U' S' Army Medical Department Special Medical Augmentation Response Team SMART - PowerPoint PPT Presentation

Loading...

PPT – U' S' Army Medical Department Special Medical Augmentation Response Team SMART PowerPoint presentation | free to view - id: e2618-ZTRmM



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

U' S' Army Medical Department Special Medical Augmentation Response Team SMART

Description:

SMART Mission ... Telemedicine SMART Personnel Composition. 1 Medical Officer (Team Leader) ... All SMART team members should have passports & security ... – PowerPoint PPT presentation

Number of Views:242
Avg rating:3.0/5.0
Slides: 37
Provided by: Tat60
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: U' S' Army Medical Department Special Medical Augmentation Response Team SMART


1
U. S. Army Medical Department - Special
Medical Augmentation Response Team (SMART)
  • Colonel Ron Poropatich, MD
  • Director, Clinical Applications Division
  • Telemedicine Advanced Technology Research
    Center
  • U. S. Army Medical Research Materiel Command
  • Fort Detrick, MD
  • Director, Telemedicine Directorate
  • Walter Reed Army Medical Center
  • Washington, DC

2
Telemedicine
  • Definition telemedicine is the use of electronic
    information communications technologies to
    provide support health care when distance
    separates the participants.
  • Institute of Medicine - 1996

3
Worldwide Telemedicine Rapid Deployments since
1993. . .
Bosnia, Macedonia Croatia, Kosovo
Sweden
Kuwait
Germany
Egypt
Ivory Coast
Haiti
Cuba
Somalia
Korea
Panama
Kwajalein
4
Worldwide Telemedicine Deployments since 1993
Ivory Coast
Germany
Bosnia Macedonia Croatia
Panama
Cuba
Haiti
Kuwait
Korea
Egypt
Kwajalein
Somalia
5
Original - 1993
Satellite VTC
- 30 cubic feet - 332 lbs. - 148K
Current - 2000
Satellite VTC
- 6 cubic feet - 175 lbs. - 58K
6
Telemedicine Consult Activity1993-1995
Radiology
  • Global Mission
  • Most common consult regardless of site was
    dermatology
  • Orthopedics - most common surgical consult
  • Total of 19 different subspecialties
  • N 240 consults

21
Medicine
Dental
40
3
Surgery
36
Telemedicine Journal 1996 2(3)201-10
7
Telemedicine Specialty Response Team
Accomplishments
  • Real World Deployments
  • Somalia Feb 93
  • Croatia May 93
  • Macedonia Mar 94
  • Haiti Aug 95
  • Kenya Sep 98
  • El Salvador Nov 98
  • Argentina Jul 99
  • Publications
  • Telemedicine Journal 1995
  • Telemedicine Journal 1996
  • Military Medicine 1998

8
Background -Specialty Response Teams
  • US Army Surgeon General directed this effort in
    1997
  • Coordinated action with the DoD other U.S.
    agencies
  • Teams composed of U.S. Army personnel DoD
    civilians
  • Equipment training provided by the US Army
    Medical Research Materiel Command, Fort
    Detrick, MD


9
SMART Mission
  • Provide a short duration, medical augmentation to
    regional domestic, Federal and Defense agencies
    responding to disaster, civil-military
    cooperative action, humanitarian emergency
    incidents.

  • Foreign nations supported thru U.S. State
    Department coordination.

10
SMART Team Categories
  • Chemical/Biological
  • Trauma/Critical Care
  • Stress Management
  • Telemedicine (MC3T)
  • Preventive Medicine
  • Burn
  • Veterinary
  • Health Systems Assessment Assistance

11
Location of Special Medical Augmentation Response
Teams in the U.S.
  • Walter Reed AMC, Washington, DC
  • Dwight David Eisenhower AMC, Augusta, GA
  • Brooke AMC, San Antonio, TX
  • Madigan AMC, Tacoma, WA
  • Tripler AMC, Honolulu, HI
  • Landstuhl AMC, Landstuhl, Germany

