Strategically, the HRP conducts research and technology development that: 1) enables the development or modification of Agency-level human health and performance standards by the Office of the Chief Health and Medical Officer (OCHMO) and 2) provides Human Exploration Operations Mission Directorate (HEOMD) with methods of meeting those standards in the design, development, and operation of mission systems.
HRP research focuses on reducing crew health and performance risks for exploration missions. In addition, HRP research gathers the data necessary to understand and mitigate the long-term health risks to the crew, to allow the update of specific crew health standards for each mission scenario, to support crew selection, and to address any rehabilitation requirements. The OCHMO owns and sets the standards upon which the HRP research efforts are based. The Transition to Medical Practice process defined by the OCHMO is used to review the HRP deliverable countermeasures and technologies prior to their operational use.
HRP technology development advances medical care and countermeasure systems for exploration and vehicle development programs’ missions. The HRP also develops and matures operational concepts to inform requirements for the design and operation of space vehicles and habitats needed for exploration. This includes requirements for displays and controls, internal environments, operations planning, habitability, and methodologies for maintaining crew physical and mental health as well as physical and cognitive capabilities.
The HRP is managed at the Johnson Space Center (JSC) and comprised of six research and technology development projects. These projects provide the program knowledge and capabilities to conduct research addressing the human health and performance risks as well as advancing the readiness levels of technology and countermeasures to the point of transfer to the customer programs and organizations. The six projects within the HRP are referred to as Program Elements throughout this document. Each Element is managed at the JSC with research and technology development expertise provided by JSC, Ames Research Center (ARC), Glenn Research Center (GRC), the Langley Research Center (LaRC), and the Kennedy Space Center (KSC), as well as other Agencies, institutions and organizations identified in the following Element descriptions. The six Elements are:
1) Space Radiation (SR) Element – The SR Element performs investigations to develop the scientific basis to accurately predict and mitigate health risks from the space radiation environment. This knowledge yields recommendations to permissible exposure limits, assessment/projection tools/models of crew risk from radiation exposure, and models/tools to assess vehicle design for radiation protection. The SR Element conducts research using accelerator-based simulation of space radiation. The SR Element explores and develops countermeasures to the deleterious effects of radiation on human health. The LaRC and ARC contribute to the SR Element.
2) Behavioral Health and Performance (BHP) Element – The BHP Element identifies and characterizes the behavioral and performance risks associated with training, living and working in space, and returning to Earth. The BHP Element develops strategies, tools, and technologies to mitigate these risks.
3) Exploration Medical Capability (ExMC) Element – The ExMC Element is responsible for defining requirements for crew health maintenance during exploration missions, developing treatment scenarios, extrapolating from the scenarios to health management modalities, and evaluating the feasibility of those modalities for use during exploration missions. The ExMC Element is also responsible for the technology and informatics development that will enable the availability of medical care and decision systems for exploration missions. GRC, LaRC and ARC contribute technology development and clinical care expertise to the ExMC Element.
4) Space Human Factors and Habitability (SHFH) Element – The SHFH Element is focused on the human system in space environments: how do humans interface with spacecraft systems, and what environmental and habitation factors are essential to maintain crew health and performance? The SHFH Element has three main focus areas: space human factors engineering, advanced environmental health, and advanced food technology. The ARC contributes to the SHFH Element.
5) Human Health Countermeasures (HHC) Element – The HHC Element is responsible for understanding the physiological effects of spaceflight and developing countermeasure strategies and procedures. The Element provides the biomedical expertise for the development and assessment of medical standards and vehicle and spacesuit requirements dictated by human physiological needs. In addition, the HHC Element develops a validated and integrated suite of countermeasures for exploration missions to ensure the maintenance of crew health during all mission phases. The ARC and GRC contribute to the HHC Element as well as international agencies cooperating on joint flight proposals, reduced gravity studies, and collaborative bed rest studies.
