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last updated: Tuesday, September 12, 2000
initiative
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ACTD SUPPORT
TATRC
The Joint Telemedicine ACTD will be a multi-service evaluation of the military utility of deploying organic telemedicine capabilities. The centerpiece of the ACTD will be an emerging concept for deployable Telemedicine Teams to provide essential capabilities dependent on information technology.
ACTD WEBSITE SUPPORT
TATRC
The TATRC provides complete Internet technology support to the personnel developing the Joint Medical Operations - Telemedicine Advanced Concepts Technology Demonstration. This support includes Web pages for briefings, IPT home pages, library and search. The project also supplies a Web calendar for scheduling meetings and an online document commenting system to develop draft plans. The current operations of the IPTs are supported through a Web bulletin board system.
AMEDD TELEDENTISTRY
TATRC
The thrust of this project is to develop a base for potential implementation of teledentistry throughout the Department of Defense. The project consists of two stages. The first stage, deployed teledentistry, provides a telemedicine network consisting of 33 Plain Old Telephone Systems (POTS) based desktop videoconferencing systems established for the Army Dental Corps at 30 sites in Germany and Italy. The second stage will provide ten Integrated Services Digital Network (ISDN) based desktop videoconferencing systems at larger clinics.
ATA-DoD TELEMEDICINE CONFERENCE
TATRC
The conference is a forum for sharing the latest findings from clinical, biomedical, and health services research; exploring new developments in technology, policy analysis, legal, operational and management issues; and the circulation of business plans and practice guidelines. The conference draws participants from the United States, Canada, and several other countries. The accompanying exposition is the largest display and demonstration of products and services showcasing advanced medical technologies.
ADVANCED MEDICAL TECHNOLOGY AND NETWORK SYSTEMS RESEARCH (MEDICAL VANGUARD PROGRAM)
Georgetown University Medical Center
This project is comprised of three tasks:
1. To establish a telemedicine network involving a number of U.S. embassies located in areas where optimum healthcare cannot be obtained locally
2. To remotely manage insulin dependent diabetes patients and patients undergoing kidney dialysis using a low-cost communication network and computer tools.
3. Utilize telemedicine capabilities to manage high-risk pregnancies and, in the case of children with developmental problems, show progress in rehabilitation by monitoring the progress over a long period using low-cost telemedicine technologies.
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BUSINESS PROCESS
RE-ENGINEERING
TATRC
This project will perform research, develop, test and evaluate commercial off the shelf technologies to support workflow and document management applications for the Command and TATRC. The project will collect requirements from functional proponents to identify current information flows, security, and reports. Products will be evaluated for their ease of administration, web support and ability to enhance current information flows.
CENTER FOR INNOVATIVE MINIMALLY INVASIVE THERAPY (CIMIT)
Mass. General/Harvard University
The Center for Innovative Minimally Invasive Therapy (CIMIT), a consortium of nonprofit Massachusetts based institutions led by Massachusetts General Hospital (MGH), Boston, MA. The primary aim of the consortium is to develop technologies that push the capability of modern medicine to diagnose and treat patients using minimally invasive approaches.
CIMIT-ADVANCED TECHNOLOGY TEAM-BIOMATERIALS
Mass. General/Harvard University
ATTs will act as a resource for technologically challenging problems within CIMIT, support the technical activities of Clinical Focus Areas and develop key enabling technologies to increase quality or decrease cost of clinical care. The goals of the biomaterials ATT are:
- To develop an electrically conducting biodegradable scaffold for tissue engineering use in nerve regeneration.
- To develop a novel polymer-based gene delivery system.
CIMIT ADVANCED TECHNOLOGY TEAM-ENDOSCOPIC DEVICES
Mass. General/Harvard University
ATTs will act as a resource for technologically challenging problems within CIMIT, support the technical activities of Clinical Focus Areas and develop key enabling technologies to increase quality or decrease cost of clinical care. The goal of the endoscopic device team is to develop a series of percutaneously deployed aortic catheters that will have the potential to abate life-threatening internal hemorrhage on the battlefield.
CIMIT-ADVANCED TECHNOLOGY TEAM-IMAGE GUIDED THERAPY-REAL TIME REGISTRATION OF INRA-OPERATIVE ULTRASOUND WITH PRE-OPERATIVE CT/MRI
Mass. General/Harvard University
ATTs will act as a resource for technologically challenging problems within CIMIT, support the technical activities of Clinical Focus Areas and develop key enabling technologies to increase quality or decrease cost of clinical care. The goal of this ATT is to demonstrate a novel new method for improving the visualization quality of intra-operative ultrasound imagery. Specifically, because of the overwhelming preference of users for high-contrast CT/MR imagery, and since such imagery is frequently acquired pre-operatively, the goal is to demonstrate the ability to register this high contrast pre-operative imagery to yield the same view as the intra-operative ultrasound.
CIMIT ADVANCED TECHNOLOGY TEAM-IMAGE GUIDED THERAPY-SEGMENTATION OF BONE FROM CT AND VESSELS FROM MRA DATA
Mass. General/Harvard University
ATTs will act as a resource for technologically challenging problems within CIMIT, support the technical activities of Clinical Focus Areas and develop key enabling technologies to increase quality or decrease cost of clinical care. The goal of this proposal is to develop a software tool that can create 3D models useful for surgical planning and image-guided intervention in the fields of orthopedic, ENT and Neurosurgery. More specifically, this program entails the development of a tool that can segment bone from CT data, and segment vessel from MRA data. The foundation of the methodology is based on three-dimensional adaptive filtering.
CIMIT ADVANCED TECHNOLOGY TEAM-MEDICAL IMAGING
Mass. General/Harvard University
ATTs will act as a resource for technologically challenging problems within CIMIT, support the technical activities of Clinical Focus Areas and develop key enabling technologies to increase quality or decrease cost of clinical care. This project will attempt to quantify imaging of tumor microvascular morphology and physiology.
CIMIT ADVANCED TECHNOLOGY TEAM-MINIATURIZED SENSORS AND DEVICES
Mass. General/Harvard University
ATTs will act as a resource for technologically challenging problems within CIMIT, support the technical activities of Clinical Focus Areas and develop key enabling technologies to increase quality or decrease cost of clinical care. The goal of this project is the development of a sensor technology capable of performing rapid biochemical analysis on a single-drop blood sample. The sensor being developed is a micro-electro-mechanical (MEM) silicon membrane resonator (SMR) that acts as a miniature, all-electronic platform for performing direct biochemical assays.
CIMIT ADVANCED TECHNOLOGY TEAM-SIMULATION, MODELING AND ROBOTICS
Mass. General/Harvard University
ATTs will act as a resource for technologically challenging problems within CIMIT, support the technical activities of Clinical Focus Areas and develop key enabling technologies to increase quality or decrease cost of clinical care. This project seeks to identify the critical sensory and environmental elements of a successful teaching simulator, and to focus on developing the software and hardware required to produce such a simulator.
CIMIT ADVANCED TECHNOLOGY TEAM- TISSUE ENGINEERING
Mass. General/Harvard University
ATTs will act as a resource for technologically challenging problems within CIMIT, support the technical activities of Clinical Focus Areas and develop key enabling technologies to increase quality or decrease cost of clinical care. The overall goal of this research is the development of an in-vitro tissue engineered device composed of living cells and matrix with its own branching vascular supply.
CIMIT CLINICAL FOCUS AREA-CANCER-EARLY DETECTION AND ABLATION OF EPITHELIAL CANCERS
Mass. General/Harvard University
This project consists of two sub-projects with the overall aim of developing a system to diagnose and treat epithelial cancer. The two sub-projects are:

ALA Enhanced Fluorescence Imaging of Barrett's Epithelium This project will determine the accuracy of orally administered ALA for marking dysplasia occurring in Barrett's esophagus, and develop and test an endoscopic fluorescence imaging system for detecting ALA in the esophagus.

