SBIR-STTR Award

The Defense Healthcare Management System Modernization (DHMSM) effort will bring about a new era in the Departments implementation of Electronic Medical Records (EMRs) and advanced health care delivery approaches. The advent of EMRs has provided better access into the workings of health care systems, but has not necessarily empowered patients and practitioners with better decision making ability. Simply providing access to form-based records presents patients and doctors with limited understanding of past, current, and future conditions that can influence treatment plans or impact the effectiveness of the care provided. EMRs brings about three exciting opportunities for better health management: communication through mobile devices, dynamic treatment plans, and analytics. On mobile devices, the opportunity is provide two-way, real-time communication that can lead to better decisions, both by patients and practitioners. On treatment plans, the opportunity is the evaluation of status updates and clinical notes against digitized treatment plans instead of the current treatment plans buried in paper documents. On analytics, the harvesting of lessons learned from frequent user updates and evaluation in dynamic plans against expected objectives for the benefit of practitioners and patients. These opportunities represent the focus areas of Milcords Medical Informatics Decision Assistance and Support capability.

Benefit:
With more than 6 million veterans and 9 million active-duty service members, the potential to improve patient-practitioner treatment efficiency and satisfaction presents an exciting opportunity. As the application is developed, the app could also integrate with existing or planned patient self-help applications, diagnoses checkers, and tele-health applications in the Defense Healthcare Management System Modernization, U.S. Army m-Care platform or DHA Tricare On Line Portal. With regards to the private healthcare technology market, the industry is expected to grow 20% each year, fueled in part by new laws mandating more up-to-date healthcare recordkeeping. It is estimated the healthcare IT industry spends more than $40 billion a year, providing many opportunities to commercialize our MIDAS capability to private medical facilities. Increasing use of smartphones, wearables, and other mobile technology is another main driver of growth. A recent study reported that more than 70% of physicians use a smartphone and more than 20% use a tablet. The forecast for the Global Healthcare IT market is that will grow at a CAGR of 5.7% over the period 2013-2018.

Keywords:
Applications, Applications, Forecasting, Data Collection, medical readiness, Medical informatics, Military Health System, mobile device, Medical Ontology

The objective of the Medical Informatics Decision Assistance and Support (MIDAS) project is to research, develop, and design a capability for sensing, addressing, and acting to combat the musculoskeletal injury epidemic facing Navy and Marine Corps personnel. The MIDAS technical solution outlined in this Phase II SBIR proposal will make relevant physical training observations and contextual information accessible to humans and machines as a knowledge graph; apply machine learning, reasoning, and semantics to assert a Musculoskeletal Injury Risk Score (MIRS) that leverages contextual knowledge, such as personnel activity, demographic data, and unit training requirements; enable USMC Force Fitness personnel and trainers to improve individual and unit injury prevention by providing dynamic training injury risk assessments; alert and quickly modify user behavior (athletic, active duty assignment, etc.) based on observed metrics (situational awareness ); and enhance timely and open communication between military unit personnel through dynamic performance monitoring, messaging, and easy to understand user interfaces. The outcomes of Phase I set the stage to research, develop, and demonstrate a full scale prototype MIDAS knowledge graph and analytics engine that targets and utilizes USMC training system concepts and resources to predict and mitigate the effects of musculoskeletal injuries.

Benefit:
The Military Training Task Force of the Defense Safety Oversight Council (DSOC) has identified an epidemic of injuries that result in 25 million limited duty days each year, threatening overall force readiness. The DSOC and others offer general recommendations for interventions, but so far, no technology has been developed to evaluate and communicate these in real time, or tailor them for specific situations and users. MIDAS will be developed to fill this void and actively combat this epidemic. According to Commandant of the Marine Corps (CMC) FRAGO 01/2016: Advance to Contact, within the Marine Corps, increasing the number of deployable and ready Marines is an imperative, as is the development of a Force Fitness Instructor Program. Consequently, tools that can help track fitness and prevent injury during training will be a key element of realizing force requirements. To help address this issue, we have therefore proposed that MIDAS be designed for integration with the Marine Corps Training Information Management System (MCTIMS), which is the current toolset that tracks training progression including a Sports Medicine Injury Prevention Module (SMIP). Instructors and trainers use MCTIMS to plan and document training. Consequently, we see these individuals, as well as their command teams, as the primary users for MIDAS. MIDAS will enhance the MCTIMS and SMIP capabilities by greatly increasing the ability to analyze different types of data to recommend training interventions to reduce injury. Mobile devices, smart algorithms and the existence of huge, easily accessible health databases are disrupting the health industry and shifting the balance of power to the patients. Smart wearable healthcare systems can detect pre-indicators of medical issues or detect diseases in individual patients. Even the slightest deterioration or improvement of a certain condition can be recorded, monitored and used to trigger medical interventions. The most important trends of this transformation are 1) the focus of healthcare will shift from disease treatment to prevention, as the convenient and continuous monitoring of the human body will detect early warning signs, and 2) medical care will be personalized to the characteristics of each person instead of the one size fits all practice. The technologies emerging from MIDAS will fit into this commercial ecosystem by bringing the context and semantically interpreting the relationship between human activities (e.g. running, climbing), context (e.g. location, humidity), and human measurements (e.g. pulse rate, body temperature) for medical intervention.

Keywords:
USMC Force Fitness, contextual knowledge, Recommendations, Knowledge Graph, Medical informatics, Transition, risk assessment, musculoskeletal injury