Results for “Medical” — Page 9

NASA NTRS2016

Conceptual Drivers for an Exploration Medical System

Interplanetary spaceflight provides unique challenges that have not been encountered in prior spaceflight experience. Extended distance and timeframes introduce new challenges such as an inability to resupply medications and consumables, inability to evacuate injured or ill crew, and communication delays that introduce a requirement for some level of autonomous medical capability. Because of these challenges the approaches used in prior programs have limited application to a proposed three year Mars mission. This paper proposes a paradigm shift in the approach to medical risk mitigation for crew health and mission objectives threatened by inadequate medical capabilities in the setting of severely limited resources. A conceptual approach is outlined to derive medical system and vehicle needs from an integrated vision of how medical care will be provided within this new paradigm. Using NASA Design Reference Missions this process assesses each mission phase to deconstruct medical needs at any point during a mission. Two operational categories are proposed, nominal operations (pre-planned activities) and contingency operations (medical conditions requiring evaluation) that meld clinical needs and research needs into a single system. These definitions are used to derive a task level analysis to support quantifiable studies into a medical capabilities trade. This trade allows system design to proceed from both a mission centric and ethics-based approach to medical limitations in an exploration class mission.

Antonsen, E.↗

NASA NTRS2018

Exploration Medical Capability System Engineering Overview

Deep Space Gateway and Transport missions will change the way NASA currently practices medicine. The missions will require more autonomous capability compared to current low Earth orbit operations. For the medical system, lack of consumable resupply, evacuation opportunities, and real-time ground support are key drivers toward greater autonomy. Recognition of the limited mission and vehicle resources available to carry out exploration missions motivates the Exploration Medical Capability (ExMC) Element's approach to enabling the necessary autonomy. The ExMC Systems Engineering team's mission is to "Define, develop, validate, and manage the technical system design needed to implement exploration medical capabilities for Mars and test the design in a progression of proving grounds." The Element's work must integrate with the overall exploration mission and vehicle design efforts to successfully provide exploration medical capabilities. ExMC is using Model-Based System Engineering (MBSE) to accomplish its integrative goals. The MBSE approach to medical system design offers a paradigm shift toward greater integration between vehicle and the medical system, and directly supports the transition of Earth-reliant ISS operations to the Earth-independent operations envisioned for Mars. This talk will discuss how ExMC is using MBSE to define operational needs, decompose requirements and architecture, and identify medical capabilities needed to support human exploration. How MBSE is being used to integrate across disciplines and NASA Centers will also be described. The medical system being discussed in this talk is one system within larger habitat systems. Data generated within the medical system will be inputs to other systems and vice versa. This talk will also describe the next steps in model development that include: modeling the different systems that comprise the larger system and interact with the medical system, understanding how the various systems work together, and developing tools to support trade studies.

Mindock, J.↗

NASA NTRS2018

Exploration Medical System Trade Study Tools Overview

ExMC is creating an ecosystem of tools to enable well-informed medical system trade studies. The suite of tools address important system implementation aspects of the space medical capabilities trade space and are being built using knowledge from the medical community regarding the unique aspects of space flight. Two integrating models, a systems engineering model and a medical risk analysis model, tie the tools together to produce an integrated assessment of the medical system and its ability to achieve medical system target requirements. This presentation will provide an overview of the various tools that are a part of the tool ecosystem. Initially, the presentation's focus will address the tools that supply the foundational information to the ecosystem. Specifically, the talk will describe how information that describes how medicine will be practiced is captured and categorized for efficient utilization in the tool suite. For example, the talk will include capturing what conditions will be planned for in-mission treatment, planned medical activities (e.g., periodic physical exam), required medical capabilities (e.g., provide imaging), and options to implement the capabilities (e.g., an ultrasound device). Database storage and configuration management will also be discussed. The presentation will include an overview of how these information tools will be tied to parameters in a Systems Modeling Language (SysML) model, allowing traceability to system behavioral, structural, and requirements content. The discussion will also describe an HRP-led enhanced risk assessment model developed to provide quantitative insight into each capability's contribution to mission success. Key outputs from these various tools, to be shared with the space medical and exploration mission development communities, will be assessments of medical system implementation option satisfaction of requirements and per-capability contributions toward achieving requirements.

