to maximize military & scientific relevance while honoring congressional language • SBIR - Authoring of Small Business Innovative Research “topics” • Opportunity: proactively submit research topics to DOD / Army to “fill gaps” • Augmentation funding - Someone submits a hot, innovative idea • AAMTI - Army Med Dept Medical Training Initiative • JPC1-MedSim - Joint Program Committee 1-MedSim UNCLASSIFIED
  • 14. Turning to medical simulation… UNCLASSIFIED
  • 15. Why We Started – Reason #1 To Improve Trauma Training •100,000 military medical personnel must practice battlefield trauma care skills* (Source: GAO Rpt, NSIAD-98-75, DOD Training in Civilian Trauma Centers) •Good News – not enough trauma patients •Bad News – not enough trauma patients, for they ARE a training opportunity •Solution: Virtual patients UNCLASSIFIED
  • 16. Why we Started – Reason #2 To Reduce the Errors • IOM report - 1999: >45,000 deaths due to errors - Medical errors 7th leading cause of U.S. death… • HealthGrades, 27 Jul 04: 195,000 deaths/yr, $6B annual costs, 6th most common death • ENT: 45 % report errors committed: 37% “Classification and Consequences of Errors in Otolaryngology “ serious harm, 9% fatal -Rahul K. Shah, et al, The Laryngoscope, August 2004 Slide courtesy of Dr. Steve Dawson, CIMIT Simulation Group UNCLASSIFIED November 09
  • 17. Long-Term Vision for Simulation-based Training • To facilitate a paradigm shift in medical training, a Grand Challenge revolution… • FROM subjective assessment of clinical skills • TO a curriculum-aligned, metrics-driven, objective system of assessment based on demonstrated proficiency to perform skills for which health care personnel have been trained. UNCLASSIFIED
  • 18. Integrated Research Team – Feb 00 •70-person IRT (government, academia, & industry) • Strategic ROAD MAP resulted • 4 general areas for research identified • Became basis of TATRC portfolio to this day UNCLASSIFIED
  • 19. Basis for Road Map: Multiple Needs, Multiple Technologies PC-based Interactive Multimedia Digitally Enhanced Mannequins Part- Task Trainers / Virtual Workbench es Total Immersion Virtual Reality UNCLASSIFIED
  • 20. PC-Based Interactive Multimedia Maintenance of Certification Social Behavior – Combat Casualty – Chemical War - SimQuest AVESSS / Second Life - Forterra (now SAIC) CBRNE Interactive Psychological Health Education Cognitive Learning & Logistics - Patient Interactions & Logistics - Total Immersive Software, Inc (JESSEY) Office of Naval – Applied Research Associates, Inc, Research (PULSE) Virtual Heroes Division (HumanSim) UNCLASSIFIED
  • 21. Digitally Enhanced Mannequins Next Generation Injury Creation - The Virtual Reality Medical Center Combat Medic Training System – Center for Integration of Medicine & Innovative Technologies (CIMIT) - (COMETS) Compartment Syndrome Task Trainer - Operative Experience UNCLASSIFIED
  • 22. Part-Task Trainers / Virtual Reality Systems Burr Hole Simulator - SimQuest Virtual Cricothyroidotomy - National Capital Area Medical Simulation Center 3-D Anatomical Model - ArchieMD, Inc. Compartment Syndrome Sim & Didactics - Touch of Life (ToLTECH) UNCLASSIFIED
  • 23. Total Immersive Virtual Reality System Wide Area Virtual Environment (WAVE)- National Capital Area Medical Simulation Image from www.simcen.org/VME%20Lab/projects/wave/index.html iGlove Robotic Controller - AnthroTronix Tactical Digital Holograms: technology Ultra High Resolution Display matured under contract with the Army - eMagin -Zebra Imaging UNCLASSIFIED
  • 24. Technical Strategy • Identify Enabling Technologies • R&D them into components that can be… • Integrated into… • Systems of simulation-based training that can be… • Validated to determine their training effectiveness, so OTHER military organizations can… • Transition / sustain them for military health care, from the foxhole to the operating room and beyond UNCLASSIFIED
  • 25. Enabling Technologies •Real-time in vivo tissue property measurement •Haptics •Tissue-tool interactions •Graphics, visualization •Augmented Reality •Learning systems •Metrics development •Learning transfer & assessment •Open source architecture •Olfactory technologies •Gaming Technologies UNCLASSIFIED
  • 26. AFSIM: Introduction to the Armed Forces Simulation Institute for Medicine Director: Thomas B. Talbot, MAJ, USA, MC Telemedicine and Advanced Technology Research Center (TATRC) United States Army Medical Research & Materiel Command (USAMRMC) UNCLASSIFIED
