HRR - Gap - Med10: We do not have the capability to provide computed medical decision support during exploration missions.

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Med10: We do not have the capability to provide computed medical decision support during exploration missions.

Last Published: 07/31/19 10:05:30 AM (Central)

Responsible Element: Exploration Medical Capability (ExMC)

Status: Open

Description

Initial State:
The ability to provide ground support from medical personnel will be limited during exploration missions due to varying lengths of communication delay. To prepare for this situation, it is essential to provide the tools for the crew to be more autonomous than the current ISS paradigm. This gap identifies the need for autonomous medical decision support to augment the knowledge of the decision-making crewmember with algorithmic support including medical image interpretation, biomedical metrics identification, medical history notification, exercise performance review, vehicle environment data review and others.

Approach:
Projects will be conducted to explore avenues that will:
    1. Identify telemedicine limitations.
    2. Identify and develop needed reference databases for intelligence augmentation.
    3. Identify and develop algorithms for augmented medical decision support.
    4. Identify and develop algorithmic support to minimize opportunity for medical errors.
    5. Define how to integrate into the exploration medical system.
    6. Collaborate to optimize crew interface with medical decision support.

Target for Closure

An information system to provide computed medical decision support during exploration missions.

Mappings

Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions

Med10: We do not have the capability to provide computed medical decision support during exploration missions.

Completed

Integration of iRevive with the Lightweight Trauma Module

Task Book: Entry
Principal Investigator: Crossin, John

Short Title: iRevive

Responsible HRP Element: Exploration Medical Capability

Collaborating Org(s):

National Space Biomedical Research Institute (NSBRI)

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Solicited

Aims:

Formalize communication protocol between iRevive and the LTM
Design GUI for LTM integration into clinical workflow
Alter iRevive GUI to accommodate LTM data fields
Re-factor iRevive Database
Test and integration
Clinical trial, system modifications and data exchange
Prepare and submit written report

Resources (None Listed)

Deliverables (1)

ExMC Support of Medical Scenarios for the Autonomous Mission Operation (AMO) Test

Task Book: Entry Unavailable
Principal Investigator: Hurst, Victor

Short Title: Medical Scenarios

Responsible HRP Element: Exploration Medical Capability

Collaborating Org(s):

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Directed

Aims:
1. To discern the level of ground-assistance (remote guidance) necessary, if any, when using minimally-trained caregivers to assess and treat a patient during an extensive communication time delay.
2. To determine whether non-physicians can autonomously assess and treat a patient with minimal training.
3. To determine whether non-sonographers can efficiently collect useful ultrasound imagery with minimal training and remote guidance.
4. To determine whether the available similar-to-current-ISS resources are sufficient for assessing and treating these exploration-relevant medical conditions.
5. To determine whether written procedures with imagery are sufficient to guide autonomous non-physicians to efficiently and effectively assess and treat a patient.

Integration/Unique Aspects:

ExMC will use the data from these evaluations as part of their preparation for the ground base test of the Exploration Medical System Demonstration (EMSD).

Resources (Other)

Deliverables (1)

Category: Technology or Tool
Subcategory: Informatics

Description:
The deliverable is a white paper outlining the findings from the evaluation. The findings indicate that although written medical procedures can be effectively executed by minimally-trained non-physician caregivers (e.g. Crew Medical Officers (CMO)) with minimal remote guidance, a lack of clinical decision support expertise prevented the non-physician CMOs from being able to autonomously administer clinical care. This white paper contributes to the closures of Gap 2.02 by addressing the interim stage 2, Gap 3.01 by addressing interim stage 1, Gap 4.01 by addressing interim stage 2, Gap 4.13 by addressing interim stage 1, Gap 4.24 by providing another analogue to include in the study of treatment of conditions in remote, resource poor environments, and Gap 5.01 by addressing interim stage 2.

Internal Customers:
Exploration Medical Capability
External Customers:
None Is a Customer-Supplier Agreement (CSA) Required? No

Planned-Funded

Human Capabilities Assessments for Autonomous Missions (HCAAM) Virtual NASA Specialized Center of Research (VNSCOR)

Task Book: Entry Unavailable
Principal Investigator: TBD

Short Title: HCAAM VNSCOR

Responsible HRP Element: Human Factors and Behavioral Performance

Collaborating Org(s):

Funding Status: Planned-Funded - Task expected to be within budget

Procurement Mechanism(s):

Solicited

Aims:
NASA envisions implementation of an intelligent system that will integrate knowledge of the past and current state of the crew and vehicle in order to appropriately adjust and adapt systems to facilitate mission success for a future state. These complex relationships must be maintained for both routine tasks and more complex tasks. The purpose of this task is to focus research on providing the basis for the development of standards, guidelines and automation tools for an advanced autonomous decision-support system for use by our astronaut population that will reflect both individual and team, real-time human performance support for autonomous spaceflight.