Optical Coherence Tomography Imaging of Esophageal Lesions The ultimate goal of this project is to determine the clinical utility of Optical Coherence Tomography for imaging lesions in the GI tract.
CIMIT CLINICAL FOCUS AREA-CANCER-MRI GUIDED FOCUSED ULTRASOUND TREATMENT OF BREAST CANCER
Mass. General/Harvard University
This project involves the feasibility of using single focused ultrasound guided by MRI for the clinical treatment of fibroadenomas of the breast.
CIMIT CLINICAL FOCUS AREA-CARDIO VASCULAR DISEASE-DETECTION OF VULNERABLE PLAQUE USING OPTICAL COHERENCE TOMOGRAPHY
Mass. General/Harvard University
The overall goal of this research is to develop, optimize and apply optical coherence tomography (OCT) for the detection of vulnerable atherosclerotic plaques in human coronary arteries.
CIMIT CLINICAL FOCUS AREA-CARDIO VASCULAR DISEASE-MINIMALLY INVASIVE CARDIAC SURGERY-ENDOSCOPIC CORONARY ANASTOMOSIS
Mass. General/Harvard University
The objective of this project is to optimize endoscopic approaches for minimally invasive coronary artery bypass graft surgery. This work aims to develop a method for achieving video assisted, endoscopic coronary anastomoses in laboratory animals to pave the way for clinical application in patients with coronary artery disease.
CIMIT CLINICAL FOCUS AREA-NEW INITIATIVE-ENDOSCOPIC RETRO-GRADE CHOLANGIO-PANCREATOGROPHY (ERCP) SIMULATOR
Mass. General/Harvard University
The ERCP Simulation project aims to develop a computer-based training tool for upper-GI endoscopy that features lifelike animation, realistic haptic interfaces, and an integrated fluoroscopic simulator for the biliary and pancreatic anatomy.
CIMIT CLINICAL FOCUS AREA-NEW INITIATIVE-ENDOSCOPICALLY ASSISTED MANDIBULAR DISTRACTION OSTEOGENESIS
Mass. General/Harvard University
This project has three aims: - To develop a totally buried, miniature, remotely activated distraction device with accurate three dimensional vector controls.

- To develop minimally invasive surgical techniques for distractor placement.

-To develop methods to control and enhance the wound healing process in order to shorten the overall treatment duration.
CIMIT CLINICAL FOCUS AREA-NEW INITIATIVE-LUNG VOLUME REDUCTION USING A BRONCHOSCOPIC APPROACH
Mass. General/Harvard University
This project involves the development and testing of a bronchoscopically based procedure that eliminates the participation of dysfunctional tissue in the breathing process.
CIMIT CLINICAL FOCUS AREA-STROKE-ACCUTE STROKE MANAGEMENT-NEURO-PROTECTION
Mass. General/Harvard University
This project is designed to develop a means to quickly cool the brain cortex to afford neuro-protection, protecting the brain from ischemic injury. A means to provide rapid, selective brain cooling would provide major benefit for patients with a wide degree of CNS injury.
CIMIT CLINICAL FOCUS AREA-STROKE-MRI GUIDED RAPID LASER ENDOVASCULAR PHOTOACOUSTIC RECANALIZATION FOR HYPERACUTE STROKE
Mass. General/Harvard University
The goal of this project is to develop a catheter based means of rapidly opening brain arteries occluded by clot with minimal or no thrombolytic drug therapy.
CIMIT CLINICAL FOCUS AREA-STROKE-OPTICAL MONITORING AND IMAGING OF STROKE
Mass. General/Harvard University
The optical imaging project is focused on developing a new imaging modality for continuous, bedside monitoring of brain perfusion. The aim is to develop a noninvasive, inexpensive, portable means of measuring cortical blood flow and brain hemorrhage.
CIMIT CLINICAL FOCUS AREA TRAUMA AND CRITICAL CARE-APPLICATION OF MICROWAVE IMAGING TO RAPID NON-INVASIVE DETECTION OF INTRACRANIAL HEMATOMA
Mass. General/Harvard University
This project is focused on the development of a microwave device that can be used to detect intracranial hematoma.
CIMIT CLINICAL FOCUS AREA-TRAUMA AND CRITICAL CARE-NEAR-INFRARED REFLECTANCE SPECTROSCOPY (NIRS) TO ASSESS REGIONAL ISCHEMIA DURING TRAUMA
Mass. General/Harvard University
This project will explore the use of NIRS and other minimally invasive technologies to determine the severity and reversibility of hemorrhagic shock by means of assessing cellular function and metabolism.
CIMIT CLINICAL FOCUS AREA-TRAUMA AND CRITICAL CARE-NOISE ENHANCED TACTILE SENSATION FOR THE MANAGEMENT OF SENSORY DEFICITS IN PATIENTS WITH STROKE
Mass. General/Harvard University
This project has two central goals:

- Design and construct a suitable apparatus for patient experiments.

- Demonstrate the feasibility of both the apparatus and an experimental protocol through implementation in patients with stroke; collect data on stroke patients.
CIMIT ENABLING TECHNOLOGIES FOR MEDICAL SIMULATIONS
Mass. General/Harvard University
The purpose of this proposal is to develop the enabling technologies that would concurrently provide a training vehicle for combat medics, and to advance the current state-of-the-science in medical simulators in general.
CIMIT TECHNOLOGY ASSESSMENT AND OUTCOMES ANALYSIS PROGRAM
Mass. General/Harvard University
The Technology Assessment and Outcomes Analysis Program was established in order to facilitate accurate and expeditious evaluation of new technologies as they are developed and implemented. The program's principal activities include decision analysis, cost-benefit and cost-effectiveness analysis, and outcome analysis.
CLINICAL EVALUATION OF A HIGH RESOLUTION DIGITIZED STEREO VIDEO SLIT LAMP
WRAMC
The specific aim of this project is to perform clinical trials to test the slit lamp developed under the Digitized Stereo Video Slit Lamp project. The purpose for the clinical tests is to compare the clinical diagnostic performance of the high resolution digitized stereo video slit lamp with in-person slit lamp examination in patients presenting to general Ophthalmology clinic.
COMPLETE CLINICAL WORKSTATION
WRAMC
The overall objective of the CCW is to improve the quality of health care provided to our beneficiaries. Specific objectives of this proposal are:

1.
To decrease the administrative time for a patient encounter

2.
To improve the patient encounter documentation

3.
Reduce the MEDCEN pharmacy budget by giving the provider easy to use information on formulary items versus cost.

4.
Build a clinical data repository (CDR) for data analysis at the clinic-level. The CDR will facilitate prevention intervention and outcome analysis.