  • 27. AFSIM ORIGINS • Department of Defense Health Affairs Initiative • Defense Health Program Dollars ~$30-45M/year (contingent on receipt of funding) • Improve medical education & readiness for all services • ULAMET – JAT Report • ASBREM Committee • JTCG-1 • JPC-1 • Initial Mandate 1. Live Tissue/Sim Research, 2. Curricula and Standards, 3. Virtual Human Coaching for OIF/OEF Veterans, 4. Ophthalmology & Anesthesia, and 5. Medical Simulation Systems. UNCLASSIFIED
  • 28. Joint Program Committee 1 • JPC-1 Tri-Service • Chair: COL Karl Friedl, PhD • Tri-Service Programmatic Committee Transparent • TATRC is primary execution agent Ethical • JPC-1a Medical Simulation & Training • Chair: MAJ Thomas B. Talbot, MD Visionary • Efforts spawned AFSIM • JPC-1b Health Information Technology Collaborative • Chair: Steve Steffensen, MD (Former Navy) Responsive • JPC-1c Decision Support Tools & Modeling • Chair: Jaques Reifman, PhD Strategic UNCLASSIFIED
  • 29. JPC-1a Voting Members US Army - PEOSTRI US Air Force - Air Education Training Command US Army - Central Simulation Committee USUHS - Natl Capital Area Med Sim Cen AMEDD C&S - Directorate, Combat Medic Training AMEDD C&S - US Army EMS Office US Navy - Office of Naval Research US Air Force - Air Education Training Command US Army - RDECOM / STTC DARPA Medical Education and Training Campus (METC) Office of Naval Research UNCLASSIFIED
  • 30. JPC-1a Advisors US Navy - Naval Postgraduate School Monterey Dept of Homeland Security DOD; USA OTSG DOD Patient Safety Office TATRC / Brussels Belgium USUHS - Natl Capital Area Med Sim Cen Defense Center of Excellence for Psych Health & TBI DOD Patient Safety Office HQ USAMRMC OASD (HA) UNCLASSIFIED
  • 31. Ground Rules • NO PROMISES • We cannot obligate the US Government to anything based upon discussions during this event • Decisions, plans and budgets are subject to approval and changes by headquarters at any time • The steering committee can and will change plans • Pending Awards • We cannot provide details on programs under review for selection or projects pending award • We want your input • We shall inform industry and academia of our efforts and wish to glean your insights on how you think we can accomplish our strategic objectives UNCLASSIFIED
  • 32. JPC-1a Structure Combat Casualty Medical Practice Training Initiative Initiative AFSIM Developer Tools Patient Focused for Medical Initiative Education UNCLASSIFIED
  • 33. Combat Casualty Training Initiative Strategic Building Blocks (CCTI) Systems & research to improve pre-hospital trauma training and maintain lifesaver resilience Superior Battlefield Integrate very advanced training technology Lifesaving DTME Capability into medical training & simulation facilities of PFI all services Advanced Training Virtual Reality individual and team training to MPI Systems replicate chaotic and mass casualty scenarios in a safe environment Tri- Service Resilience Compatible Research & Curricula Integration Real world benefits: -Pre-hospital assets continuously in a high state of readiness Simulator Olfaction & Gap R&D to -Potential to replace animal training equal animal PTSD Research efficacy -Training geared towards psychological Animal / Improved resilience during and after deployments Simulator Task Improved Learning -Improved safety by statistically valid Comparison (CCTC) Trainers & Manikins Metrics recognition of lost skills UNCLASSIFIED
  • 34. FY11 Combat Casualty Training Initiative • Combat Casualty Training Consortium Program Announcement - $15.2M • Timeline Released Summer 2010 Closed November 19th, 2010 Scientific Review Complete Programmatic Review Underway Selection Board February 24th, 2011 Award(s) Anticipated Late Summer 2011 • Critical Research Areas • Trauma Airway • Hemorrhage • Emergency Medical Skills (Nerve Agent Casualty) • Goals • Live Animal / Simulator Comparative Research • Curriculum Development • Simulator System Gap Analysis UNCLASSIFIED
  • 35. FY10 Combat Casualty Training Initiative Combat Casualty Training Initiative Project Perfomer Budget Live tissue / sim - metrics research NAVAIR $ 369,835 BCT-3 live tissue / sim study Brooke Army Medical Center $ 250,000 Multiple Amputee Trauma Trainer STTC Orlando $ 756,000 Rapid trauma skills training Operative Experience $ 497,750 COMETS improved capabilities for combat medics CIMIT Sim Group $ 449,901 Maxillofacial & Ophthalmology Trauma Trainer Pending Extramural Award Pending Award TOTAL: ~$ 5,550,000 UNCLASSIFIED
  • 36. CCTI FY11 Plans • CTCC PA Award $15.2 M • Extend BCT-3 research efforts ($1.8M) ~$17 Million UNCLASSIFIED
  • 37. CCTI FY12 Plans • No Program Announcement Plans for FY12 • Consider PA in FY13 • CTCC is just starting and will not produce feedback by FY12 to know where to add additional funding to CTCC • Should we start a new advanced training platform in FY12? • Advanced open architecture manikin • Possible, but we don’t have research data to know everything it will need • Advanced talking task trainers • It is a stronger possibility. What would we do? UNCLASSIFIED