6) International Space Station Medical Projects (ISSMP) Element – The ISSMP Element is responsible for managing all ISS and ground analog human research activities, including those integrated with operational medical support of the crews, and to ensure research tasks are completed. The ISSMP is responsible for all planning, integration, and implementation services for HRP research tasks and evaluation activities requiring access to space or related flight resources on the ISS, Soyuz, Progress, Multi-Purpose Crew Vehicle (MPCV), commercial vehicles and ground-based spaceflight analogs. This includes support to related pre- and postflight activities. The ARC contributes to the ISSMP with technical support to experiment management, hardware development, and international partner integration. KSC provides support for baseline data collection requirements development for future crew vehicles.
The work performed within the six Elements is supported by numerous collaborative efforts with academia and international agencies. Relationships with the ISS Program, the National Space Biomedical Research Institute (NSBRI), the Brookhaven National Laboratory (BNL), and the University of Texas Medical Branch (UTMB) are critical to the HRP successfully meeting its objectives. The HRP also maintains collaborative relationships with the International Partners through various working groups. These relationships enhance the research capabilities and provide synergy between the research and technology efforts of different countries.
","programId":273,"responsibleMd":{"organizationId":9526,"organizationName":"Space Operations Mission Directorate","acronym":"SOMD","organizationType":"NASA_Mission_Directorate","canUserEdit":false,"locationEdit":false,"organizationRolePretty":"","organizationTypePretty":"NASA Mission Directorate"},"responsibleMdOffice":9526,"stockImageFileId":28253,"title":"Human Research Program","acronymOrTitle":"HRP"},"description":"Key to this system is the collection and presentation of data. This has required: 1) rewriting the iRevive GUI and database codebase using current technology; 2) defining the communication protocol between the LTM and iRevive; and 3) building a LTM simulator to debug the iRevive-LTM communication protocol, which was hardcoded into the LTM. In the past year we have rewritten the GUI and database for iRevive to increase the speed, portability, and maintainability of the codebase, which is now in Python for improved interaction with the Internet and the world wide web. The GUI has improved graphics and more complete pull down menus, to facilitate ease of use and generate a more complete record with less user training required. Another focus has been defining a communication protocol for the LTM to exchange data with iRevive. This protocol was implemented as an LTM simulator for testing, debugging, and then in a FPGA. Our approach defined a base protocol to transmit parametric vital sign information. It was then extended to transmit wave type data, alarms, device configuration, and connection initiation. This effort produced a high-level protocol specification. We are using traditional Internet protocols, including UDP at the transport layer to exchange end-to-end packets. This information includes a sequence number, time stamp, packet type, and meta information describing the data from the LTM. The packet format defines all parametric vital sign data from each device module in the LTM, including SpO2, EtCO2, temperature, invasive and non-invasive blood pressure, ECG, and ventilator settings. These packets contain meta information, which describes attributes such as when measurements should be flagged with an alarm and the measurement units. The packet format also defines device alarms including their priority, how an alarm is indicated to the user (i.e., audible and latching), and information unique to each LTM device module. Work was also done to define the protocols and processes required for waveform data as well as an initiation protocol. Waveform data will be displayed with allowable ranges. Initiation protocols will synchronize these ranges and timing as well as provide the connection between LTM and iRevive. As the funding period is now complete, and the defined goals reached, the technical, funding, and schedule risk for this proposal are by definition low or non-existent.","benefits":"Civilian pre-hospital providers (e.g., paramedics and emergency medical technicians) collect and act upon a wide variety of complex visual clues, while monitoring and adjusting to continually changing sets of vital signs. Pre-hospital vital sign information in the form of trending data is rarely integrated