5.
Reduce the Medical Center's dependence on transcriptionists
COMPUTER ASSISTED MINIMALLY INVASIVE SURGERY (CAMIS)
Cleveland Clinic,
Cleveland Ohio
This project attempts to integrate previously developed technology that would allow the simultaneous display of patient data in a "Personal Surgical Display" (Head Mounted Device) that could be controlled with voice communications. This device would be supported by a web based "Patient Resource Database" that would collect, manage and provide patient data from various patient data sources. This project also will develop prototypes of a micro-endoscope and surgical micro-invasive tool with haptic or force feedback capabilities that would feed data into the "Patient Resource Database" allowing for potential surgical procedures into areas that are not directly visualized.
COMPUTER BASED DIAGNOSTICS CEPDCE
TATRC
The purpose of this Concept Evaluation Program Data Collection Effort (CEPDCE) is to provide a means to evaluate the Medics ability to employ computers in far forward situations, the utility of such an employment, the determination of the suitability and capability of computer aided diagnostics, and the generation of information management requirements as these systems mature.
CONNECTIVITY, SECURITY, PERFORMANCE TESTBED NGI FOR MEDICAL IMAGING APPLICATIONS
University of California-San Francisco
The testbed for medical imaging applications will provide insight into Next Generation Internet capabilities in three aspects: its' performance for medical imaging applications in a regional environment, its potential value for extending the service to the national level, and necessary improvements in its capability for increased future benefits.
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DEFENSE HEALTH PROGRAM REQUEST FOR SUBMISSIONS SYSTEM
TATRC
This project will develop a Web-based system to collect and evaluate Defense Health Program submissions. This project will require the development of a database system that allows reviewers to enter their evaluations online. It will also encompass the creation of analysis reports on the data.
DEFENSE HEALTHCARE INFORMATION ASSURANCE PROGRAM (DHIAP)
SCRA
The focus of the DHIAP is the protection of electronic military healthcare information. The program will analyze security requirements and demonstrate the application of information protection technologies to electronic healthcare data at various military installations.
DESIGN AND DEVELOPMENT OF A HIGH RESOLUTION DIGITIZED STEREO VIDEO SLIT LAMP
University of Utah-Moran Eye Center
This project envisions a multiphase development of a remotely operated, high resolution digitized video stereo slit lamp. This technology will allow for a remote examination of the eye of sufficient quality that a specialist can diagnose and recommend treatment without having actually seen the patient.
DEVELOPMENT OF PROCEDURES TO INCREASE ACCESS TO HEALTH CARE AND MEDICAL EDUCATION AND TRAINING IN ISOLATED AREAS THROUGH TECHNOLOGICAL INNOVATION-CERMUSA CRADA
CERMUSA
The purpose of this Agreement is to test and evaluate telemedicine equipment and practices for military application in a rural, austere environment and within a health care infrastructure.
DEVELOPMENT OF PROCEDURES TO INCREASE ACCESS TO HEALTH CARE AND MEDICAL EDUCATION AND TRAINING IN ISOLATED AREAS THROUGH TECHNOLOGICAL INNOVATION-HOWARD UNIVERSITY CRADA
Howard University
The purpose of this collaborative effort is to test and evaluate telemedicine technologies and practices in a non- traditional, urban environment, through development of a comprehensive needs assessment and research projects.
DEVELOPMENT OF A TECHNOLOGY STRATEGY TO REDUCE HEALTHCARE COSTS
Sandia Labs
This project will demonstrate increasingly functional telemedicine systems based upon the secure, plug-and-play architecture developed in a prior technology roadmapping project. These demonstrations will be accomplished by clinical evaluations of the cost-effectiveness and diagnostic feasibility of technology relative to commercial telemedicine offerings.
DIGITAL MEDICAL LIBRARY PILOT/IMPLEMENTATION
TATRC
The Digital Library project will identify requirements for distributed, electronic access to library information. The pilot will determine the current use of digital resources, identify requirements and implement a pilot system. The project will be developed in conjunction with the MEDCOM Librarian.
DISTANCE LEARNING USING THE WORLD WIDE WEB
Illinois Institute of Technology Research Institute
The objective of this project is to design a distance learning system using the World Wide Web that will provide an infrastructure to support remote teaching and novel instructiona1 technologies such as simulation-based training.
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DREAMS-DISASTER RELIEF AND EMERGENCY MEDICAL SERVICES PROJECT
University of Texas
The Disaster Relief and Emergency Medical Services (DREAMS) program is a joint Medical Research and Development initiative conducted at the University of Texas-Houston Health Science Center (UT-Houston) and Texas A&M University Systems (TAMUS). It is designed to leverage the resources at both academic institutions for the express purpose of saving lives and reducing costs for injured persons in both the military and civilian sectors. The DREAMS project consists of three interrelated components:

Emergency medical services-Digital EMS

Chemical and biological warfare defense

Diagnostic methods and therapies for shock injuries-Clinical and Science Projects
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DREAMS-CLINICAL AND SCIENCE PROJECTS-CLINICAL TRIALS-ARE LIVES SAVED BY THE USE OF EXTERNAL DEFIBRILLATORS BY FIRST RESPONDERS
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DREAMS-CLINICAL AND SCIENCE PROJECTS-CLINICAL TRIALS-EFFECT OF INHALED NO ON OXYGEN SATURATION IN VICTIMS OF AIRWAY BURN INJURY
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DREAMS-CLINICAL AND SCIENCE PROJECTS-CLINICAL TRIALS-EFFECT OF LIPOSOMAL PGE AND SELECTIN ANTAGONISTS IN ACUTE MYOCARDIAL INFARCTION
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DREAMS-CLINICAL AND SCIENCE PROJECTS-CLINICAL TRIALS-FIBROBLAST GROWTH FACTOR (FGF-2) TO ENHANCE ANGIOGENESIS AND HEALING IN LIMB AND MYOCARDIAL ISCHEMIA
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DREAMS-CLINICAL AND SCIENCE PROJECTS-DISCOVERY AND INVENTION-ROLE OF SENTRIN IN APOPTOSIS
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DREAMS-CLINICAL AND SCIENCE PROJECTS-DISCOVERY AND INVENTION-MECHANISMS OF CELL ADHESION AND REPERFUSION INJURY
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DREAMS-CLINICAL AND SCIENCE PROJECTS-DISCOVERY AND INVENTION-NOVEL METHODS OF PROTEIN AND GENE LOADING IN MACROPHAGES
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DREAMS-CLINICAL AND SCIENCE PROJECTS-DISCOVERY AND INVENTION-GENES REGULATING WOUND HEALING AND SUSCEPTIBILITY TO OXIDATIVE INJURY
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DREAMS-CLINICAL AND SCIENCE PROJECTS-DISCOVERY AND INVENTION-OVER EXPRESSION OF VEGF IN SMOOTH MUSCLE CELLS TO ENHANCE ENDOTHELIAL REGENERATION IN LV ASSIST DEVICES, STENTS, VASCULAR PROSTHESES AND THE TOTAL ARTIFICIAL HEART
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DREAMS-CLINICAL AND SCIENCE PROJECTS-DISCOVERY AND INVENTION-NONTOXIC PEPTIDE ENHANCEMENT OF DNA UPTAKE
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DREAMS-CLINICAL AND SCIENCE PROJECTS-DISCOVERY AND INVENTION-ROLE OF FGF-2 IN MITOGENESIS AND CARCINOGENESIS
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DREAMS-CLINICAL AND SCIENCE PROJECTS-DISCOVERY AND INVENTION-LUMINESCENT AND FLUORESCENT MOLECULAR IMAGING
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DREAMS-CLINICAL AND SCIENCE PROJECTS-DISCOVERY AND INVENTION-COMPLEMENT C5a TO ENHANCE CELL UPTAKE OF DNA
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DREAMS-CLINICAL AND SCIENCE PROJECTS-DISCOVERY AND INVENTION-MECHANISMS OF FGF SIGNAL TRANSDUCTION
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DREAMS-CLINICAL AND SCIENCE PROJECTS-DISCOVERY AND INVENTION-ENHANCING RESISTANCE OF INHALED TOXINS BY AEROSOL: TRANSFER OF THE CYTOCHROME p450 GENES TO ALVEOLAR AND TRACHIOBRONCHIAL EPITHELIUM AND MICROPHAGES
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DREAMS-CLINICAL AND SCIENCE PROJECTS-DISCOVERY AND INVENTION-GENE TRANSFER: MANIPULATING LIPOSOMAL STRUCTURE TO INCREASE AND DECREASE NO PRODUCTION
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DREAMS-CLINICAL AND SCIENCE PROJECTS-DISCOVERY AND INVENTION-ELECTRIC IMPEDANCE AND NEAR-IR FOR LOCALIZATION OF PLAQUE LIPID
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DREAMS-CLINICAL AND SCIENCE PROJECTS-DISCOVERY AND INVENTION-ACOUSTIC ANALYSIS TO IDENTIFY HEART FAILURE, CARDIAC TAMPONADE AND PNEUMOTHORAX
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DREAMS-CLINICAL AND SCIENCE PROJECTS-PRE-CLINICAL TRIALS-EVALUATION OF BASIC FIBROBLAST GROWTH FACTOR (FGF-2) INJECTIONS TO MAINTAIN TISSUE VIABILITY IN RATS WITH HEMORRHAGIC SHOCK
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DREAMS-CLINICAL AND SCIENCE PROJECTS-PRE-CLINICAL TRIALS-LIPOSOMAL PREPARATIONS OF PROSTAGLANDIN E1 AND SELECTIN ANATOGONISTS TO PREVENT REPERFUSION INJURY IN A CANINE MODEL OF CARDIOGENIC SHOCK
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DREAMS-CLINICAL AND SCIENCE PROJECTS-PRE-CLINICAL TRIALS-INFR-RED CATHETER DETECTION OF INFLAMMATION
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DREAMS-CLINICAL AND SCIENCE PROJECTS-PRE-CLINICAL TRIALS-INITIAL EVALUATION OF A NEW AXIAL FLOW PUMP, INSERTED BY MINIMALLY INVASIVE THORACOTOMY, TO MAINTAIN CARDIAC OUTPUT IN A PORCINE MODEL OF CARDIOGENIC AND HEMORRHAGIC SHOCK
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DREAMS-CLINICAL AND SCIENCE PROJECTS-PRE-CLINICAL TRIALS-INHALED NO TO PREVENT PULMONARY HYPERTENSION IN ANIMAL MODELS OF PULMONARY INHALANT INJURY
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DREAMS-CLINICAL AND SCIENCE PROJECTS-PRE-CLINICAL TRIALS-"FOXHOLE" STENT TO PROTECT CELLS
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DREAMS-DIGITAL EMS
University of Texas
The digital Emergency Medical Services project will feature an ambulance retrofitted with integrated vital signs monitoring equipment, video cameras, and an on-board navigation system that will be connected with a designated medical communications suite in Hermann Hospital via advanced communications equipment.
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DREAMS-DIGITAL EMS AND THE DETECTION AND REMEDIATION OF CHEMICAL THREAT AGENTS
University of Texas
This project outlines a collaborative research program designed to identify the medical needs associated with involvement of chemical or biological weapons of mass destruction, which might range from noxious fumigants to neurotoxic chemical warfare agents, infective biological spores or viruses and their toxins. Additionally, the Digital EMS will be enhanced with an expanded hardware and software engineering and integration effort.
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EMERGENCY PERSONAL ISOLATION AND CONTAINMENT SYSTEM (EPICS)
Illinois Institute of Technology Research Institute
The EPICS project is focused on the design and development of a prototypical, single patient, trauma and evacuation support platform system for chemical-biological protection. The EPIC system would be ideally suited for both civilian and military trauma scenarios where patients have been exposed to/or threatened by chemical/biological agents.
FIELD DEPLOYABLE RECORD
TATRC
The Field Deployable Record (FDR) is a computer-based patient record designed to interact with a PIC. It is being designed around the forms currently found in the military medical record. It will be designed in phases that will continually allow for the addition of new functions.
FORENSIC PATHOLOGY VISUALIZATION PROJECT
AFIP
This project involves the creation of an Atlas of Patterned Injury database. This effort will consist of retrospective and prospective analysis. The retrospective aspect will consist of a triage and cataloguing of the OAFME image collection. The prospective element will consist of organizing the collection of case data with various civilian Medical Examiner offices.
GLOBAL GRID TELEMEDICINE SYSTEM (GGTS)
University of Pittsburgh
This project envisions a computer supported global telemedicine command and control center at a major military communications center. The objectives are to (1) leverage the extensive national command DoD communications facilities throughout the world to provide global telemedicine support to US and allied forces, worldwide; (2) provide a transparent fully-integrated commercial communications network backup to military facilities; and (3) develop a computer assisted consultation routing system that maximizes world-wide projection of consultation support from medical consultants and sub-specialists located at military and civilian medical centers throughout the United States.
GLOBAL GRID TELEMEDICINE SYSTEM (GGTS) EXPERT CONSULT MANAGER
University of Pittsburgh
This project is focused on the design, development and prototyping of the Expert Consult Broker for the GGTS. The project will employ a combination of cognitive science, computer science, artificial intelligence, and management science methodologies to perform the task.
GTE INTEGRATION SERVICES FOR TELECOMMUNICATIONS AND TELEMEDICINE SUPPORT
TATRC
This project provides for assistance to the TATRC for engineering, planning, coordination, deployment and management of telemedicine projects.
GUIDLEINE INTERCHANGE FORMAT (GLIF)
Brigham and Women's Hospital
The Guideline Interchange Format (GLIF) was developed over a three-year period and first published in mid-1998 as a sharable, structured representation of guidelines to be utilized in decision support/systems. The goals of the project are to:

1. Review strengths and shortcomings of the GLIF model and specification.

2. Propose extensions to GLIF that enhance its ability to express clinical guidelines and to support implementation of applications utilizing guideline knowledge.

3. Propose directions for future research in guideline representation.

4. Form a working group of institutions and individuals that will coordinate the development of the GLIF specification and will pursue publication of GLIF as a national and international standard.
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IMPLEMENTATION OF A GLOBAL GRID TELEMEDICINE SYSTEM (ACTD) INFRASTRUCTURE FOR USE IN JOINT MEDICAL OPERATIONS-TELEMEDICINE (JMO-T) ADVANCED CONCEPTS TECHNOLOGY DEMONSTRATION (ACTD)
GSA/TATRC
OBJECTIVE: The purpose of this work is to develop an implementation plan for the information architecture for the Telemedicine ACTD that defines the specific global grid system architecture and communications infrastructure, based on the original Global Grid Telemedicine System concepts, and identifies the specific equipment, systems and network management capability required to implement it within the JMO-T ACTD "order of battle" in the US Pacific Command and CONUS-based support facilities.
INTRA-OPERATIVE ACOUSTIC HEMOSTASIS DEVICE FOR TRAUMA CARE
University of Washington
This project intends to utilize both the imaging and therapeutic capabilities of ultrasound to construct a range of devices for use in intra-operative treatment of organ trauma. The first step entails the development of a device that would rapidly treat visible bleeding in organs and other tissues. The second step would combine the imaging and therapeutic capabilities of ultrasound into a single image-guided acoustic hemostasis device for the treatment of bleeding sites that are located internally within an organ, or in difficult to access locations.
KNOWLEDGE MANAGEMENT TOOLS
TATRC
The Knowledge Management tools project will identify and perform RDT&E on applications that will support the following applications:

- Natural language processing searches on large data repositories

- Expert profiling

- Agent technologies

- Data query and clip retrieval of digital video and audio media

- Educate USAMRMC personnel on Knowledge Management technologies, culture and applications
MEDICAL MEMS-MICRO ELECTRONIC MEDICAL SYSTEMS
DARPA
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META-ANALYSIS AND PLANNING OF SIM-TRAUMA; MEDICAL SIMULATION FOR COMBAT CARE TRAINING
Tech-Med, Inc.
This project involves a meta-analysis of virtual reality simulation literature and a review of all available combat medic and trauma training programs. Upon review of this information a detailed plan regarding future DOD expenditures in virtual reality based simulation technology will be developed and delivered.
MINIMALLY INVASIVE SURGICAL RESEARCH: ENDOSCOPIC SIMULATOR DEVELOPMENT
HT Medical Systems
This project involves the development of a flexible ureteroscopic simulator with various anatomical variations (normal, benign, cancer, etc). This simulator will incorporate better methods for photo-realistic texture mapping, techniques for the simulation of physiologic events, creation of realistic endoscopic lighting simulation, real time collision processing, representation of the physics of the flexible endoscope and integration of a computer-based geometric model of the urinary tract.
MOBILE BREAST CARE CENTER
TATRC
This project has developed a prototype Mobile Breast Care Center to provide a comprehensive system for early breast cancer diagnosis, patient counseling, and integration of on-line multidisciplinary academic expert clinical teleconsultation with local treatment providers. This mobile laboratory will facilitate greater interaction of government facilities with academia, industry, consumer groups, and community outreach services in researching and implementing the most effective methods of screening and diagnosis, including digital mammography, CAD, teleradiology, telepathology, and remote consultation.
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ADVANCED TECHNOLOGY FOR IMPROVED HEALTH CARE- NATIONAL MEDICAL TECHNOLOGY TESTBED
Loma Linda University Medical Center
This project is responsible for accomplishing the following objectives: To provide a testbed for instrumentation and technology developed in the aerospace and military fields. To bring existing products, technology and techniques to market. To conduct valid biomedical scientific experiments and gain new knowledge as the same products are developed and tested. To stimulate thinking by bioengineers and physicians whereby ideas from diverse fields may find application in medicine.
NATIONAL MEDICAL TECHNOLOGY TESTBED-ADVANCED ACOUSTIC SIGNAL PROCESSING DIAGNOSTIC AIDS FOR CARDIAC EVALUATION
Johns Hopkins University
The project goal is to explore the use of advanced signal processing techniques to develop low cost diagnostic decision support tools that would take advantage of current computing performance, miniaturization, and previous investments made by the Department of Defense in automated target detection and classification.
NATIONAL MEDICAL TECHNOLOGY TESTBED-AMBULATORY, ELECTRONIC MEDICAL OXYGEN GENERATOR
IGR Enterprises, Inc.
The overall objective of this project is to develop a small, lightweight, wearable, battery-powered, ambulatory, electronic medical oxygen generator for comfortable use by civilian patients in pedestrian, vehicular, and residential settings.
NATIONAL MEDICAL TECHNOLOGY TESTBED-COMBINATION BAX/TNF-a GENE THERAPY AND RADIATION FOR THE TREATMENT OF CANCER
Loma Linda University Medical Center
The project goal is to improve the efficacy of malignant brain tumor treatment through a combined bax/TNF-a and radiotherapy protocol using the emerging biotechnology of gene therapy.
NATIONAL MEDICAL TECHNOLOGY TESTBED-DEVELOPMENT OF ANTI-MICROBIAL COATINGS FOR EXTERNAL FIXATION PINS
Battelle Memorial Institute
The goal of this proposal is to continue the development and testing of materials that will enable the development of infection resistant external fixation pins.
NATIONAL MEDICAL TECHNOLOGY TESTBED-DEVELOPMENT OF NANODOSIMETRY FOR BIOMEDICAL APPLICATIONS
Loma Linda University Medical Center
This project involves the study of clustered ionizations in sensitive volumes, simulating the size of the DNA double helix. Nanodosimetry will enhance basic knowledge about the nature of radiation-induced DNA damage and, once fully developed, will have many practical applications in radiation protection, space radiation, and radiation medicine.
NATIONAL MEDICAL TECHNOLOGY TESTBED-EVALUATION OF THE ROLE OF GROWTH HORMONE/INSULIN LIKE GROWTH FACTOR-I AXIS IN MEDIATING SKELETAL CHANGES THAT OCCUR DURING PUBERTY
Loma Linda Veterans Association for Research and Education
The long-term goal of this project is to identify the mechanisms responsible for the accelerated bone formation seen during puberty that culminates in the acquisition of peak bone density at the end of puberty.
NATIONAL MEDICAL TECHNOLOGY TESTBED-FLEXIBLE ARRAY TECHNOLOGY FOR MEDICAL IMAGING
HD Laboratories, In
The goal of the proposed research is to provide an improved sensor for ultrasonic imaging of battlefield or emergency room injuries.
NATIONAL MEDICAL TECHNOLOGY TESTBED-GENE THERAPY FOR SKELETAL REPAIR
Loma Linda University
The long-term goal of this project is to apply state-of-the-art technologies in gene therapy to increase the repair rate of all types of skeletal lesions.
NATIONAL MEDICAL TECHNOLOGY TESTBED-GROWTH FACTOR MEDIATED WOUND HEALING
BioProbes Inc./Johns Hopkins Medical Center
This project involves the development of a novel system that can deliver therapeutic levels of growth factors to enhance healing of cutaneous wounds.
NATIONAL MEDICAL TECHNOLOGY TESTBED-HYPERSPECTRAL IMAGING MODALITY FOR IMPROVED DIAGNOSIS OF RETINAL PATHOLOGIES
Kestral Corporation
The goal of this project is the identification of spectral wavelengths that will give the clinicians and researchers in ophthalmology a new diagnostic instrument for early detection and management of the effects of age-related macular degeneration (ARMD).
NATIONAL MEDICAL TECHNOLOGY TESTBED-IMPROVING DNA VACCINATION FOR IDDM PREVENTION WITH GENE CO-EXPRESSION
Loma Linda University
The goal of this project is to improve the method of intramuscular DNA vaccination when applied to the treatment/prevention of insulin dependent diabetes mellitus (IDDM).
NATIONAL MEDICAL TECHNOLOGY TESTBED-INTELLIGENT CONTROL OF HEMOFILTRATION SYSTEMS: DESIGN OF SUPERVISORY CONTROL ALGORITHM
University of Cincinnati
This project will develop an intelligent control and filtration system for a computerized hemofiltration machine that will respond to patient needs based on moment to moment monitoring and thereby result in more accurate hemofiltration with reduced human intervention.
NATIONAL MEDICAL TECHNOLOGY TESTBED-IN-VITRO MODEL OF MECHANICAL FORCE INDUCED NEURO-DEGENERATION
Texas Engineering Experiment Station
The aims of this project are 1) to develop an in-vitro model of mechanical force induced neurodegeneration which is appropriate for the use in studying traumatic head injury and 2) to identify new therapeutic strategies to reduce the neurological damage associated with traumatic head injury.
NATIONAL MEDICAL TECHNOLOGY TESTBED-NEUROLOGICAL AND VITAL ORGAN PROTECTION AFTER BATTLE INDUCED INJURIES
Life Enhancement Technologies, Inc.
The primary objective of this program is to develop and test a prototype medical cooling device for neuro-protection that can be used in clinical trials. The proposed device will include a mobile coolant delivery system for in-hospital use, and a cooling garment adaptable to both a gurney in the field and a hospital bed.
NATIONAL MEDICAL TECHNOLOGY TESTBED-RADAR VITAL SIGNS MONITOR PHASE II
Georgia Tech Research Institute
This project will develop and deliver a field-testable hardware Radar Vital Signs Monitor prototype, suitable for testing by the medical community.
NATIONAL MEDICAL TECHNOLOGY TESTBED-ROLE OF TELOMERASE IN GENITOURINARY MALIGNANCIES
Loma Linda University
The specific aim of this proposal is to develop the telomeric repeat amplification protocol (TRAP) analysis of prostatic fluid into a clinical tool that can be used to detect prostate cancer.
NATIONAL MEDICAL TECHNOLOGY TESTBED-SELF-MANAGEMENT SOFTWARE FOR DIABETIC PATIENTS-YEAR 2
Georgia Institute of Technology
This project entails the development of additional data presentation and automated analysis features to current PDA/Internet based software tools for the self-management of diabetes mellitus.
NATIONAL MEDICAL TECHNOLOGY TESTBED-SYNTHESIS AND TESTING OF RESORABLE VASCULAR TEMPLATES
Pacific Northwest Laboratory
The aim of this proposal is to develop and test material(s) that serve as templates for tissue reconstruction and meet the following four criteria: 1) enhance healing; 2) are bioabsorbable; 3) provide a porous surface; and 4) are mechanically robust.
NATIONAL MEDICAL TECHNOLOGY TESTBED-TECHNIQUES FOR IMPROVING HIGH ENERGY PHOTON RADIOTHERAPY
Excelar Corporation
This project is developing a new method in which magnetic fields from small, topically applied, superconducting magnets control dose distributions along high-energy photon beams as used in modem radiation therapy of cancer.
NATIONAL MEDICAL TECHNOLOGY TESTBED-TISSUE ENGINEERING FOR AUTOLOGOUS DISC CELL THERAPY IN A SMALL ANIMAL MODEL
Carolinas Medical Center
The long-term goal of this research is to develop a technique which would utilize a patient's own healthy disc cells in the therapy of disc sites which are degenerating.
NATIONAL MEDICAL TECHNOLOGY TESTBED-TISSUE REPAIR IN WARM ISCHEMICALLY DAMAGED LIVER ALLOGRAFTS
Breonics, Inc.
This project is involved in developing Exsanguinous Metabolic Support (EMS) an integrated technology with the goal of substantially increasing the number of human organs for transplantation.
NATIONAL MEDICAL TECHNOLOGY TESTBED-THE USE OF ABDUCTIN AS A MODEL FOR THE DEVELOPMENT OF A NOVEL BIOPOLYMER FOR CARTILAGE REPLACEMENT-PHASE II
Loma Linda Veterans Association Research and Education
This project aims to develop a prosthetic bioelastomer material (PBM) for the repair of articular cartilage in weight bearing joints.
NATIONAL MEDICAL TECHNOLOGY TESTBED-UTILITY OF BREATH ANALYSIS FOR NON-INVASIVE MONITORING OF INFECTIOUS DISEASE: FOCUS ON BURN VICTIMS
Pacific Northwest National Laboratory
The ultimate objective of the proposed research is to develop a cost-effective, noninvasive, continuous monitoring device for diagnosing the onset and progression of bacterial infection associated with severe burn victims.
NATIONAL MEDICAL TECHNOLOGY TESTBED-VACCINIA VIRUS BASED CANCER GENE THERAPY
Loma Linda University Medical Center
The project goal is to determine the efficacy and safety of recombinant vaccinia treatment with radiation therapy against a highly malignant tumor in a cost-effective pre-clinical model.
OCULAR TRAUMA
TATRC
The purpose of this study is to evaluate the efficacy of current technology in the assessment of traumatic ocular injuries. This study is a direct comparison of several imaging devices to each other and to in-person direct examination of eye injuries in an animal (goat) model of ocular trauma.
PIC-FBI HIGH CAPACITY PIC EUE
FBI
This program is an early user evaluation of a PIC-type device to be tested by the FBI's Hostage Release Teams. The PICs will be populated with data and will have capacities ranging from 2 MB to 48 MB. The maximum amount of data possible will be added to the PIC in order to assess the relevance of recording all medical data and to estimate the capacity requirement.
PIC-PERSONAL INFORMATION CARRIER-PIC (FORCE HEALTH PROTECTION)
TATRC
The Personal Information Carrier (PIC) is a small electronic data storage device that stores pertinent electronic medical data about the individual who carries it. The PIC will serve as the primary medical data source about the individual in settings where computer network connectivity is not available.
PIC-TECHNICAL SUPPORT TO USAMRMC FOR TELEMEDICINE AND HEALTHCARE TECHNOLOGIES
Department of Energy-Oak Ridge
The objective of this project is to demonstrate the feasibility of information transfer across multiple platforms and develop a proof of concept model for the PIC. The project would have three components: Requirements Analysis; Feasibility Study; Proof of Concept Model.
PERISCOPIC SPINE SURGERY
Georgetown University Medical Center
This project focuses on the advancement of minimally invasive spine surgery using advanced image-guided techniques. The successful completion of this project will provide a prototype system for a new generation of image-guided spine surgery techniques, allowing for improved care for both military and civilian beneficiaries, specifically patients with both degenerative and traumatic spine injuries.
PORTABLE APOLLO X-RAY SYSTEM FOR MILITARY APPLICATIONS
General Electric
The objective of the Portable Apollo X-Ray System is to design, build, integrate and test a portable digital x-ray system capable of being dropped and deployed in far forward applications. The system will allow for digital image communication to facilitate remote diagnosis. The unit will be suitable for operation in a military environment, including resistance to shock, vibration, stress, humidity, and temperature extremes.
REFINED EQUIPMENT AND PROCEDURES FOR PROSTATE CANCER DETECTION AND TREATMENT
Henry Jackson Foundation
This project will develop new and innovative imaging modalities for both detection and accurate treatment of prostate cancer. The project outlines specific promising technologies that will improve the capability to cure prostate cancer before it has the ability to become widely metastatic.
SATELLITE COMMUNICATIONS EVALUATION AND TRAINING SUPPORT-VSAT
TATRC
 
