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This viewgraph presentation reviews the development of an Integrated Medical Model (IMM) decision support tool for in-flight crew health care safety. Clinical methods, resources, and case scenarios are also addressed.
In 1969 the Jet Propulsion Laboratory undertook an investigation to determine which of its space-derived capabilities could make significant contributions to the improvement of health care delivery in the U.S. The area of planetary quarantine was identified as one of high relevance. Two studies were conducted in this connection. The first study, which could contribute to infection reduction and control, was concerned with conversion of infection implicated complex, nonheat sterilizable equipment to dry heat, sterilizable equipment by changes in design and materials of construction. The second study area related to hospital acquired infection is clean room technology. A definite investigation has been performed to demonstrate and statistically evaluate performance under controlled conditions.
Old Dominion University embarked on a project to see how current computer technology could be applied to reduce the cost and or to improve the efficiency of health care services. We designed and built a prototype for an integrated medical record system (MRS). The MRS is written in Tool control language/Tool kit (Tcl/Tk). While the initial version of the prototype had patient information hard coded into the system, later versions used an INGRES database for storing patient information. Currently, we have proposed an object-oriented model for implementing MRS. These projects involve developing information systems for physicians and medical researchers to enhance their ability for improved treatment at reduced costs. The move to computerized patient records is well underway, several standards exist for laboratory records, and several groups are working on standards for other portions of the patient record.
The purpose of this catalog is to provide a detailed description of each piece of hardware in the Crew Health Care System (CHeCS), including subpacks associated with the hardware, and to briefly describe the interfaces between the hardware and the ISS. The primary user of this document is the Space Medicine/Medical Operations ISS Biomedical Flight Controllers (ISS BMEs).
This viewgraph presentation provides information on trends in NASA nanotechnology research and development, and future biotechnological applications for that nanotechnology. The presentation covers nanoelectronics, nanosensors, and nanomaterials, biomimetics, devices and materials for health care, carbon nanotubes, biosensors for astrobiology, solid-state nanopores for DNA sequencing, and protein nanotubes.
This paper will provide an overview of the International Space Station (ISS) Environmental Control and Life Support (ECLS) design of the Crew Health Care System (CHeCS) Rack 1 and it will document some of the lessons that have been learned to date for the ECLS equipment in this rack.
Abstract Patellar tendinopathy (PT) is a common nontraumatic orthopaedic disorder of the knee suffered by many service members. Understanding the make-up of usual care for PT at the system level can better frame current clinical gaps and areas that need improvement. Exercise therapy is recommended as a core treatment for PT, but it is unclear how often it is used as a part of usual care for PT within the Military Health System (MHS). The purpose of the study was to identify interventions used in the management of PT and the timing of these interventions. A secondary purpose was to determine if exercise therapy use was associated with reduced recurrence of knee pain. In total, 4,719 individuals aged 17 to 50 years in the MHS diagnosed with PT between 2010 and 2011 were included. Pharmacological and nonpharmacological interventions, visits to specialty providers, and imaging services were captured. Descriptive statistics were used to report the findings. Interventions were further categorized as being part of initial care (within the first 7 days), the initial episode of care (within the first 60 days), or the 2-year time period after diagnosis. Linear regression assessed the relationship between the number of exercise therapy visits in the initial episode of care and recurrences of knee pain. In total, 50.6% of this cohort had no more than one medical visit total for PT. Exercise therapy (18.2%) and nonsteroidal anti-inflammatory drugs (4.3%) were the two most used interventions in the initial episode of care. Radiographs were ordered for 23.1% of the cohort in the initial episode of care. The number of exercise therapy visits a patient received during the initial episode of care was not associated with recurrences of knee pain. Half of the individuals received no further care beyond an initial visit for the diagnosis of PT. Exercise therapy was the most common intervention used during the initial episode of care, but exercise therapy did not influence the recurrence of knee pain.
