Center Develops Partnerships to Create Cutting-Edge Medical Technology

By Navy Lt. Jennifer Cragg
Special to American Forces Press Service

June 22, 2008 - The U.S. Army Medical Research and Materiel Command's Telemedicine and Advanced Technology Research Center is dedicated to advancing the discovery of new and novel medical technologies and research and following them through to implementation, said the center's director. Col. (Dr.) Karl Friedl, who leads the center on Fort Detrick, Md., discussed the center's mission during an interview on the "Dot Mil Docs" program on BlogTalkRadio.com on Thursday.

"TATRC is about connecting strategic partnerships and trying to facilitate the novel cutting-edge import of medical technologies and research that are going to make a difference for the DOD, especially in those areas that fall outside of our planned programs that weren't necessary in the president's budget," Friedl said.
Friedl pointed out that the center has the ability to be both agile and responsive.

"We're both sort of a catcher's mitt as well as a forward recon group for military medical research, and we ... [serve] in a function as a primer or an incubator for innovative medical research," he said.

TATRC has been exploring and implementing telemedicine and other advanced medical technology solutions for over 15 years. Today, TATRC supports approximately 500 ongoing research projects.

TATRC works with industry, academia and the government to research and find solutions to medical advancements in numerous areas, to include diseases such as diabetes, Parkinson's and gynecological cancers.

These solutions provide models with dual use applications, providing the DOD with new approaches for physiological monitoring, glycemic control of casualties, neuropsychological monitoring tools, and interventions to protect against effects of head injury and neurotoxic chemical exposures. They also create a network for DOD patient care and personalized medicine.

He added that osteoporosis research funding has produced new discoveries and understanding that, if implemented, could nearly eliminate stress fracture from initial entry training. Additionally, TATRC is researching other avenues, such as teleneurosurgery projects by using new robotic technologies to bridge the "distance" gap between the patient and the doctor.

"A clinician can manipulate this robot with a screen, so people at the other end can see the clinician and respond to him," Friedl said.

Friedl said TATRC is exploring the usage of robotic technologies through the RP-7 Remote Presence Robotic System, which is a wireless, mobile, remote presence robot that allows a doctor to be in two places at once. TATRC is exploring the use of remote presence robots at a handful of Army medical facilities.

He added that the camera enables the clinician to move the robot around to see the patients to get the best view. "It wasn't something that required new research or discovery of something new, but was to show that these things would work in that environment and refine how they might work and to overcome those barriers to implementing a great solution," Friedl said.

Friedl said that TATRC has been working on various significant military medical research,including computational biology predictive modeling, electronic health records and outcomes-based research, and neurosciences.

"The most significant pieces for the future of our military medical research that we are invested in right now, we are focused on computational biology, which contributes to predictive modeling and tools for decision support systems, everything from how we would interpret the sensors that we might put on a casualty from the evacuation all the way through to their rehabilitation in some remote area ... where we would need to monitor how they are doing," he said.

Another key technology is electronic health records and outcomes-based research to enable the mining of medical records to detect such items as health ailments or identifying supplements that people in the Defense Department are taking that might have adverse outcomes.

"DOD has the largest single electronic health record collection in the world," said Friedl. "Imagine if we now have a good pharmaceutical vigilance system built into this so you could monitor closely any adverse outcomes that we would be the first to detect."

He added that having a pharmaceutical vigilance system built into an electronic health record, would allow early detection.

"Electronic health records is key to our future ... if we make it work right; it's going to change the way we do business," said Friedl.

Friedl added that another significant military medical research area deals with neurosciences.

"Every one of these projects that come in, we consider how it's going to contribute to some piece of our neurosciences interest, the watchword of the day is mild TBI and PTSD," said Friedl.

However, there are some 40 main areas in medical technology that TATRC are currently working on. In addition to research, TATRC is also working on another 20 key medical initiatives.

"The DOD has the opportunity to be in the leadership role, because of the kinds of models and problems that we have," said Friedl. "We are here to try solving problems."

Friedl said one of the 20 key initiatives that TATRC is exploring is the concept of the "hospital of the future," which TATRC works on harnessing and gathering up the technology, advancements and research from the Center for Integration of Medicine and Innovative Technology (CIMIT) in Boston and the Center for Advanced Surgical and Interventional Technology at the University of California Los Angeles medical center, for example, and connecting these with the Army Health Facility Planning Agency.

"When we open up a new facility, we actually open it up with new technology and cutting-edge concepts instead of something that is already 10 years old," Friedl said.

CIMIT involves interaction of science and engineering to promote innovative medical research advances such as autonomous medical training manikins, medical device plug-and-play standards, and medical equipment for austere environments such as a neonatal incubator composed exclusively of Toyota car parts.

Friedl added that TATRC is committed to their strategic partnering and collaboration-building activities with universities, such as University of Texas Health Sciences Center Houston and the South Carolina academic consortium.

TATRC is also working with the University of Texas on the Nanohealth Alliance, encephalitis surveillance, radioprotection, and medical emergency response. In addition the center addresses systems wellness and integrative healthcare studies with new recruits and biobehavioral factors at the South Carolina academic consortium.

(Navy Lt. Jennifer Cragg works in the New Media directorate of the Defense Media Activity.)