TATRC

&

P R O J E C T T E A MP R O J E C T T E A M

Dr. Gerald R. Moses, Projects Supervisor301 – 619 – 4000 / moses@tatrc.org

J. Harvey Magee, Project Officer301 – 619 – 4002 / magee@tatrc.org

TATRC MTATRC MEDICALEDICAL M MODELINGODELING

P O R T F O L I OP O R T F O L I O

SSIMULATIONIMULATION

Open Source Software Framework for Organ Modeling and Simulation

Conference National Library of Medicine

June 24, 2001

I N F O R M A T I O N B R I E F I N G T O

Presenter: J. Harvey MageePresenter: J. Harvey Magee

http://www.tatrc.orghttp://www.tatrc.org

Fort DetrickFrederick, Maryland

Headquarters U.S. Army Medical Researchand Materiel Command

Major General John S. Parker, Commanding General

Telemedicine and Advanced Medical Technology Program

Mission Apply physiological and medical knowledge,

advanced diagnostics, simulations, and effector systems integrated with information and telecommunications to enhance operational and medical decision-making, improve medical training, and deliver medical treatment across all barriers.

The program scope is to identify, explore, and demonstrate key technologies and biomedical principles required to overcome technology barriers that are both medically and militarily unique.

Telemedicine & Advanced Technology Research Center Cutting Edge Medical Technology

Department of Defense,Joint Warfighting Science and Technology Plan, Chapter IX, Joint Readiness and Logistics, 1999

TATRC

TATRC

Why do we Need Simulation?Why do we Need Simulation?

• Military medical personnel [note: 100,000 of

them] must practice battlefield trauma care

skills (GAO Report June 98).

•Training should replicate combat specific wounds & battlefield

environmental stressors. Civilian injuries are unlike war.

•Traditional “see one, do one, teach one” method is changing.

•There are increased restrictions on animal use for training.

•Cost to conduct mass casualty exercises is prohibitive.

•Health care payors are resistant to reimburse for training.

•There are risks from treatment by care providers-in-training.

TATRC

PLUS………..PLUS………..

Kohn, Corrigan, Donaldson,Institute of Medicine, 1999

• “Every year at least 44,000 Americans die …of medical errors”

• Medical errors are the 7th leading cause of U.S. death, greater than car accidents, breast cancer, or AIDS

• Pharmacy errors are no longer the leading medical error. Surgical errors are.

• “Recommendation 4.1: Congress should create a Center to…develop knowledge and understanding of errors…develop a research agenda…evaluate methods for identifying and preventing errors….”

FUNDING EFFORTSRELATIONSHIPS

COLLABORATIONSPORTFOLIO

TissueModeling

STATCARE(Simulation

Technologies for Trauma Care)

MSTI(Medical

SimulationTrainer

Initiative)

CTPS(Combat TraumaPatient Simulator)

SimulationMeta-

Analysis(Complete)

ENTSurgicalSimulator(Complete)

UreteroscopicEndoscopicSimulator(Complete)

3-D VolumetricImaging, Haptics

Strategic Plan,Good Science, Sound

Business Processes

Strategic Plan,

Good Science, SoundBusiness Processes

Workshop on Surgical Simulation

[Algorithms] (Stanford)

June 01

Surgical Metrics (Yale)July 01

Haptics Users Group

(Colorado)Oct 01

Open Source Framework

(NFAS)July 01

TATRC

T O M E E T M U L T I P L E T R A I N I N G N E E D ST O M E E T M U L T I P L E T R A I N I N G N E E D S

PC-based Interactive VR/Multimedia

MMULTIPLEULTIPLE T TECHNOLOGIESECHNOLOGIES

Digitally EnhancedMannequins

VirtualWorkbenches

Total Immersion Virtual Reality

TATRC

Assessment of MedicalAssessment of MedicalTraining SimulatorsTraining Simulators

• Evaluation methodology• Formulate overall objectives of the evaluation.• Develop general experimental design.• Select and develop appropriate treatment

scenarios.• Develop dependent variables / performance

metrics.• Performance Metrics

• Develop measurable standards against which to assess performance.

• Determine participants & pre-evaluation orientation requirements.

TATRC

Research ChallengesResearch Challenges

• Real-time in vivo tissue property measurement and mathematical modeling

• Tissue-tool interactions• Graphics and visualization• Learning systems• Metrics development and learning transfer

assessment• Open source architecture (Common

Anatomical Modeling Language [CAML], CIMIT)

TATRC

Original Strategy (Feb 00)

•Assess the landscape – “Meta-Analysis”

•Engage the experts – 70-person “Integrated

Research Team”, Feb 00

•Converge the worlds

•Support the science

•Designate the “lead agency” to integrate

efforts – TATRC has been designated.

•Develop & honor professional business

practices at all stages of the process

TATRC

Current StrategyCurrent Strategy

• Expand our consortia to address the core problems facing simulation.

• Constructively collaborate on various aspects of essential research.

• Demonstrate that simulator-based learning actually transfers to patient care, through validation studies and development of training metrics based upon simulator use.

• Identify sufficient funds to answer these needs within the next five years (well…not ALL these needs).

TATRC

Informal Ways We’re Trying to HelpInformal Ways We’re Trying to Help

•Broad Agency Announcement, US Army Medical Broad Agency Announcement, US Army Medical Research Materiel CommandResearch Materiel Command

• http://www-usamraa.army.mil/

• Broad Agency Announcement #99-1

• Section F, Telemedicine and Advanced Technology Program

•Ask to be added to our “Funding Opportunity List”

•Contact me if questions:J. Harvey Magee301-619-4002magee@tatrc.org