Mindock, J.↗

NASA NTRS2018

Exploration Medical Cap Ability System Engineering Overview

Deep Space Gateway and Transport missions will change the way NASA currently practices medicine. The missions will require more autonomous capability compared to current low Earth orbit operations. For the medical system, lack of consumable resupply, evacuation opportunities, and real-time ground support are key drivers toward greater autonomy. Recognition of the limited mission and vehicle resources available to carry out exploration missions motivates the Exploration Medical Capability (ExMC) Element's approach to enabling the necessary autonomy. The ExMC Systems Engineering team's mission is to "Define, develop, validate, and manage the technical system design needed to implement exploration medical capabilities for Mars and test the design in a progression of proving grounds." The Element's work must integrate with the overall exploration mission and vehicle design efforts to successfully provide exploration medical capabilities. ExMC is using Model-Based System Engineering (MBSE) to accomplish its integrative goals. The MBSE approach to medical system design offers a paradigm shift toward greater integration between vehicle and the medical system, and directly supports the transition of Earth-reliant ISS operations to the Earth-independent operations envisioned for Mars. This talk will discuss how ExMC is using MBSE to define operational needs, decompose requirements and architecture, and identify medical capabilities needed to support human exploration. How MBSE is being used to integrate across disciplines and NASA Centers will also be described. The medical system being discussed in this talk is one system within larger habitat systems. Data generated within the medical system will be inputs to other systems and vice versa. This talk will also describe the next steps in model development that include: modeling the different systems that comprise the larger system and interact with the medical system, understanding how the various systems work together, and developing tools to support trade studies.

McGuire, K.↗

NASA NTRS2021

Exploration Medical Capability Clinical Decision Support System Concept of Operations

The Clinical Decision Support (CDS) project supports the Exploration Medical Capability (ExMC) Element of the Human Research Program (HRP). Specifically, the CDS project addresses the ExMC gap, Medical-701: Enhance medical capabilities within an exploration medical system. For long-duration, deep space missions, computational and data resources will play an important role in maintaining crew health, wellness and performance where the crew will need to be more self-reliant as we enter a new era in space exploration to return to the moon and explore Mars. These ambitious goals will require significant change in in-flight medical care due to constraints on mass, volume, power, crew time, skills reduction over time and medical evacuation capabilities. These constraints make it absolutely necessary to develop transformative solutions using new technologies. Unlike the current paradigm for crew health in low-Earth orbit missions that rely on constant communication with Mission Control, the deep space missions will experience communication delays and possibly, no communications for finite periods of time. Hence, crew health management will benefit from analytics’ capabilities to augment decision support. A comprehensive, multi-functional on-board clinical decision support system (CDSS) will help crews assess and diagnose conditions, decide appropriate responses, and guide the provision of tailored and evidence-based treatments, while reflecting contextual factors and constraints. The context may include present and historical data, viable diagnostic equipment, available supplies and medications, and vehicle and environmental health. Communication time with ground-based personnel is delayed or non-existent during significant portions of the mission so the crew will need to autonomously respond to health, performance and medical situations, particularly those that are unplanned. The CDSS must also provide additional capabilities as complex as training for an emergency situation while augmenting non-expert practitioner skillsets if the Crew Medical Officer (CMO) is incapacitated, and as routine as facilitating delayed communication with flight surgeons on the ground. The CDSS must connect complex issues involving health, wellness, task performance and environmental domains. Furthermore, CDSS functionality will focus on semi-autonomous and autonomous decision-making by the crew that is necessary to address challenges in executing a self-contained medical system that enables health care without assistance from ground clinical experts. The document, ExMC CDSS Architecture Recommendation, (HRP- 48032) establishes a description of the envisioned CDSS architecture. The analytics, descriptive or advanced, contained in a CDSS will interface with the integrated crew health and performance architecture that provides the appropriate data sets. The aim of the CDS project is to develop requirements for a CDSS through a series of test-bed prototype developments and demonstrations.