into the patient care record, so how the vital signs change in response to specific treatment measures is largely undocumented and poorly understood. As a consequence, the care that is provided to a patient in the field is anticipatory and reactive. It is not time sensitive and the accompanying patient medical record is oftentimes incomplete. Healthcare providers do not give medications or adjust the ventilator and IV fluids as often or as accurately as a smart, vigilant system might and, as a result, patients likely do not respond or recover as quickly as they could. We have developed a fully integrated system for mobile critical care patient support and documentation. The iRevive-LTM system is composed of physiological sensors, monitors, and therapeutic hardware devices, linked by a suite of software applications. The components integral to the LTM include: a ventilator; 3/5/12-lead ECG (electrocardiogram); pulse oximeter; noninvasive blood pressure (NIBP); end-tidal carbon dioxide (EtCO2); patient temperature; invasive arterial and intracranial pressure monitoring capabilities; Ethernet communications; closed-loop control of oxygenation (and soon ventilation and IV fluid control); an integrated electronic medical record (iRevive) for clinical data storage and export; alarming, and smart help. The LTM supports up to three external intravenous (IV) pumps and is designed to support other to be developed noninvasive monitors, all connected via powered-USB ports. It supports several additional modules, including an oxygen concentrator, patient warming, and an anesthesia control module. Software will oversee a growing number of autonomous care applications within the integrated system, which will reduce the need for constant attention by a healthcare provider or crew medical officer. While space flight design requirements are of paramount importance to the current project, we are cognizant of U.S. military funding and civilian needs for improved transport monitoring technology. The small, lightweight, rugged, low power design specifications for space flight are equally important here on Earth. A transport monitor that goes into space should have facility for remote calibration and maintenance, as should a transport monitor that is deployed on the battlefield or in other remote locations. Incorporation of redundant systems, automated alarms and, increasingly, closed loop control algorithms will be essential. The value of consolidating patient monitoring, support, and documentation into a single system, capable of automatically collecting and transmitting real-time patient care data, cannot be overemphasized. Integrating these data streams has many advantages, not only in providing real-time information display both locally and centrally for triage decision support, but in trauma system development. More importantly, the physiologic and electronic patient care data that will be captured by the iRevive-LTM system will be fully integrated and time synchronized. New state-of-the-art machine learning, feature extraction, and advanced statistical methods are showing great promise in analyzing these types of complex data sets, uncovering many important, previously hidden physiological relationships and treatment effects. As these relationships are further defined and understood, our models of health and disease will become more complex and accurate. They will provide more reliable, real-time insight into the current and predicted future status of our patients. In time, machine-based comprehension of semantic clinical information together with real-time physiological data will lead to the development of fully autonomous patient care systems.","releaseStatus":"Released","status":"Completed","viewCount":769,"destinationType":["Moon_and_Cislunar","Mars"],"trlBegin":4,"trlCurrent":6,"trlEnd":6,"lastUpdated":"10/27/20","favorited":false,"detailedFunding":false,"projectContacts":[{"contactId":228519,"canUserEdit":false,"firstName":"John","lastName":"Crossin","fullName":"John P Crossin","fullNameInverted":"Crossin, John P","middleInitial":"P","receiveEmail":"Subscribed_User","projectContactRole":"Principal_Investigator","projectContactId":35468,"projectId":23271,"programContactRolePretty":"","projectContactRolePretty":"Principal Investigator"},{"contactId":98208,"canUserEdit":false,"firstName":"Daniel","lastName":"Myung","fullName":"Daniel Myung","fullNameInverted":"Myung, Daniel","receiveEmail":"Subscribed_User","projectContactRole":"Co_Investigator","projectContactId":33411,"projectId":23271,"programContactRolePretty":"","projectContactRolePretty":"Co-Investigator"},{"contactId":161903,"canUserEdit":false,"firstName":"George","lastName":"Beck","fullName":"George