  • 38. Medical Practice Initiative Strategic Building Blocks (MPI) Development of medical training systems & competency assessment for sustained military medical readiness. Advanced Doctor Education PFI Continuous Observation of Medical System (COMRADE DTME Records for Advanced Doctor Education ) (COMRADE) Virtual Human Standardize Real-time specialty specific evaluation for d Patients loss of skills & knowledge JPC-1b EHR JPC-1c Education & Decision Real world benefits: CCTI Reference Support Integration Integration -Reduced cost for training Educational -Reduced liability Content Military Serious Medical -Cost savings by replacing expensive Games for Lifecycle standardized live patient teaching Training Counselor cases with reusable virtual human (DKO) patients Loss of Common Curricula & Military Skills. -Improved Tri-Service medical Retraining Metrics Medical Simulation interoperability & (Tri Service Masters Competence Consortium) -Leverages Electronic Health Record system as training portal -Can use AHLTA or another EHR UNCLASSIFIED
  • 39. Continuous Observation of Medical Records for Advanced Doctor Education (COMRADE) Medical Record EHR Development Extensive hyper-linking and floating reference info Meaningful visual formats Advanced Clinical practice guideline based formats when appropriate Doctor Intelligent summarization of data Education System Health records that communicate (COMRADE) Visual decision support tools Intelligent Assessment & Tutoring System tracks procedures, CME, findings & assessments to determine physician exposures against list of expected knowledge by their specialty board System determines if lack of exposure is sufficient for a refresher in a certain area System schedules a teaching case or a virtual patient into the physicians patient schedule System recommends periodic procedure observed training Automatic & documented maintenance of certification UNCLASSIFIED
  • 40. FY10 Medical Practice Initiative Medical Practice Initiative Project Perfomer Budget Medical Training Evaluation and Review (MeTER) RDECOM / STTC $515,000 Training Outcomes Research Metrics UCLA / CRESST $450,000 Hospital disaster simulator - CBRNE Based Breakaway Games $2,671,322 Redeployment skills evaluation Madigan Army Medical Center $800,000 Tri Service Medical Simulation Training Consortium Air Force / ONR / USUHS $2,500,000 Anesthesia and Anaphylaxis for Physicians Applied Research Associates $1,900,000 Virtual Sick Call RDECOM / STTC $773,000 TOTAL: $ 9,609,322 UNCLASSIFIED
  • 41. MPI FY11 Plans • Navy Redeployment Skills Degradation • Multiple Amputee Trainer (MATT) final year • Olfaction training device & study • Medical Simulation Training Consortium Years 2-3 • Simulation for Futuristic Surgery (VR Urology) • CBRNE Hospital Incident Management Radiological Scenarios • Ocular Craniofacial Manikin Advanced Development • Medical Simulation Master’s Degree Program • Student Innovations in Medical Simulation (Skunk Works) • Unfunded request for large web portal hosted by Air Force ~$13.5 Million UNCLASSIFIED
  • 42. MPI FY12 Plans • We would like a program announcement for FY12 • PA would be major effort for AFSIM for the year • Things we are thinking about: • How can electronic health record data be used to discern a physician’s educational needs? • Military Medical Career Training Guidance • How can we deliver training content with all the things we want to do on government computer systems? • For what applications are Virtual Reality & networked training appropriate and efficacious? • Are there things going on in the civilian world that we can leverage? UNCLASSIFIED
  • 43. Patient Focused Initiative Strategic Building Blocks (PFI) Advanced user interface and interactive technologies for healthy living, medical practice , MPI patient rehabilitation & training Advanced CCTI Virtual Reality & Augmented Reality Training Advanced technology for training Technology applications leveraging investments of DoD and Government Partners Virtual Human Patients & Coaches Adapts therapeutic technology targeting warfighter readiness and mental health Mobile Physical & Technology Neurocognitive Integration for Therapy Real world benefits: Health & Applications Training -High impact development at reduced costs, especially for VR-based training JPC-8 NIH – Virtual Rehabilitation, -Technology highly adaptable to Reality for Obesity & Physical and Neurocognitive training Diabetes Rehabilitation -Direct injured warfighter benefit -Traumatic Brain Injury ICT simCoach -Psychological Health (PTSD, Suicide) DARPA – Game Industry & Emotionally Healing Heroes Technology Expressive -Physical Therapy Characters -Adaptation of mobile and tele-health technology PARTNERSHIPS UNCLASSIFIED