SECURITY-WEB BASED MEDICAL INFORMATION TECHNOLOGY
TATRC
The focus of this project is the securing of web-based medical information technology elements through C2 assessment, evaluation of firewall technologies, and the evaluation of server and network technologies.
SHARED INTERNET SERVER FOR DELIVERING HEALTH CARE GUIDELINES
National Medical Laboratory
The goal of this project is to develop tools and techniques to promote the computerization of guidelines by developing a standard to represent them, an Internet server to store and execute them, mechanisms for translation into a local execution environment, and finally, implementation in conjunction with electronic medical record systems.
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SIMULATION TECHNOLOGIES FOR ADVANCED TRAUMA CARE
Research Triangle Institute
The specific aim is to improve upon the prototype trauma patient simulator developed under the Trauma Patient Simulator project. The tasks are:

-Achieve Additional Realism in Trauma Patient Simulation
-Refine Technologies
-Mature the Technology and Sustain Quality
- Extend the Trauma Patient Simulator to Dual-Use
SPECIALOperations Medical Diagnostic System
SRMC
The SFMDS project integrates the major functions of a medical reference library, diagnostic and treatment decision aids, medical sustainment training, and medical mission planning, into a single portable computer-based device with Internet access capabilities.
SPECIAL MEDICAL AUGMENTATION RESPONSE TEAM-MC3T
MEDCOM
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STANFORD AFFILIATES PROGRAM
Stanford University
Stanford Medical Informatics (SMI) Industrial Affiliates Program is a novel program that provides substantive opportunities for technology transfer by developing close interaction and collaboration between academia and industry through an annual SMI Symposium and Affiliates' Seminar.
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AMEDD TELEDERMATOLOGY TELEMEDICINE PROJECT
TATRC
This project is a study of the efficacy of a World Wide Web-based store and forward teledermatology consultation service designed around a single medical center "hub and spoke" system. This project is intended to test the deployability of this system within a network of five medical centers, each providing an independent hub and spoke node that is interconnected cooperatively with the entire network through a centrally managed program.
TELEGENETICS
AFIP
This project will provide for initial telegenetics activities at the Center for Medical and Molecular Genetics (CMMG)/Armed Forces Institute of Pathology (AFIP), to include development of a CMMG/AFIP Internet Home Page, electronic linkage among facilities within the National Capital Area and a web-based genetics consultative application.
TELEMEDICINE ADVANCED DEVELOPMENT
Los Alamos National Laboratory
This project involves the development of a web-based version of TeleMed, a multimedia, virtual, electronic medical record. The web-based version will have a Patient Identification Service (PIDS) which allows access to patient information without the need for a universal patient identifier, public/private key authentication and authorization security for software and hardware, and server and client support for DICOM images and MIME documents.
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TELEMEDICINE ARMY POLYSOMNOGRAPHY PROJECT (TAPP)
WRAMC
This project will utilize Army Telemedicine resources to allow the performance and interpretation of high quality sleep studies at Landstuhl Army Medical Center in partnership with the Sleep Disorders Center at Walter Reed Army Medical Center
TELEMEDICINE ENGINEERING TECHNICAL SUPPORT TO AMEDD REQUIREMENTS
TATRC
This is the parent project for the services and support functions provided by the Operations Division of the TATRC. The Operations Division researches and prototypes telemedicine systems utilizing current and emerging commercial and government off-the-shelf technologies to enhance tri-service medical care, medical command and control, and situational awareness; provides medical augmentation to regional domestic, Federal and Defense agencies; provides technical, engineering, and telemedical support, as well as prototyping and evaluation of new technologies.
TELEMEDICINE SUPPORT FOR ADVANCED TRAUMA CARE
DSCC
This project provides support in telecommunications, medical informatics, and analog-to-digital conversion technologies to investigate and prototype an example telemedicine system for support of advanced trauma care.
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TELEMEDICINE WEB SITES
TATRC