J Beck","fullNameInverted":"Beck, George J","middleInitial":"J","email":"george.j.beck@jpl.nasa.gov","receiveEmail":"Subscribed_User","projectContactRole":"Co_Investigator","projectContactId":23403,"projectId":23271,"programContactRolePretty":"","projectContactRolePretty":"Co-Investigator"},{"contactId":311591,"canUserEdit":false,"firstName":"Mark","lastName":"Gaynor","fullName":"Mark Gaynor","fullNameInverted":"Gaynor, Mark","receiveEmail":"Subscribed_User","projectContactRole":"Co_Investigator","projectContactId":39392,"projectId":23271,"programContactRolePretty":"","projectContactRolePretty":"Co-Investigator"},{"contactId":448989,"canUserEdit":false,"firstName":"Steven","lastName":"Moulton","fullName":"Steven Moulton","fullNameInverted":"Moulton, Steven","receiveEmail":"Subscribed_User","projectContactRole":"Co_Investigator","projectContactId":13252,"projectId":23271,"programContactRolePretty":"","projectContactRolePretty":"Co-Investigator"},{"contactId":463624,"canUserEdit":false,"firstName":"Thomas","lastName":"Hatfield","fullName":"Thomas R Hatfield","fullNameInverted":"Hatfield, Thomas R","middleInitial":"R","email":"thomas.hatfield@nasa.gov","receiveEmail":"Subscribed_User","projectContactRole":"Co_Investigator","projectContactId":29394,"projectId":23271,"programContactRolePretty":"","projectContactRolePretty":"Co-Investigator"}],"programContacts":[{"contactId":103847,"canUserEdit":false,"firstName":"David","lastName":"Baumann","fullName":"David K Baumann","fullNameInverted":"Baumann, David K","middleInitial":"K","email":"david.k.baumann@nasa.gov","receiveEmail":"Subscribed_User","programContactRole":"Program_Director","programContactId":181,"programId":273,"programContactRolePretty":"Program Director","projectContactRolePretty":""}],"leadOrganization":{"organizationId":4853,"organizationName":"Johnson Space Center","acronym":"JSC","organizationType":"NASA_Center","city":"Houston","stateTerritoryId":29,"stateTerritory":{"abbreviation":"TX","country":{"abbreviation":"US","countryId":236,"name":"United States"},"countryId":236,"name":"Texas","stateTerritoryId":29,"isTerritory":false},"country":{"abbreviation":"US","countryId":236,"name":"United States"},"countryId":236,"zipCode":"77058","projectId":23271,"projectOrganizationId":4781,"organizationRole":"Lead_Organization","canUserEdit":false,"locationEdit":false,"organizationRolePretty":"Lead Organization","organizationTypePretty":"NASA Center"},"otherOrganizations":[{"organizationId":4853,"organizationName":"Johnson Space Center","acronym":"JSC","organizationType":"NASA_Center","city":"Houston","stateTerritoryId":29,"stateTerritory":{"abbreviation":"TX","country":{"abbreviation":"US","countryId":236,"name":"United States"},"countryId":236,"name":"Texas","stateTerritoryId":29,"isTerritory":false},"country":{"abbreviation":"US","countryId":236,"name":"United States"},"countryId":236,"zipCode":"77058","projectId":23271,"projectOrganizationId":4781,"organizationRole":"Lead_Organization","canUserEdit":false,"locationEdit":false,"organizationRolePretty":"Lead Organization","organizationTypePretty":"NASA Center"},{"organizationId":1752,"organizationName":"10 Blade, Inc.","organizationType":"Industry","dunsNumber":"196314244","projectId":23271,"projectOrganizationId":4727,"organizationRole":"Supporting_Organization","canUserEdit":false,"locationEdit":false,"organizationRolePretty":"Supporting Organization","organizationTypePretty":"Industry"},{"organizationId":1753,"organizationName":"Impact Instruments","organizationType":"Industry","projectId":23271,"projectOrganizationId":31693,"organizationRole":"Supporting_Organization","canUserEdit":false,"locationEdit":false,"organizationRolePretty":"Supporting Organization","organizationTypePretty":"Industry"},{"organizationId":1059,"organizationName":"Saint Louis University","organizationType":"Academia","city":"Saint Louis","stateTerritoryId":38,"stateTerritory":{"abbreviation":"MO","country":{"abbreviation":"US","countryId":236,"name":"United States"},"countryId":236,"name":"Missouri","stateTerritoryId":38,"isTerritory":false},"country":{"abbreviation":"US","countryId":236,"name":"United States"},"countryId":236,"murepUnitId":179159,"academicDegreeType":"Private_4_year","projectId":23271,"projectOrganizationId":4730,"organizationRole":"Supporting_Organization","canUserEdit":false,"locationEdit":false,"organizationRolePretty":"Supporting Organization","organizationTypePretty":"Academia"},{"organizationId":1174,"organizationName":"Wyle Laboratories, Inc.","organizationType":"Industry","city":"Houston","stateTerritoryId":29,"stateTerritory":{"abbreviation":"TX","country":{"abbreviation":"US","countryId":236,"name":"United