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A real-time system that connects medics on the battlefield with surgeons at a hospital would save lives, if it can be made to work.
Over the summer at Fort Dix, N.J., the Army continued its tests of whether telemedicine is a viable option on the battlefield, trying out a real-time 4G system.
"Cellular technology could be the future of telehealth on the modern battlefield, but we need to know if it can be done and, if so, would it actually enhance the delivery of information?" Jason Sypniewski, chief for PD C4ISR & Network Modernization’s Integrated Event Design & Analysis branch, said in a release from the Army.
The goal of the program is to improve medical care for the wounded soldier both on and off the battlefield.
"If you've ever seen the movie, 'Black Hawk Down,' the medic is trying to treat the guy with the artery issue in his leg; the medic goes through all his resources, and once he exhausted all his knowledge, he was stuck," said Carl Manemeit, Physiological Monitoring project lead for the Army’s Medical Research and Materiel Command’s (MRMC) Telemedicine & Advanced Technology Research Center, or TATRC. "If he had been connected to the surgeons back at the treatment facility, they could have given him more guidance on how to save that soldier's life. By injecting this expertise, we might be able to do that one thing that could save some guy's life; that's what we're looking to do."
Both prototype medical military software and off-the-shelf physiological monitoring devices were tested over 4G networks. Medics sent streaming video, voice and photos to surgeons away from the battlefield so they could see the injuries and treatment received before a patient’s arrival at a surgical facility.
Once wounded soldiers are provided immediate care on the battlefield, they are outfitted with a triage tag, known in the Army as a T3, which identifies the patient, provides an assessment of his/her condition and ranks treatment priority. Currently these are paper tags held on by metal wire to a patient’s zipper or wrist, and which, in some cases, are missing by the time the the patient arrives at the hospital. Spc. Daniel Vita, a medic with the 130th Engineer Brigade Headquarters in Iraq, preferred using tape and a Sharpie because "it stayed."
By using electronic records, medics are able to send information on the wounded soldier before arrival, allowing surgical facility staff to determine what kinds of casualties are coming in and better prioritize treatment.
"There's an information gap that lies between the point of injury on the field and point of treatment back at a medical facility," said Dr. Gary R. Gilbert, TATRC Research, Development, Test and Evaluation program manager for Secure Telemedicine. "We need to do a better job of being able to record what the medic saw and did prior to the patient being evacuated to the treatment facility, and we want this record to be transmitted to the soldier's permanent health records. Now when the patient goes to a combat support hospital, or gets back to Walter Reed for further care, the doctors can see what happened in the field; and five years from now when the patient goes into a [Veterans Affairs Department] hospital seeking treatment, the care providers can see everything that's been done."
Electronic records may also lower medical transport costs.
"The Army uses Medevac, but the bad news is that it costs about $20,000 per patient flight," said Dave Williams, project manager for Theater Tele-Health Initiatives at TATRC. "If we can determine which patients can be held and which can be treated and stabilized on site, it might be a less expensive way to save a patient's life."
MRMC and the U.S. Army Research, Development and Engineering Command tested the technology at PD C4ISR & Network Modernization’s, research and development facility, which is part of CERDEC, the Communications-Electronics Research, Development and Engineering Center.
"There are a lot of technologies required to make this work, and we don't have all of these," Gilbert said. "CERDEC is helping to fill in those gaps."
This is the third year that PD C4ISR & Network Modernization has examined network capabilities for telemedicine.
"You don't solve all the problems in one 12-month cycle," said Williams. "This has been a complete team effort to develop a solution that did not exist six years ago."
VA is also testing telemedicine as an option to help treat veterans in geographically remote areas or with mobility issues in the Midwest.