  • 44. FY10 Patient Focused Initiative Patient Focused Initiative Project Perfomer Budget Vitalize Game Based Wellbeing (Kinect-based Physical Therapy Coach) Blitz Games Studios $4,325,024 Refining medical outcomes deployment: Naval Health Research Center $500,055 TBI Rehabilitation Surface Blue Marble $1,374,447 Olfaction & Resilience Research (10 studies 6.1) Monell Chemical Senses Center $4,000,000 TOTAL: $10,199,526 UNCLASSIFIED
  • 45. PFI FY11 Plans • Natural Language Processing for Virtual Humans • 3D motion tracking for rehabilitation • DARPA: Healing Heroes ~$5 Million UNCLASSIFIED
  • 46. PFI FY12 Plans • We want to consider a program announcement in FY12 • Things we are thinking about: • Virtual Humans for Coaching • Assessment of off the shelf and easily hacked technology for the rehabilitation, assessment and therapy environments • Mobile Technology • Constantly proposing SBIR topics in this area UNCLASSIFIED
  • 47. Developer Tools for Medical Education Strategic Building Blocks (DTME) Transformational open source advanced developer tools to reduce MPI development costs and democratize access to technology. CCTI Affordable Training Based on the need to greatly reduce the Content Creation burden to develop interactive medical & CCTI surgical training content. Character AI Open Source (OS) promotes low cost and innovation Surgical VR Advanced Training Real world benefits: System Displays & Interfaces -Greatly reduced development costs Standards Online -Saves development time Portal -Facilitates content creation OS Practical Physiology OS Speech & Motion -Greatest need as program matures Engine Recognition -Opens development to a more diverse and wider community OS VR OS Natural OS Medical -Reduced system procurement costs Language Anatomy & Haptic Asset Processing Library -Reduces redundant development Platform UNCLASSIFIED
  • 48. FY10 Developer Tools for Medical Education Developer Tools For Medical Education Perfomer Budget Dynamic Holographic Displays & 3D in medical education RDECOM & PEOSTRI $ 3,000,039 Tri-Service Open Platform for Simulation USUHS $ 2,000,000 TOTAL: $ 5,000,039 UNCLASSIFIED
  • 49. DTME FY11 Plans • Advanced VR Eyewear Display ~$4 Million UNCLASSIFIED
  • 50. DTME FY12 Plans • We want to consider a program announcement in FY12 • Things we are thinking about in the near term: • Open Source Practical Physiology Engines • Open Source Visual Human toolkit for VR surgical applications • Things we are thinking about down the road • Open Source Virtual Character Behavior Engine • Medical Asset Exchange (Radiographs, sounds, slides, etc.) • Character emotional display, speech & movement tools • Natural Interface Tools, Facial Recognition for Emotion, etc. UNCLASSIFIED
  • 51. Summary • Many thanks to the Games for Health community. You are part of an unprecedented opportunity to shape the future of medical training • We welcome your input • Make the most of the week! • Harvey.magee@tatrc.org UNCLASSIFIED
  • 52. Opportunity-Driven Model - Examples • Congressionals - a “Line Item” appears in DOD Authorization / Appropriation Bills • Opportunity / obligation: to shape it to maximize military & scientific relevance while honoring congressional language • SBIR - Authoring of Small Business Innovative Research “topics” • Opportunity: proactively submit research topics to DOD / Army to “fill gaps” • Augmentation funding - Someone submits a hot, innovative idea • AAMTI - Army Med Dept Medical Training Initiative • JPC1-MedSim - Joint Program Committee 1-MedSim UNCLASSIFIED
  • 53. Congressional Process • Our role is to manage congressionally supported research as directed. • Constituents’ opportunity is to educate and inform your congressional representative . Government officials are prohibited from involvement with constituents in seeking to influence Congress. •If you have questions, contract Mr Tony Story, TATRC’s congressional liaison. •301-619-7033 •tony.story@tatrc.org UNCLASSIFIED
  • 54. Locate the USAMRMC Broad Agency Announcement (the “BAA”) • http://www.tatrc.org • Click “Funding” at top-line menu. • On Funding Opportunity page, click “USAMRMC BAA 10-1”. • Click “Click here to visit the USAMRMC Broad Agency Announcements (BAA) Website”. • Or just go here: http://www.usamraa.army.mil/pages/baa_forms/index.cfm • READ and UNDERSTAND IT! • You can take it from there. UNCLASSIFIED
  • 55. Questions ? UNCLASSIFIED