States"},"countryId":236,"name":"Texas","stateTerritoryId":29,"isTerritory":false},"country":{"abbreviation":"US","countryId":236,"name":"United States"},"countryId":236,"zipCode":"77058","dunsNumber":"059728480","projectId":23271,"projectOrganizationId":38766,"organizationRole":"Supporting_Organization","canUserEdit":false,"locationEdit":false,"organizationRolePretty":"Supporting Organization","organizationTypePretty":"Industry"}],"primaryTx":{"taxonomyNodeId":11169,"taxonomyRootId":8817,"parentNodeId":11168,"code":"TX06.3.1","title":"Medical Diagnosis and Prognosis","description":"This functional area provides a suite of medical technologies, knowledge, and procedures that reduce the likelihood and/or consequence of both nominal and off-nominal medical events during exploration missions.","exampleTechnologies":"Emerging screening technologies, preventative countermeasures, low resource imaging modalities, laboratory analysis platforms and assays, sterile fluid generation, medication packaging options and long-term medication storage, medical equipment re-use and in-situ manufacturing, integrated medical equipment and software suite, autonomous clinical care and decision support","level":3,"hasChildren":false,"selected":false,"isPrimary":true,"hasInteriorContent":true},"primaryTxTree":[[{"taxonomyNodeId":11157,"taxonomyRootId":8817,"code":"TX06","title":"Human Health, Life Support, and Habitation Systems","level":1,"hasChildren":true,"selected":false,"hasInteriorContent":true},{"taxonomyNodeId":11168,"taxonomyRootId":8817,"parentNodeId":11157,"code":"TX06.3","title":"Human Health and Performance","description":"Human health and performance technologies and solutions support optimal and sustained performance throughout the duration of a mission and promote the health of the crew before, during, and after a mission.","level":2,"hasChildren":true,"selected":false,"hasInteriorContent":true},{"taxonomyNodeId":11169,"taxonomyRootId":8817,"parentNodeId":11168,"code":"TX06.3.1","title":"Medical Diagnosis and Prognosis","description":"This functional area provides a suite of medical technologies, knowledge, and procedures that reduce the likelihood and/or consequence of both nominal and off-nominal medical events during exploration missions.","exampleTechnologies":"Emerging screening technologies, preventative countermeasures, low resource imaging modalities, laboratory analysis platforms and assays, sterile fluid generation, medication packaging options and long-term medication storage, medical equipment re-use and in-situ manufacturing, integrated medical equipment and software suite, autonomous clinical care and decision support","level":3,"hasChildren":false,"selected":true,"hasInteriorContent":true}]],"technologyOutcomes":[{"technologyOutcomeId":7201,"projectId":23271,"project":{"projectId":23271,"title":"Integration of iRevive with the Lightweight Trauma Module","startDate":"2009-09-01","startYear":2009,"startMonth":9,"endDate":"2011-08-31","endYear":2011,"endMonth":8,"programId":273,"program":{"ableToSelect":false,"acronym":"HRP","isActive":true,"description":"Strategically, the HRP conducts research and technology development that: 1) enables the development or modification of Agency-level human health and performance standards by the Office of the Chief Health and Medical Officer (OCHMO) and 2) provides Human Exploration Operations Mission Directorate (HEOMD) with methods of meeting those standards in the design, development, and operation of mission systems.
HRP research focuses on reducing crew health and performance risks for exploration missions. In addition, HRP research gathers the data necessary to understand and mitigate the long-term health risks to the crew, to allow the update of specific crew health standards for each mission scenario, to support crew selection, and to address any rehabilitation requirements. The OCHMO owns and sets the standards upon which the HRP research efforts are based. The Transition to Medical Practice process defined by the OCHMO is used to review the HRP deliverable countermeasures and technologies prior to their operational use.
HRP technology development advances medical care and countermeasure systems for exploration and vehicle development programs’ missions. The HRP also develops and matures operational concepts to inform requirements for the design and operation of space vehicles and habitats needed for exploration. This includes requirements for displays and controls, internal environments, operations planning, habitability, and methodologies for maintaining crew physical and mental health as well as physical and cognitive capabilities.