12
Special Medical Augmentation Response
Team Medical Command, Control, Communications
Telemedicine (MC3T) - Overview
  • Readily Deployable
  • 72 hour on site capability
  • 58,000 for the complete set
  • 175 lbs for the complete set

13
(No Transcript)
14
Telemedicine (MC3T) SMART Mission
  • Provide medical command, control communications
    to any of the deployed SMART teams
  • Provide world-class telemedicine augmentation
    (technical advice/support) to local medical
    authorities in disasters/mass casualty incidents


15
Telemedicine SMART Capabilities
o Initial on-scene incident assessment
capabilities to task organize and call
forward additional tailored teams, supplies
and equipment. o Basic manportable
communication equipment sufficient to
communicate intra and inter-team and to home
base. o Technical expertise and manportable
telemedicine equipment sufficient to install,
operate and maintain a rudimentary, emergency
telemedicine capability from a remote field
site.
16
Telemedicine SMART Capabilities (continued)
o Assistance to civil authorities in
communicating emergency patient and provider
needs providing local authorities with
medical situational awareness.
17
Telemedicine SMART Personnel Composition
  • 1 Medical Officer (Team Leader)
  • 1 Operations/Technical Officer
  • 1 Medical Logistics/Administrator

18
Telemedicine SMART Equipment
  • Laptop computers (3)
  • Field Computer (rugged)
  • Zydacron V.35 Interface card
  • Audio/Video capture board
  • MS OS, Windows NT (3)
  • Digital cameras
  • 3 Lead EKG/Pulse oximeter/BP with data interface
  • Gas powered generator
  • Uninterruptable Power Supply (UPS)
  • Power strip
  • Printer
  • Satellite Service, 64 Kbps INMARSAT
  • Cellular phones (2)
  • Hand held radios (10)

19
Estimated Telemedicine SMART Costs
  • Deployment Equipment 58,000/team
  • Training 8,000/team
  • Communications 10,000/yr
  • Yearly Sustainment Costs
  • Maintenance 3,500/team
  • Hardware (3 yr life cycle) 15,000/team
  • Retraining 2,000/team

20
Medical Command, Control, Communications,
TelemedicineConcept of Operations
  • Issue Warning Order
  • Deploy within 12 hours of notification
  • Equipment checked as baggage for commercial
    airline (if military air not possible)

Tokyo subway CW attack, 1995
21
Current Capabilities
  • Digital camera - Sony DKC-ID1
  • Color scanner/printer - Canon BJC-80
  • Lunch pail-Type computer w/ VTC
  • 2 Laptop computers - Dell
  • LAN

22
Capabilities (contd)
  • INMARSAT B-terminal (MacKay)
  • 2 Cell phones (Nokia 2160i)
  • Analog/digital/IS-136
  • Digital message mode
  • 1 kW Gasoline generator (Honda)

23
Capabilities (contd)
  • 10 hand-held radios
  • Motorola XTS 3000 Model III (UHF version)
  • Encryption
  • Analog/Digital Capable
  • 255 channels
  • Range 5 miles
  • Optional repeater can extend to gt30 miles

24
Very Small Aperture Terminal (VSAT) Satellite
Augmentation
  • 72 hour - 1 week deployment from TATRC
  • 64 - 768 kbps data rate
  • 2-4 phones
  • TCP/IP
  • ISDN for VTC

25
Responsibilities
  • Regional Medical Center
  • Staffing
  • Readiness status
  • Feedback
  • TATRC
  • Training
  • Maintenance
  • 24hr Help Desk Support
  • Modernization (assuming MEDCOM reimbursement)

26
Responsibilities (contd.)
  • Communications costs
  • Regional Medical Centers
  • INMARSAT bills (4/min voice, 9/min data)
  • Cell phone bills
  • TATRC (assuming MEDCOM funding)
  • VSAT air time

27
SMART MC3-T - Benefits
  • Rapidly deploy and re-deploy
  • Increase situational awareness-anytime, anywhere
  • Provide real-time command and control
  • Maintaining Standard of Care for all military
  • Miniaturization will increase deployability
  • Use will decrease need for on-the-ground medical
    presence (?)

