Technology in Disaster Environments (TiDE) Multi-Topic

In support of COVID-19 surge response, the Telemedicine & Advanced Technology Research Center (TATRC) has funded the development and deployment of the National Emergency TeleCritical Care Network (NETCCN), a set of cloud-based, low-resource, stand-alone health information management systems for the creation and coordination of flexible and extendable “virtual critical care wards.” These high acuity, virtual wards bring high-quality critical care [expertise] capability to nearly every bedside, be it healthcare facility, field hospital, or gymnasium regardless of geographic location. Based on available communication networks, mobile technologies and cloud computing, NETCCN platforms support the extension of high-quality intensive care to locations that lack adequate critical care expertise or resources

necessary for care of COVID-19 patients.

In anticipation of scaled response to COVID-19, each of these teams has validated their individual platforms through simulation testing and, through the MTEC consortium, is presently delivering tele-critical care for COVID from their clinical networks through their NETCCN platforms (“apps”) to healthcare organizations.

TATRC and the U.S. Department of Health and Human Services (HHS) Assistant Secretary for Preparedness and Response (ASPR) have established a Memorandum of Agreement (MOA) to incorporate NETCCN into broader COVID surge response systems and processes. This partnership will also support the addition of capabilities to the NETCCN platform and study its deployment on a local, regional and national basis for COVID and other disasters.

TATRC has identified the addition of “virtual hospital” capabilities to NETCCN platforms as a key strategy to enhance the scope and impact of tele-critical care support to resource-limited environments. The ultimate objective of a virtual hospital would be to have remote control access to all bedside devices and availability to all data from bedside devices. By adding these advanced capabilities through the NETCCN platforms, we can address resource limitations and increase capability and capacity of healthcare delivery during a disaster. By accelerating development and inclusion of medical devices that utilize interoperable, remote control, and autonomous technologies, we can augment the knowledge, skills, and abilities of local caregivers.

Currently, tele-critical care providers (i.e., clinicians delivering critical care at a distance) have limited ability to monitor, assess, and control the operation of essential medical devices (e.g., physiologic monitors, intravenous (IV) pumps, ventilators) used in the care of COVID-19 patients due to proprietary interfaces, absence of remotely controllable functions, and the need for custom licensing agreements.

TATRC has also identified the need to measure NETCCN performance and to identify and rapidly exploit improvement opportunities as vital to the scaling and impact of the initiative in the fight against COVID. And importantly, establishing a Technology in Disaster Environments (TiDE) continuous learning system for iteratively improving disaster healthcare support during this disaster can inform care in the civilian context for future disasters and in optimizing military healthcare during large scale combat operations (e.g., massive numbers of casualties).

This RPP is focused on the following two focus areas:

  1. FOCUS AREA #1: Accelerating Medical Device Interoperability and Autonomy (MDIA) – This topic is focused on accelerating mechanical ventilator and/or infusion pump interoperability, remote control and integration into NETCCN (National Emergency TeleCritical Care Network) platforms in support of tele-critical care of COVID-19 patients.
  2. FOCUS AREA #2: Technology in Disaster Environments (TiDE) Learning Accelerator (TLA) This topic is focused on developing performance measures and accelerating the availability and application of insight for use in improving delivery of tele-critical care through NETCCN and to technology in civilian and military disaster and mass casualty environments more broadly.

The research project award recipients were selected from the Offerors who responded to MTEC’s Request for Project Proposals (21-04-TiDE).

Accelerating the Improvement of Disaster Medicine: From Performance and Data Sciences to Field-Level Results

Project Team: Indiana University

Award Amount: $2.28M

Project Duration: 12 months

Project Objective: Our hypothesis is that performance science, data science and communications technologies can (a) provide data-driven measures that give an accurate picture of the effectiveness of technology-enabled disaster medical response and how it can be improved for the current and future responses, (b) drive the identification of best practices for technology-enhanced medical response, and (c) support research into best practices for the development of telemedicine and medical technologies themselves. The objective is to test the hypothesis for the current COVID19 crisis, with the intent to deliver immediate value through an initial set of measures, medical best practices, and research capabilities leading to insights and best practices.

Remote Control of Mechanical Ventilators

Project Team: Nihon Kohden OrangeMed

Award Amount: $1.10M

Project Duration: 13 months

Project Objective: The offeror proposes to develop a solution for remotely controlled ventilator on the basis of its existing NKV-550 ventilator. The NKV-550 ventilator currently can be remotely controlled through a wired connection for clinical use as cleared by FDA in 2018, and can be remotely controlled through an ethernet connection for internal manufacturing testing purpose. The project objective is to successfully develop, test, and document the NKV-550 ventilator remote control function in collaboration with NETCCN performers, cybersecurity experts, and medical device interoperability experts.

Remote Control of Bedside Medical Devices

Project Team: Cognitive Medical Systems

Award Amount: $0.85M

Project Duration: 16 months

Project Objective: Team Cognitive envisions a series of medical devices (ventilator and IV pump) that providers can remotely control across a NETCCN architecture to augment the capacity of local bedside providers to care for sick and

injured patients. For example, a pulmonologist will be able to fine tune Positive End Expiratory Pressure (PEEP) to ensure adequate lung inflation. Similarly, a critical care specialist will be able to adjust a dopamine drip to better support blood pressure by increasing an IV pump’s rate.

A Framework for Safe Remote Control of Medical Devices for Tele-Critical Care

Project Team: Massachusetts General Hospital

Award Amount: $0.71M

Project Duration: 23 months

Project Objective: We propose introducing a generic, standards-based protocol for remote control of devices including ventilators, infusion pumps, and patient monitors. We will work with the NETCCN teams to identify clinical scenarios for remote and autonomous control of these devices and work with manufacturers to prototype an implementation of this system. This proposal has significant short-term contributions, including incorporation of existing devices and capabilities into the NETCCN platforms within a few months, and a long-term contribution of an interoperable control protocol and associated risk management framework that will enable manufacturers to more quickly and easily develop and bring to market remote and autonomously controllable devices.