The HRP is managed at the Johnson Space Center (JSC) and comprised of six research and technology development projects. These projects provide the program knowledge and capabilities to conduct research addressing the human health and performance risks as well as advancing the readiness levels of technology and countermeasures to the point of transfer to the customer programs and organizations. The six projects within the HRP are referred to as Program Elements throughout this document. Each Element is managed at the JSC with research and technology development expertise provided by JSC, Ames Research Center (ARC), Glenn Research Center (GRC), the Langley Research Center (LaRC), and the Kennedy Space Center (KSC), as well as other Agencies, institutions and organizations identified in the following Element descriptions. The six Elements are:
1) Space Radiation (SR) Element – The SR Element performs investigations to develop the scientific basis to accurately predict and mitigate health risks from the space radiation environment. This knowledge yields recommendations to permissible exposure limits, assessment/projection tools/models of crew risk from radiation exposure, and models/tools to assess vehicle design for radiation protection. The SR Element conducts research using accelerator-based simulation of space radiation. The SR Element explores and develops countermeasures to the deleterious effects of radiation on human health. The LaRC and ARC contribute to the SR Element.
2) Behavioral Health and Performance (BHP) Element – The BHP Element identifies and characterizes the behavioral and performance risks associated with training, living and working in space, and returning to Earth. The BHP Element develops strategies, tools, and technologies to mitigate these risks.
3) Exploration Medical Capability (ExMC) Element – The ExMC Element is responsible for defining requirements for crew health maintenance during exploration missions, developing treatment scenarios, extrapolating from the scenarios to health management modalities, and evaluating the feasibility of those modalities for use during exploration missions. The ExMC Element is also responsible for the technology and informatics development that will enable the availability of medical care and decision systems for exploration missions. GRC, LaRC and ARC contribute technology development and clinical care expertise to the ExMC Element.
4) Space Human Factors and Habitability (SHFH) Element – The SHFH Element is focused on the human system in space environments: how do humans interface with spacecraft systems, and what environmental and habitation factors are essential to maintain crew health and performance? The SHFH Element has three main focus areas: space human factors engineering, advanced environmental health, and advanced food technology. The ARC contributes to the SHFH Element.
5) Human Health Countermeasures (HHC) Element – The HHC Element is responsible for understanding the physiological effects of spaceflight and developing countermeasure strategies and procedures. The Element provides the biomedical expertise for the development and assessment of medical standards and vehicle and spacesuit requirements dictated by human physiological needs. In addition, the HHC Element develops a validated and integrated suite of countermeasures for exploration missions to ensure the maintenance of crew health during all mission phases. The ARC and GRC contribute to the HHC Element as well as international agencies cooperating on joint flight proposals, reduced gravity studies, and collaborative bed rest studies.
6) International Space Station Medical Projects (ISSMP) Element – The ISSMP Element is responsible for managing all ISS and ground analog human research activities, including those integrated with operational medical support of the crews, and to ensure research tasks are completed. The ISSMP is responsible for all planning, integration, and implementation services for HRP research tasks and evaluation activities requiring access to space or related flight resources on the ISS, Soyuz, Progress, Multi-Purpose Crew Vehicle (MPCV), commercial vehicles and ground-based spaceflight analogs. This includes support to related pre- and postflight activities. The ARC contributes to the ISSMP with technical support to experiment management, hardware development, and international partner integration. KSC provides support for baseline data collection requirements development for future crew vehicles.
The work performed within the six Elements is supported by numerous collaborative efforts with academia and international agencies. Relationships with the ISS Program, the National Space Biomedical Research Institute (NSBRI), the Brookhaven National Laboratory (BNL), and the University of Texas Medical Branch (UTMB) are critical to the HRP successfully meeting its objectives. The HRP also maintains collaborative relationships with the International Partners through various working groups. These relationships enhance the research capabilities and provide synergy between the research and technology efforts of different countries.