28
Development Issues
  • Personnel turn-over
  • Equipment maintenance
  • Difficulty with use of the current VTC system
  • User feedback for future changes
  • Portable civilian satellite limited to 56/64kpbs
    transmission speed

29
Schedule
  • SMART MC3-T equipment deployed to 6 Regional
    Medical Centers
  • Milestones (24-36 months out)
  • Upgrade INMARSAT B units
  • Update/convert VTC units
  • TMED Master Storage System configuration and
    procurement
  • Telemedicine Training course refinement

30
Modernization for the SMART MC3-T
  • Newer INMARSAT technologies
  • Speech/Voice Recognition
  • H.323 videoconferencing
  • Wearable computers
  • Ultrasound

31
OB/Gyn clinic in a suitcase
32
Special Operations Medical Diagnostic
System (Clinical Assessment Recording Environment)
  • Embedded Functions
  • Interactive Medical Reference Library
  • Electronic Medical Record
  • Specialty Medical Knowledge Bases
  • Provides Interactive
  • Diagnoses and Treatment Decision Aids
  • Medical Sustainment Training
  • Interface Features
  • PIC Read/Write
  • Focused Tele-consultation
  • Internet Access
  • Speech Recognition/Language Translation
  • Chem/Bio Threat Detection Module
  • Supports
  • Medical Mission Planning
  • Medical Reconnaissance

33
ConclusionQuestions??
34
Further information
  • Telemedicine Advanced Technology Research
    Center, Fort Detrick, MD
  • http//www.tatrc.org
  • Walter Reed Army Medical Center, Washington, DC
  • http//www.wramc.amedd.army.mil

35
(No Transcript)
36
Global Grid Telemedicine System (GGTS) - Concept
  • Use EXISTING AVAILABLE military
    telecommunication infrastructure located at
    Site R
  • Add an Expert Management System
  • Final Product A military telemedicine
    communications backbone with an intelligent,
    transparent, consultation routing system

37
What is Site R ?
  • Originally established (June 1953) as an
    Alternate Joint Communications Center
  • Extensive capability to provide world wide
    command control communications
  • Located in Ravenrock Mountain, PA (100 Km from
    Washington, DC)
  • Fort Detrick, MD inherited installation support
    mission (October 1997)
  • Feasibility study completed (May 1998)

38
Global Grid Telemedicine System - Vision
  • Access to DoD (as well as commercial)
    communications infrastructure at bandwidth
    appropriate to the telemedicine application.
  • An intelligent (artificial intelligence based)
    object oriented global teleconsultation yellow
    pages sytem designed to route incoming consults
    to the appropriate on duty consultant.
  • Connectivity from anywhere to anyone

39
Global Grid Telemedicine System - Next steps
  • Concept for developing GGTS is feasible
  • U.S. Army Medical Department developing
  • complete functional analysis
  • business process review
  • list of validated functional requirements
  • operational concept

40
Lessons Learned
  • All SMART team members should have passports
    security clearance on orders.
  • Test system all components before deployment
    include all necessary peripherals.
  • Activate cell phones
  • Load anti-virus software on all systems.
  • Load all drivers on to system.
  • Insure you have all required backup cables
    connectors
  • Insure you deploy with right size team package
    (60 CMF) (70CMF) (91 CMF)

41
Lessons Learned
  • Pre-coordinate INMARSAT stowage on aircraft.
  • All point to point VTC calls should be POINT TO
    POINT. (Minimizes potential points of failure
    when using video bridge)
  • Have a copy of published local VTC numbers.
  • Coordinate ground transportation for movement.
  • Insure MREs and water are provided and packed.
  • Insure members have travel credit card a line
    of credit for local purchases
  • Add a 50 - 100 extension cord with more than
    one surge protector
About PowerShow.com