1) Characterize human capabilities and limitations related to potential performance decrements during long duration exploration mission (LDEM) spaceflight as relevant to both routine and complex task performance.

2) Determine appropriate advanced, autonomous intelligent system decision and execution support responses in order to reduce the likelihood or impact of potential decrements in human performance capabilities.

3) Perform integrated assessment of intelligent system responses in order to determine positive or negative interactions and validate recommended approaches.

4) Propose specific updates to existing standards and handbooks to enable implementation of findings for upcoming LDEM systems.

Resources (Ground Analog)

Deliverables (1)

Documentation:

No Documentation Available

Related Gaps (34)

HCI-06: We need guidelines to ensure crewmembers receive all of the information required to accomplish necessary tasks in a timely fashion, even when operating autonomously. (Previous title: SHFE-HCI-06)

Common Item(s)
	Human Capabilities Assessments for Autonomous Missions (HCAAM) Virtual NASA Specialized Center of Research (VNSCOR)

TRAIN-02: We need to identify effective methods and tools that can be used to train for long-duration, long-distance space missions. (Previous title: SHFE-TRAIN-02)

Common Item(s)
	Human Capabilities Assessments for Autonomous Missions (HCAAM) Virtual NASA Specialized Center of Research (VNSCOR)

HCI-03: We need HCI guidelines (e.g., display configuration, screen-navigation) to mitigate the performance decrements and operational conditions of long duration spaceflight. (Previous title: SHFE-HCI-03)

Common Item(s)
	Human Capabilities Assessments for Autonomous Missions (HCAAM) Virtual NASA Specialized Center of Research (VNSCOR)

HARI-03: We do not know how to quantify overall human-automation-robotic system performance to inform and evaluate system designs to ensure safe and efficient space mission operations. (Previous title: SHFE-HARI-03)

Common Item(s)
	Human Capabilities Assessments for Autonomous Missions (HCAAM) Virtual NASA Specialized Center of Research (VNSCOR)

MPTASK-01: We need methods and tools to collect measures of missions, process, and task performance. (Previous title: SHFE-TASK-01)

Common Item(s)
	Human Capabilities Assessments for Autonomous Missions (HCAAM) Virtual NASA Specialized Center of Research (VNSCOR)

HARI-02: We need to develop design guidelines for effective human-automation-robotic systems in operational environments that may include distributed, non-colocated adaptive mixed-agent teams with variable transmission latencies. (Previous Title: SHFE-HARI-02)

Common Item(s)
	Human Capabilities Assessments for Autonomous Missions (HCAAM) Virtual NASA Specialized Center of Research (VNSCOR)

HCI-04: We need to understand how emerging multi-modal and adaptive display and control technologies are best applied to the design of HCI for proposed long-duration DRM (Design Reference Missions) operations. (Previous title: SHFE-HCI-04)

Common Item(s)
	Human Capabilities Assessments for Autonomous Missions (HCAAM) Virtual NASA Specialized Center of Research (VNSCOR)

MPTASK-02: We need methods and tools to support mission, process, and task design. (Previous title: SHFE-TASK-02)

Common Item(s)
	Human Capabilities Assessments for Autonomous Missions (HCAAM) Virtual NASA Specialized Center of Research (VNSCOR)

ExMC 1.03: Inadequate information on the individual susceptibility to decompression sickness (DCS) in hypobaric environments relevant to space flight (CLOSED)

Common Item(s)
	Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions

ExMC 3.01: We do not know the optimal training methods for in-flight medical conditions identified on the Exploration Medical Condition List taking into account the crew medical officer’s clinical background (Closed)

Common Item(s)
	Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions
	ExMC Support of Medical Scenarios for the Autonomous Mission Operation (AMO) Test

ExMC 3.02: Lack of knowledge about the current state of the art in telementoring/telemedicine as a tool for assisting crewmembers to diagnose and treat medical conditions that occur in space flight (CLOSED)

Common Item(s)
	Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions

ExMC 4.07: Limited wound care capability to improve healing following wound closure (Closed)

Common Item(s)
	Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions

ExMC 4.10: Lack of rapid vascular access capability for space flight (CLOSED)

Common Item(s)
	Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions

ExMC 4.11: Limited dental care capabilities (Closed)

Common Item(s)
	Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions

ExMC 4.16: Lack of technique or procedure to draw injectable medication into a syringe without bubble formation or bubble removal prior to medication delivery (CLOSED)