","programId":273,"responsibleMd":{"organizationId":9526,"organizationName":"Space Operations Mission Directorate","acronym":"SOMD","organizationType":"NASA_Mission_Directorate","canUserEdit":false,"locationEdit":false,"organizationRolePretty":"","organizationTypePretty":"NASA Mission Directorate"},"responsibleMdOffice":9526,"stockImageFileId":28253,"title":"Human Research Program","acronymOrTitle":"HRP"},"description":"Key to this system is the collection and presentation of data. This has required: 1) rewriting the iRevive GUI and database codebase using current technology; 2) defining the communication protocol between the LTM and iRevive; and 3) building a LTM simulator to debug the iRevive-LTM communication protocol, which was hardcoded into the LTM. In the past year we have rewritten the GUI and database for iRevive to increase the speed, portability, and maintainability of the codebase, which is now in Python for improved interaction with the Internet and the world wide web. The GUI has improved graphics and more complete pull down menus, to facilitate ease of use and generate a more complete record with less user training required. Another focus has been defining a communication protocol for the LTM to exchange data with iRevive. This protocol was implemented as an LTM simulator for testing, debugging, and then in a FPGA. Our approach defined a base protocol to transmit parametric vital sign information. It was then extended to transmit wave type data, alarms, device configuration, and connection initiation. This effort produced a high-level protocol specification. We are using traditional Internet protocols, including UDP at the transport layer to exchange end-to-end packets. This information includes a sequence number, time stamp, packet type, and meta information describing the data from the LTM. The packet format defines all parametric vital sign data from each device module in the LTM, including SpO2, EtCO2, temperature, invasive and non-invasive blood pressure, ECG, and ventilator settings. These packets contain meta information, which describes attributes such as when measurements should be flagged with an alarm and the measurement units. The packet format also defines device alarms including their priority, how an alarm is indicated to the user (i.e., audible and latching), and information unique to each LTM device module. Work was also done to define the protocols and processes required for waveform data as well as an initiation protocol. Waveform data will be displayed with allowable ranges. Initiation protocols will synchronize these ranges and timing as well as provide the connection between LTM and iRevive. As the funding period is now complete, and the defined goals reached, the technical, funding, and schedule risk for this proposal are by definition low or non-existent.","benefits":"Civilian pre-hospital providers (e.g., paramedics and emergency medical technicians) collect and act upon a wide variety of complex visual clues, while monitoring and adjusting to continually changing sets of vital signs. Pre-hospital vital sign information in the form of trending data is rarely integrated into the patient care record, so how the vital signs change in response to specific treatment measures is largely undocumented and poorly understood. As a consequence, the care that is provided to a patient in the field is anticipatory and reactive. It is not time sensitive and the accompanying patient medical record is oftentimes incomplete. Healthcare providers do not give medications or adjust the ventilator and IV fluids as often or as accurately as a smart, vigilant system might and, as a result, patients likely do not respond or recover as quickly as they could. We have developed a fully integrated system for mobile critical care patient support and documentation. The iRevive-LTM system is composed of physiological sensors, monitors, and therapeutic hardware devices, linked by a suite of software applications. The components integral to the LTM include: a ventilator; 3/5/12-lead ECG (electrocardiogram); pulse oximeter; noninvasive blood pressure (NIBP); end-tidal carbon dioxide (EtCO2); patient temperature; invasive arterial and intracranial pressure monitoring capabilities; Ethernet communications; closed-loop control of oxygenation (and soon ventilation and IV fluid control); an integrated electronic medical record (iRevive) for clinical data storage and export; alarming, and smart help. The LTM supports up to three external intravenous (IV) pumps and is designed to support other to be developed noninvasive monitors, all connected via powered-USB ports. It supports several additional modules, including an oxygen concentrator, patient warming, and an anesthesia control module. Software will oversee a growing number of autonomous care applications within the integrated system, which will reduce the need for constant attention by a healthcare provider or crew medical officer. While space flight design requirements are of paramount importance to the current project, we are cognizant of U.S. military funding and civilian needs for improved transport monitoring technology. The small, lightweight, rugged, low power design specifications for space flight are equally important here on Earth. A transport monitor that goes into space should have facility for remote calibration and maintenance, as should a transport monitor that is deployed on the battlefield or in other remote locations. Incorporation