www.tatrc.org
www.dod-telemedicine.org

TELEOPTHALMOLOGY FOR DIABETIC RETINOPATHY SCREENING
WRAMC
This project will investigate whether a medical technician (untrained in ophthalmic photography) is able to gather digital images that are adequate for a trained ophthalmologist to utilize in determining the level of diabetic retinopathy that exists in a given patien
TELEPRESENCE MICROSURGERY SYSTEM FOR USUHS
USUHS
This project involves a consortium of civilian and DoD facilities (USUHS) to research and develop technologies that advance minimally invasive surgical techniques. This project was developed to address device development to improve microsurgical dexterous manipulations, in particular, to optimize fine motor control and minimize hand tremor and fatigue.
TELEPSYCHIATRY VERSUS IN-PERSON INTERVIEWS
WRAMC
The objectives of this study are to examine the elements of the developing therapeutic alliance from the first psychiatric interview based upon the parental perspective. The primary distinction will be made in determining whether there is a significant difference between the questionnaires obtained from in-person interviews and those obtained from telepsychiatry interviews.
TESTING THE APPLICABILITY OF TELEMEDICINE TECHNOLOGY FOR USE IN EMERGENCY ENVIRONMENTS
Mercy Health Systems, Inc.
This study will the extent to which the use of telemedical equipment will expedite the triage and treatment process in emergency situations for patients in remote areas, thereby improving timeliness, quality care, and patient outcomes.
SUPPORT FOR THE CONTINUATION OF THE CLINICAL ASSESSMENT RECORDING ENVIRONMENT (CARE) PROJECT
SRMC
This project consists of six tasks central to the advancement of the CARE program. The tasks are: 1) Complete the design development, integration and testing of an improved user interface prototype to allow clinicians to easily and efficiently enter essential patient data and simultaneously present the suggestions for care and treatment in the forms of suggested tests, diagnoses and treatments. 2) Complete the design development, integration and test of a prototype system that integrates the CARE electronic patient record and computer-assisted diagnosis and treatment system with modules that provide patient appointments, doctor scheduling, lab reports and drug interactions. 3) Work with healthcare experts to develop, integrate and test a prototype knowledge base of decision-making rules and outcome statistics for patient problems of pediatric fever, occupational health for caregivers (commonly exposed to needle sticks), asthma, and COPD. 4) Plan, train, and conduct a 60 day beta test of the prototype system at a military clinic setting. Analyze test results to complete and submit a Beta Test Report. 5) Complete the design development, knowledge acquisition, integration and test of a new prototype to provide an expert system to identify and triage possible biological/chemical exposures in the field, enhancing fundamental medical systems for biological defense. 6) Manage the development of the CARE project in accordance with good commercial practice.
TROPICAL MEDICINE CENTRAL RESOURCE
USUHS
The objective of this Tropical Medicine Imaging Project (TMIP) is to create a global resource for health care providers on Tropical Medicine, with emphasis on the radiography of tropical diseases.
USAMRMC PATENT AND TRADEMARK DATABASE WEB APPLICATION
TATRC
 
USAMRMC/DARPA TECHNICAL OVERWATCH
SRA, International
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3D ULTRASOUND IMAGING INITIATIVES
Cleveland Clinic
The Ultrasound Imaging Initiative is focused on the development of technology required for far-forward, accurate, ultrasound imaging of the combat casualty. It addresses the capabilities of the medic, physician assistant and general medical officer.
UPGRADE OF LOMA LINDA UNIVERSITY PROTON SYNCHROTON AND SWITCHYARD FOR PERFORMING BEAM SCANNING OF LARGE IRREGULAR TARGETS IN HUMAN PATIENTS WITH CANCER
Loma Linda University
This project will develop the accelerator and switchyard upgrades capable of bringing the proton beam to the treatment room with the essential beam characteristics needed for beam scanning of various modes. This work includes modification of existing accelerator and switchyard control systems to allow a complete integration of the accelerator, switch yard and treatment room.
VIRTUAL FLIGHT SURGEON OFFICE
Fort Rucker
This project involves the provision of a prototype central medical review authority teleconsultation system that is scalable and widely available. The Aeromedical Activity at Fort Rucker with its' subordinate elements of the aviation medicine program is the test community. The overall goal of the project is to migrate the Aviation Epidemiology Data Register to a backend database, and develop transaction business tier and web enabled applications for the central aeromedical review authority and remote aviation medicine clinic.
VIRTUAL OFFICE PROGRAM
TATRC
The Virtual Office project will research, develop, test and evaluate COTS Internet technology applications for application to TATRC, Command and Medical information management challenges. The Virtual Office will support these requirements through the application of Web sites, database applications, Internet calendars, workflow, and knowledge management.
VIRTUAL SLIDE
AFIP
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VISN-1 DISEASE MANAGEMENT PROJECT: DIABETES MELLITUS
Veterans Army Medical Center-Boston
This project proposes to study patients with diabetes mellitus, type 2 (DM2) in collaboration with the Joslin Diabetes Center (JDC). The ultimate goal of the project is to establish a system of diabetes management for VISN-1which could serve as a model for the VHA.
VOLUME ANGIOCAT
MDI, Inc.
The proposed new technology called VolumeAngioCAT (VAC) goes beyond current scanning methods to provide true real-time and true volume 4D imaging. It is anticipated that the new VAC will accomplish the following clinical objectives: Implementation of a preventive medicine capability whereby a 5-10 second inexpensive whole body scan supplants or augments the "annual physical" examination. Create a new, single, rapid diagnostic examination that spatially and temporally integrates detailed anatomic 3D/4D imaging with quantitative physiologic and biochemical analysis. Provide advanced simulation training and routine therapy simulations prior to therapeutic procedures/surgery.
WARFIGHTER INFORMATION NETWORK-TERRESTRIAL VERSUS TELEMEDICINE
Fort Gordon
The Warfighter Information Network (WIN) is an evolving integrated C4 network that is comprised of commercially based, high technology information and communications systems. It will be designed to increase the security, capacity, and velocity of information distribution throughout the battlespace in order to gain information dominance.
Telemedicine Army Polysomnography Project (TAPP)
WRAMC
Description: A project to utilize Army Telemedicine resources to allow the performance and interpretation of high quality sleep studies at Landstuhl Army Medical Center in partnership with the Sleep Disorders Center at Walter Reed Army Medical Center. Currently, Landstuhl is unable to perform high quality sleep studies on soldiers, dependents or retirees. Hence, patients must be funded for these studies through supplemental care and studied in German Hospitals (dependents, retirees) or air-evacuated to Walter Reed (active-duty soldiers). The cost of Army Telemedicine sleep studies in the start-up year will be $430 per study. This cost will decrease to $325 per study in subsequent years. Currently, sleep studies cost $1,000-1,500 each on the local economy. TDY costs for patients air-evacuated to Walter Reed from Landstuhl also increase the real cost of sleep studies on active-duty soldiers to $1,000 to $2,000 each.