Common Item(s)
	Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions

ExMC 4.22: Limited capability to diagnose and treat radiation sickness (Closed)

Common Item(s)
	Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions

ExMC 4.24: Lack of knowledge regarding the treatment of conditions on the Exploration Medical Condition List in remote, resource poor environments (Closed)

Common Item(s)
	Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions
	ExMC Support of Medical Scenarios for the Autonomous Mission Operation (AMO) Test

MPTASK-03: We need methods and tools for planning and dynamic re-planning of crew schedules. (Previous title: SHFE-TASK-03)

Common Item(s)
	Human Capabilities Assessments for Autonomous Missions (HCAAM) Virtual NASA Specialized Center of Research (VNSCOR)

HCI-07: We need to define the acceptable level of risk for HCI performance relative to terrestrial baselines. (Previous title: SHFE-HCI-08)

Common Item(s)
	Human Capabilities Assessments for Autonomous Missions (HCAAM) Virtual NASA Specialized Center of Research (VNSCOR)

Team Gap 6: We need to identify methods to support and enable multiple distributed teams to manage shifting levels of autonomy during long duration and/or distance exploration missions.

Common Item(s)
	Human Capabilities Assessments for Autonomous Missions (HCAAM) Virtual NASA Specialized Center of Research (VNSCOR)

HAB-05: We need to identify technologies, tools, and methods for data collection, modeling, and analysis that are appropriate for design and assessment of vehicles/habitats (e.g., net habitable volume, layout, and usage) for predetermined mission attributes, and for refinement and validation of level of acceptable risk. (Previous title: SHFE-HAB-09)

Common Item(s)
	Human Capabilities Assessments for Autonomous Missions (HCAAM) Virtual NASA Specialized Center of Research (VNSCOR)

HARI-04: We need to identify and scope the critical human-automation/robotic mission activities and tasks that are required for future long duration, long distance space missions. (Previous title: SHFE-HARI-05)

Common Item(s)
	Human Capabilities Assessments for Autonomous Missions (HCAAM) Virtual NASA Specialized Center of Research (VNSCOR)

Med01: We do not have a concept of operations for medical care during exploration missions.

Common Item(s)
	Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions
	ExMC Support of Medical Scenarios for the Autonomous Mission Operation (AMO) Test
	Human Capabilities Assessments for Autonomous Missions (HCAAM) Virtual NASA Specialized Center of Research (VNSCOR)

Med02: We do not have the capability to provide a safe and effective pharmacy for exploration missions.

Common Item(s)
	Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions

Med03: We do not know how to apply personalized medicine effectively to reduce health risk for a selected crew.

Common Item(s)
	Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions

Med04: We do not have a defined rehabilitation capability for injured or de-conditioned crew members during exploration missions.

Common Item(s)
	Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions

Med05: We do not know how to train crew for medical decision making and medical skills to enable extended mission or autonomous operations.

Common Item(s)
	Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions
	ExMC Support of Medical Scenarios for the Autonomous Mission Operation (AMO) Test
	Integration of iRevive with the Lightweight Trauma Module

Med06: We do not know how to define medical planning or operational needs for ethical issues that may arise during exploration missions.

Common Item(s)
	Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions

Med07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions.

Common Item(s)
	Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions
	ExMC Support of Medical Scenarios for the Autonomous Mission Operation (AMO) Test
	Human Capabilities Assessments for Autonomous Missions (HCAAM) Virtual NASA Specialized Center of Research (VNSCOR)

Med08: We do not have quantified knowledge bases and modeling to estimate medical risk incurred on exploration missions.

Common Item(s)
	Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions
	ExMC Support of Medical Scenarios for the Autonomous Mission Operation (AMO) Test

Med09: We do not have the capability to predict estimated medical risk posture during exploration missions based on current crew health and resources.

Common Item(s)
	Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions

Med11: We do not have the capability to minimize medical system resource utilization during exploration missions.

Common Item(s)
	Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions

Med12: We do not have the capability to mitigate select medical conditions.

Common Item(s)
	Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions

Med13: We do not have the capability to implement medical resources that enhance operational innovation for medical needs.

Common Item(s)
	Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions
	ExMC Support of Medical Scenarios for the Autonomous Mission Operation (AMO) Test

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PRRs (1)

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Ground-Based Flight Analogs	Controlled Research Analog, Long Duration (4 months or more) – isolated and confined with spaceflight mission scenario [e.g., NEK/Russian Chamber], ICE Field Analog, Short Duration (4 months or less) – isolated, confined and extreme; may not have spaceflight mission scenario
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