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NASA NTRS2019

Development of an Accepted Medical Condition List for Exploration Medical Capability Scoping

The Accepted Medical Conditions List (AMCL) is a product designed to provide a traceable, repeatable, evidence-based consensus process for scoping the medical capability needs for future design reference missions (DRMs) and upcoming programs. These include a Mars transit DRM and a shorter duration cis-lunar DRM. The development of a baseline AMCL by the Exploration Medical Capability (ExMC) Element will assist the effort to identify high priority medical capabilities for inclusion in mission and vehicle planning and provide traceable and documented clinical needs to the Systems Engineering teams tasked with requirements development and design work.

Medical Condition List↗
NASA NTRS2019

Exploration Medical Capability Medical System Recommendations for Gateway

- Medical System Content Development - 2019: Develop clinical content to inform medical system design; Iterate on content with wider ExMC (Exploration Medical Capability) team; Capture processes used to perform these tasks. - Using model content to inform system design - SME (Subject Matter Expert) collaboration to refine systems using clinical content.

Hailey, Melinda↗
NASA NTRS2019

Medical System Concept of Operations for Mars Exploration Mission-11: Exploration Medical Capability (ExMC) Element - Human Research Program

NASA’s exploration missions to Mars will have durations of 2-3 years and will take humans farther away from Earth than ever before. This will result in a paradigm shift for mission planning, spacecraft design, human systems integration, and in-flight medical care. Constraints on real-time communication, resupply, and medical evacuation are major architectural drivers. These constraints require medical system development to be tightly integrated with mission and vehicle design to provide crew autonomy and enable mission success. This concept of operations provides a common vision of medical care for developing a medical system for Mars exploration missions. It documents an overview of the stakeholder needs and goals of a medical system and provides examples of the types of activities the system will be used for during the mission. Development of the concept of operations considers mission variables such as distance from Earth, duration of mission, time to definitive medical care, communication protocols between crewmembers and ground support, personnel capabilities and skill sets, medical hardware and software, and medical data management. The information provided in this document informs the ExMC Systems Engineering effort to define the functions to be provided by the medical system. In addition, this concept of operations will inform the subsequent systems engineering process of developing technical requirements, system architectures, interfaces, and verification and validation approaches for the medical system. This document supports the closure of ExMC Gap Med01: We do not have a concept of operations for medical care during exploration missions, corresponding to the ExMC-managed human system risk: Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions. This document is applicable to the ExMC Element Systems Engineering process and may be used for collaboration within the Human Research Program.

Urbina, Michelle↗
NASA NTRS2023

Exploration Medical Capability Clinical Decision Support Use Cases for CDSS Test Bed

Long-duration, deep-space exploration missions present significant challenges to crew health and performance. These challenges include the individual and combined effects of microgravity, radiation exposure, isolation, limited resources (mass, volume, power, data, and crew time), limited options for evacuation, and those associated with delayed or constrained communications. Each of these challenges necessitates greater degrees of crew autonomy as our distance from Earth increases. Specifically, as communication delays intensify - and evacuation capability diminishes the further we explore space - the unqualified need for Earth-independent medical operations focused on autonomous diagnosis, treatment and prevention will become key to mission continuation and success. This need will be especially true should a crewmember become ill or injured wherein treatment and disposition “in-situ” ultimately falls to the crew itself to determine. To augment the requisite knowledge, skills, and abilities (KSAs) of a time-constrained exploration mission crew operating under stressful conditions, combatting fatigue, and facing a potential medical crisis, a robust clinical decision support system (CDSS) is a probable solution. A CDSS would facilitate, guide, and inform Earth-independent medical operations while assisting crewmembers through various clinical presentations. The CDSS would allow crewmembers to take advantage of pre-mission training tied to the in-flight/in-mission use of pre-planned protocols that offer both a range of diagnostic options and “just-in-time” (refamiliarization) training and assistance. CDSS will expand such capabilities by improving the utility and effectiveness of various available diagnostic, treatment, and health maintenance tools, techniques, and measures.

ExMC↗
NASA NTRS2010

Human Research Program Exploration Medical Capability

NASA s Human Research Program (HRP) conducts and coordinates research projects that provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. The Program is divided into 6 major elements, which a) Provide the Program s knowledge and capabilities to conduct research, addressing the human health and performance risks. b) Advance the readiness levels of technology and countermeasures to the point of transfer to the customer programs and organizations. The National Space Biomedical Research Institute (NSBRI) is a partner with the HRP in developing a successful research program. 3

Barsten, Kristina↗
NASA NTRSDate not supplied

Leveraging Medical Operations in the Work of HRP Exploration Medical Capability

Aerospace Medicine focuses on humans in the space and aviation environments. Particularly, through medical system design, advancing technologies for clinical care in remote and extreme environments, and studying the complex physiological changes that occur when humans are placed in these extreme environments, it seeks to prepare humans for the next step of exploration. For reasons of organization and funding, there has historically been a division between NASA’s medical operations team, responsible for clinical care and near-term operations, and the research team, responsible for longer-term exploration mission work. Clinicians typically work for one group or the other. Recently, however, a new “blended clinician” position was created that functions as a bridge between medical operations and research, bringing insight and expertise to both teams.

E.R. Stratton↗
NASA NTRS2009

Human Research Program (HRP) Exploration Medical Capability (ExMC) Standing Review Panel (SRP)

The SRP believes strongly that regularly performed in-flight crew assessments are needed in order to identify a change in health status before a medical condition becomes clinically apparent. It is this early recognition in change that constitutes the foundation of the "occupational health model" expounded in the HRP Requirements Document as a key component of the HRP risk mitigation strategy that will enable its objective of "prevention and mitigation of human health and performance risks". A regular crew status examination of physiological and clinical performance is needed. This can be accomplished through instrumented monitoring of routine embedded tasks. The SRP recommends addition of a new gap to address this action under Category 3.0 Mitigate the Risk. This new gap is closely associated with Task 4.19 which addresses the lack of adequate biomedical monitoring capabilities for performing periodic clinical status evaluations and contingency medical monitoring. A corollary to these gaps is the critical emphasis on preventive medicine, not only during pre- and post-flight phases of a mission as is the current practice, but continued into the in-flight phases of exploration class missions.

Cintron, Nitza↗