We propose to train available, designated technicians at Landstuhl on all skills needed to perform these sleep studies and to relay these by electronic mail to Walter Reed for interpretation. We will also supply equipment to perform these studies which is compatible with Walter Reed's equipment. A systematic quality assurance program will be used to insure the adequacy of all steps of the sleep study process.

We request that funding for this program start on 1 July 1998 and be designated on a yearly basis to allow for continuity. Once this sleep study program is established, we will perform and interpret 400 studies per year at Landstuhl. This capacity will allow the Landstuhl site to act as a referral center for sleep studies for eligible Americans throughout Europe.
Virtual Flight Surgeon Office
Fort Rucker
Description: Virtual Flight Surgeon Office: This project will develop and evaluate a web-based aeromedical store-and-forward telemedical consultation system. This system will be compliant with existing legacy informatic systems. Once proven, this system will have tri-service applicability. The USA aviation medicine program promotes safety, prevention of chronic disease and injury, and maintainence of optimal physiological capability. A key program element is the centralized aeromedical consultation authority to develop aeromedical policy and standards, disseminate aeromedical doctrine through education and training, and conduct administrative and epidemiological reveiw of disabilities among aircrew members. The problem is that the vast majority of USA aviation medicine clinics operate at airfields that are miles away from the mainstream of hospital based medical care, disconnected from the medical information management system.
Joslin Diabetes
Joslin Diabetes Center
Description: Despite demonstrated means to reduce the risk of vision loss from diabetes, diabetes mellitus remains a major cause of blindness. One reason for this unnecessary loss of vision is that only 50% of patients with diabetes receive timely eye care. Furthermore, diabetes is a significant cause of morbidity and mortality in the United States.

The Joslin Diabetes Eye Health Care Model is a telemedicine initiative, using the Joslin Vision Network telemedicine platform, designed to access all diabetic patients into a cost-effective, quality eye care program across geographic and cultural boundaries. The Joslin Vision Network also includes components to identify undiagnosed type 2 diabetes, store and retrieve data for outcome and population based studies, educate patients and health care providers, and facilitate individual diabetes case management strategies through Joslin's Diabetes Outpatient Intensive Treatment (DOIT) program. The Joslin Vision Network has the potential to provide the enabling technology to reduce vision loss and other complications of diabetes
New Advanced Technology to Improve Prediction and Prevention of Type I Diabetes
Children's Hospital of Pittsburgh
Description: Scientists involved with the study of insulin-dependent Diabetes Mellitus (IDDM) at the Children's Hospital of Pittsburgh, are committed to collaborate with experts in fluorochromes and robotic devices at the NSF Science & Technology Center of Carnegie-Mellon University in Pittsburgh and experts in microarray technology at the University of Tuebingen, Germany, to promote further studies of the various parameteres involved in the complex relationship between HLA molecule alleles conferring sussceptibility to the disease, diabetogenic T cell receptor forms, and possibly-triggering viral antigenic peptides, able to bring aboug Type 1 diabetes.

The working hypothesis is based on the conclusion that in genetically at-risk individuals, certain strains of enterovirus are able to trigger the autoimmune attack responsible for the IDDM onset. The technical objectives proposed to prove this assumption will be reached by using not only existing advanced technology, but also developing new technology like microarrays in suspension, i.e., microspheres barcoded with different concentrations of different fluorescent dyes, each carrying a covalently attached polymer of a different oligonucleotide probe for a different protein produce expressed by each DNA of organized sets. The clinical relevance of the newly characterized T cell receptor molecules, or of the newly characterized pancreatic auto-antigens will be finally tested by generating transgenic mice that should be spared from the pathologic characteristics associated with IDDM and proven unable to transfer the disease by adoptive transfer of their T cells.

The final goal is to improve IDDM predictive capabilities, and to design safe, prophylactic intervention protocols to be eventually tested in clinical trials of people at high-risk for developing the disease.
University of Hawaii Cooperative Agreement
John A. Burns School of Medicine University of Hawaii, Honolulu, HI
Description: The University of Hawaii Telemedicine Curriculum Development Project is a Cooperative Agreement between the University of Hawaii and the USAMRMC, designed to assess and establish an effective telemedicine curriculum for the training of military healthcare personnel in the use of contemporary communication, automation, and informatics technology in the delivery of healthcare. This curriculum will be uniquely tailored to the needs of the military health care provider (HCP). The telemedicine curriculum is designed to both impart necessary knowledge and practice skills to the HCP. The HCP will learn the clinical use of telemedicine and the HCP will understand the clinical and organizational barriers of the successful utilization of telemedicine. The evaluation process will be structured to determine whether the student has or has not acquired the appropriate knowledge, skills and behavior (e.g., the process will quantify a change in behavior that will lead to desired organizational outcomes). The telemedicine curriculum will address the communication and automation tools available to the military healthcare system particularly in its mobilization environment. This new innovative telemedicine curriculum will help the Department of Defense (DOD) to assess the efficacy and efficiency of their investment in technology for communication and healthcare delivery. A multidisciplinary team of academic healthcare providers, educators, support personnel and experts in curriculum development will develop, test and evaluate the telemedicine curriculum. Key team members will be drawn from the existing personnel at the University of Hawaii, the majority from the John A. Burns School of Medicine. A virtual laboratory will be established where the curriculum will be developed, tested, studied and evaluated. This virtual laboratory will be in an environment where healthcare delivery is the major mission of the facility. This assures that the developed curriculum is realistic, practical and utilizable by the DOD.
Emergency Telemedicine (Mercy)
Mercy Health Care Center, Philadelphia, PA
Description: This study intends to show that the use of telemedical equipment will expedite the triage and treatment process in emergency situations for patients in remote areas, thereby improving timeliness, quality care, and patient outcomes. Data generated from this study can be compared to other like telemedical devices and wavelet compression applications with the goal of establishing cost effective telemedical devices for use in the remote and austere battlefield environments with technology transfer to the civilian at-home or assisted-living environments.

This project has four components, remote telemonitoring (Space Labs), teleradiology (MUSTPAC-3), Center of Excellence for ChemBio disaster relief, and wavelet compression (Wavenet). Each is a multiple phase study independent of each other. The general approach to the Space Labs is evaluating the cost/benefit of remote monitoring using Mercy's at-home or assisted-living facilities. The cost savings of the number of avoided potentially unnecessary transfers and early-indicated appropriate transfers will be considered. Provider satisfaction on the efficacy of the remote monitoring will be documented by survey.

The MUSTPAC is a double blind study that must first prove that the image taken by the automatic scanner (with a skilled sonographer) is as good as the conventional image. Then MUSTPAC must prove that the virtual probe (physician operated) and its B-scan image of a 3D construct is just as diagnostic. Then lastly, a low-skilled operator can take a quality, diagnostic image. All this must be done before testing its store and forward capability.

The Center of Excellence for Biological and Chemical Medical Response component will research the Philadelphia civilian EMS's and hospital's ability to respond to a biological or chemical disaster and make recommendations to markedly improve its ability to respond. The recommendations will leverage from the military and other like civilian programs, thereby establishing a Center of Excellence in the greater Philadelphia area. Advanced sensing technologies and telemedicine business practices will markedly improve the EMS's timeliness and efficacy of emergency response.

The WaveNet should be a double blind study of a radiologic image (such as an x-ray) with, calibration marks on it. The original image and the WaveNet conditioned/compressed image will be read by a radiologist (or radiologists, each reading both images and their accuracy compared one to the other). The calibration marks will give absolute resolution, the radiologists' readings will give diagnostic capability.
Combat Trauma Patient Simulator
STRICOM, Florida
Description: The CTPS is aimed at developing an integrated military medical simulation system for training, test and evaluation, to more realistically assess the impact of battlefield casualties. The system uses primarily commercial-off-the-shelf and government off-the-shelf live, virtual, and constructive simulation components that would allow the system to respond to both wound condition and medical treatment interventions such as a human would.