HRP↗

NASA NTRS2023

Exploration Medical Capability Clinical Decision Support System Architecture Recommendation

A new era in space exploration has arrived with the goal of establishing a long-term presence on the Moon and using those learning to take the next giant leap: sending the first astronauts to Mars. These ambitious goals will require significant changes in in-flight medical care due to constraints on mass, volume, power, crew time, and medical evacuation capabilities. Furthermore, while crews currently rely on real-time communications with ground-based medical providers, as distance from Earth increases, so do communication delays and disruptions. The crew will need to autonomously detect, diagnose, treat, and prevent medical events. These constraints require development of transformative solutions and new technologies. Through participation in the Human Research Program’s (HRP) Exploration Medical Capability (ExMC) research, NASA has developed and demonstrated a Medical Data Architecture (MDA), a platform upon which a robust capability of Clinical Decision Support (CDS) can be built. As a result, NASA is now positioned to build an advanced autonomous CDS System (CDSS) which will aid in crew health decision-making. The CDSS combines data management aspects of a system that would lead to the autonomy required by NASA-STD-3001, Section 3, Health and Medical Care Standards. The project addresses the ExMC gap Medical-701: We need to increase inflight medical capabilities and identify new capabilities that (a) maximize benefit and/or (b) reduce “costs” on human system/mission/vehicle resources. This architecture recommendation document introduces an integrated data architecture that provides self-sufficient medical care for crews on long-duration spaceflight missions.

ExMC↗

NASA NTRSDate not supplied

Crew Medical Training to Progressively Enable EIMO

Background. Onboard medical capabilities have greatly expanded over the history of the US space program. Newly identified space-related medical conditions, technological advances, and longer mission durations have led to an increasing need for on-demand medical expertise. Lengthy communications delays, lack of resupply and evacuation opportunities on exploration-class missions place an ever-increasing burden on the crew to provide medical care. Having adequate knowledge, skills, and abilities (KSA) available is an essential component of successful Earth Independent Medical Operations (EIMO). Without appropriate crew training and KSA, cutting-edge medical equipment has little value. Presumably, the crew will include a qualified physician; however, if the physician is incapacitated, a non-physician crew medical officer (CMO) will be needed. While more crew time is needed for medical training, there will be concomitant increases in preflight training demands for vehicle system management, operations, science, and contingencies. In truly independent operations, onboard resources such as just-in-time training, mixed reality, decision support tools, and AI-enabled chatbot “consultants” will be needed to augment KSA. Overview. Because of crew time constraints, topical priorities must be determined for preflight training. Curricula should be developed that emphasize management of conditions with relatively high incidence and morbidity/mortality. Defining the required KSA levels to treat each condition is essential, but all crewmembers should have basic lifesaving skills. Procedural and diagnostic training on live patients and simulators should be prioritized over classroom lectures. Crews must be trained with onboard equipment, resources, mixed reality, and AI-based decision support tools. Mission simulations should include medical problems with/without ground support and with appropriate communication delays. Certification guidelines for each level of KSA must be established. Skills rapidly decay for non-physician CMO’s; both pre-flight and in-flight refresher training will be needed. During spaceflight just-in-time training, simulations, and onboard CME with crew physician can help retain skills. Discussion. Medical technology, simulation design, mixed reality, and AI are advancing at a dizzying rate. Recognizing the severe constraints on crew time, it is critical that astronaut training is highly efficient and adapted to keep pace with new innovations both pre-flight and during exploration missions. These challenges will be discussed during this panel session.