of redundant systems, automated alarms and, increasingly, closed loop control algorithms will be essential. The value of consolidating patient monitoring, support, and documentation into a single system, capable of automatically collecting and transmitting real-time patient care data, cannot be overemphasized. Integrating these data streams has many advantages, not only in providing real-time information display both locally and centrally for triage decision support, but in trauma system development. More importantly, the physiologic and electronic patient care data that will be captured by the iRevive-LTM system will be fully integrated and time synchronized. New state-of-the-art machine learning, feature extraction, and advanced statistical methods are showing great promise in analyzing these types of complex data sets, uncovering many important, previously hidden physiological relationships and treatment effects. As these relationships are further defined and understood, our models of health and disease will become more complex and accurate. They will provide more reliable, real-time insight into the current and predicted future status of our patients. In time, machine-based comprehension of semantic clinical information together with real-time physiological data will lead to the development of fully autonomous patient care systems.","releaseStatus":"Released","status":"Completed","destinationType":["Moon_and_Cislunar","Mars"],"trlBegin":4,"trlCurrent":6,"trlEnd":6,"favorited":false,"detailedFunding":false,"programContacts":[{"contactId":103847,"canUserEdit":false,"firstName":"David","lastName":"Baumann","fullName":"David K Baumann","fullNameInverted":"Baumann, David K","middleInitial":"K","email":"david.k.baumann@nasa.gov","receiveEmail":"Subscribed_User","programContactRole":"Program_Director","programContactId":181,"programId":273,"programContactRolePretty":"Program Director","projectContactRolePretty":""}],"endDateString":"Aug 2011","startDateString":"Sep 2009"},"technologyOutcomePartner":"Other","technologyOutcomeDate":"2011-08-31","infusion":"Other","technologyOutcomePath":"Closed_Out","technologyOutcomeRationale":"Other","details":"Key to this system is the collection and presentation of data. This has required: 1) rewriting the iRevive GUI and database codebase using current technology; 2) defining the communication protocol between the LTM and iRevive; and 3) building a LTM simulator to debug the iRevive-LTM communication protocol, which was hardcoded into the LTM. In the past year we have rewritten the GUI and database for iRevive to increase the speed, portability, and maintainability of the codebase, which is now in Python for improved interaction with the Internet and the world wide web. The GUI has improved graphics and more complete pull down menus, to facilitate ease of use and generate a more complete record with less user training required. Another focus has been defining a communication protocol for the LTM to exchange data with iRevive. This protocol was implemented as an LTM simulator for testing, debugging, and then in a FPGA. Our approach defined a base protocol to transmit parametric vital sign information. It was then extended to transmit wave type data, alarms, device configuration, and connection initiation. This effort produced a high-level protocol specification. We are using traditional Internet protocols, including UDP at the transport layer to exchange end-to-end packets. This information includes a sequence number, time stamp, packet type, and meta information describing the data from the LTM. The packet format defines all parametric vital sign data from each device module in the LTM, including SpO2, EtCO2, temperature, invasive and non-invasive blood pressure, ECG, and ventilator settings. These packets contain meta information, which describes attributes such as when measurements should be flagged with an alarm and the measurement units. The packet format also defines device alarms including their priority, how an alarm is indicated to the user (i.e., audible and latching), and information unique to each LTM device module. Work was also done to define the protocols and processes required for waveform data as well as an initiation protocol. Waveform data will be displayed with allowable ranges. Initiation protocols will synchronize these ranges and timing as well as provide the connection between LTM and iRevive. As the funding period is now complete, and the defined goals reached, the technical, funding, and schedule risk for this proposal are by definition low or non-existent.","infoText":"Closed out","infoTextExtra":"Project closed out","isIndirect":false,"technologyOutcomeRationalePretty":"Other","infusionPretty":"Other","isBiDirectional":false,"technologyOutcomeDateString":"Aug 2011","technologyOutcomeDateFullString":"August 2011","technologyOutcomePartnerPretty":"Other","technologyOutcomePathPretty":"Closed Out"}],"libraryItems":[{"files":[],"libraryItemId":314178,"title":"Project Website","libraryItemType":"Link","url":"https://taskbook.nasaprs.com","projectId":23271,"internalOnly":false,"publishedDateString":"","entryDateString":"01/22/25 01:10 AM","libraryItemTypePretty":"Link","modifiedDateString":"10/25/24 02:23 PM"}],"states":[{"abbreviation":"MA","country":{"abbreviation":"US","countryId":236,"name":"United States"},"countryId":236,"name":"Massachusetts","stateTerritoryId":30,"isTerritory":false}],"endDateString":"Aug 2011","startDateString":"Sep 2009"}}