INTELSAT, the International Telecommunications Satellite Organization, is a not-for-profit commercial cooperate of 124 member nations, created on 20 August 1964. It owns and operates a global system of communications satellites that provides international telecommunications services to 180 countries, territories, and dependencies, and domestic telecommunications services to 40 nations. INTELSAT has actively encouraged the use of satellites for both telemedicine and disaster relief. Topics discussed include: INTELSAT domestic/regional services; use of transportable antennas; INTELNET; using the existing telecommunications infrastructure for remote health care applications: Project Access; INTELSAT's role in disaster telecommunications efforts; and how INTELSAT's existing infrastructure can be used for disaster telecommunications.
Crews and passengers on future long-duration Earth orbital and interplanetary missions must be provided quality health services - to combat illnesses and accidental injuries, and for routine preventive care. People on Earth-orbital missions can be returned relatively easily to Earth, but those on interplanetary missions cannot. Accordingly, crews on long-duration missions will likely include at least one specially trained person, perhaps a physician's assistant, hospital corpsman, nurse, or physician who will be responsible for providing onboard health services. Specifically, we must determine the most effective way to administer health care to a remotely located population. NASA with the cooperation of the Department of Health, Education, and Welfare is pursuing a program for providing health services to remote locations on Earth as a necessary step to developing and verifying this capability on a spacecraft. The STARPAHC program is described.
Operations research activities developed to identify the information required to manage both the efficiency and effectiveness of the Veterans Administration (VA) health services as these services relate to individual patient care are reported. The clinical concerns and management functions that determine this information requirement are discussed conceptually. Investigations of existing VA data for useful management information are recorded, and a diagnostic index is provided. The age-specific characteristics of diseases and lengths of stay are explored, and recommendations for future analysis activities are articulated. The effect of the introduction of new technology to health care is also discussed.
Life science will be one of the pacing technologies for long duration manned spaceflight. The ability to effectively deliver state-of-the-art inflight medical care will have a major impact on crew health and mission success. The future Space Station crews will participate in missions of extended duration with limited capability for emergency return. This factor alone places great responsibility on program designers to ensure the health, safety, and well-being of the crews. The Health Maintenance Facility (HMF) under development at the Johnson Space Center is described.
This paper discusses the issues involved with establishing an integrated satellite health network in West Africa based on currently available technology. The system proposed makes use of a central national facility capable of transmitting and receiving voice/data and video signals from the entire country. Regional, field and local facilities provides timely epidemiologic information, sharing of medical expertise through telemedical consultations, enhances optimized resource distribution and builds a framework for telecommunications for the entire country.
This paper discusses the issues involved with establishing an integrated satellite health network in West Africa based on currently available technology. The system proposed makes use of a central national facility capable of transmitting and receiving voice/data and video signals from the entire country. Regional, field and local facilities provide timely epidemiologic information, sharing of medical expertise through telemedical consultations, enhance optimized resource distribution and build a framework for telecommunications for the entire country.
Efficient resource allocation is crucial in many domains, particularly in senior care, where assigning resources to older adults must consider uncertainties associated with vulnerable populations. In collaboration with Senior Health Facilities (SHFs) and domain experts, this paper presents iFair, a novel framework designed to assist decision-makers in equitably allocating scarce resources to older adults. iFair was prototyped in the context of ongoing work on a data exchange platform, CAREDEX, used for enhancing older adults' resilience during disasters. A key novelty of iFair focuses on aligning resident preferences with resources in urgent situations, expediting care, and enhancing task efficiency. We integrate static and dynamic environmental data, including facility layouts and sensor data, with detailed resident profiles to cater to the individual needs and preferences of residents. While our framework primarily focuses on allocation within facilities, it also extends to a regional scale to support the planning and transfer of seniors to mutual aid facilities. Our experiments adapt data from a real SHF to emulate resource allocation in an emergency fire evacuation setting and highlight the delicate balance that decision-makers can achieve between efficiency and fairness.
Specific requirements for medical support of a long-duration manned facility in a low earth orbit derive from inflight medical experience, projected medical scenarios, mission related spacecraft and environmental hazards, health maintenance, and preventive medicine. A sequential buildup of medical capabilities tailored to increasing mission complexity is proposed. The space station health maintenance facility must provide preventive, diagnostic, and therapeutic medical support as immediate rescue capability may not exist.
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