Jay Lemery↗

NASA NTRS2025

Evaluating the Viability of Compact and Portable X-Ray Systems for an Exploration Medical System in a Ground Demonstration

MOTIVATION FOR INCLUDING X-RAY CAPABILITIES For upcoming exploration missions, the need for enhanced medical care becomes critical due to extended mission durations, significant communication delays, and minimal evacuation opportunities. Previous evidence by our team has revealed that among the 119 medical conditions targeted for management during spaceflight within NASA Exploration Medical Capability’s IMPACT Condition List, at least 36 could benefit from radiography (XR). Utilizing XR for diagnosis and management is hypothesized to significantly improve management of crew health by enabling the immediate evaluation and confirmation of potential injuries or illnesses. Beyond clinical applications, XR also holds potential for non-destructive testing (NDT). This includes applications such as assessing the structural integrity of the spacecraft, analyzing surface and meteorite samples, and inspecting onboard electronics. THREE CANDIDATE X-RAY SYSTEMS CHOSEN FOR GROUND DEMONSTRATION The Exploration Medical Capability Element (ExMC) and the Exploration Medical Integrated Product Team (XMIPT) of the Mars Campaign Office initiated early background work for ground demonstrations. In FY21, ExMC published a Concept of Operations to guide requirements development. By FY23, XMIPT and yet2, a technology scouting and open innovation consulting firm, had completed a market survey and trade study to identify potential miniature XR systems. Selection criteria included commercial-off-the-shelf availability, low mass and volume, and regulatory compliance. The top three candidate devices—Remedi REMEX-KA6, MinXray Impact, and FujiFilm Xair—were acquired to characterize the requirements and capabilities of each device. To facilitate testing, phantoms, and radiographic personal protective equipment (PPE) were purchased, and a dedicated space was designated for XRS usage at Glenn Research Center. During this presentation, the mass, volume, and power requirements for each of the three piloted devices are revealed, as well as information regarding the detector, mA, and kV of the devices. GOAL AND OBJECTIVES OF A MINI XRS GROUND DEMONSTRATION The primary goal of ExMC/XMIPT technology demonstrations is to bridge the gap in available, flight-ready medical device technology by flight-testing diagnostic and treatment technologies essential for managing medical conditions during exploration missions. These technologies must adhere to vehicle constraints such as mass, volume, power, and data requirements, integrate seamlessly with medical decision-support tools, and support increasingly Earth-independent operations. There are three main objectives for the future ground demonstration of these three devices. First, we aim to determine the full capabilities of these three miniature XR systems within the context of the spaceflight environment. While medical applications are the primary focus for the miniature XR, a comprehensive exploration of non-medical uses has been initiated by an XMIPT-sponsored NASA SPARK campaign to identify collaborators. Second, we plan to establish criteria and to use insights gained from evaluating each miniature XR against those criteria to select the most suitable system among the three candidates. Third, we intend to evaluate their suitability for flight certification, which includes assessing its durability for launch, reentry, and exposure to high background radiation, as well as its compatibility with existing data architecture systems. Numerous subject matter experts from NASA and partner institutions will support these objectives.

C A Haddix↗

NASA NTRS2023

A Pilot Project for Quantifying the Effect of Medical Provider Knowledge, Skills, and Abilities on Outcomes for Spaceflight Using a Probabilistic Risk Assessment Tool

In order to enable the future of long-duration deep space exploration we must confront the uncertainty in medical risk. Limitations of communication, resupply, and evacuation in deep space will require a high degree of crew autonomy and accurate risk assessment will be critical to ensure adequate crew training and medical system design. To address this, NASA’s Human Research Program Exploration Medical Capability Element has developed the Informing Mission Planning via Analysis of Complex Tradespaces Tool (IMPACT). IMPACT is a suite of tools that can provide evidence-based, data-driven trade space assessments between available medical resources in the mass- and volume-constrained environment of a deep space exploration vehicle. In the current model, medical conditions either can or cannot be treated based on the availability of medical system resources and equipment. However, medical outcomes often depend just as much on the knowledge, skills, and abilities (KSA) of the provider operating the system. This paper presents a method for modeling and quantifying the effect of medical officer KSA on medically relevant mission risk outcomes during spaceflight.

capabilities↗

NASA NTRS2008

The Integrated Medical Model: Statistical Forecasting of Risks to Crew Health and Mission Success

The Integrated Medical Model (IMM) helps capture and use organizational knowledge across the space medicine, training, operations, engineering, and research domains. The IMM uses this domain knowledge in the context of a mission and crew profile to forecast crew health and mission success risks. The IMM is most helpful in comparing the risk of two or more mission profiles, not as a tool for predicting absolute risk. The process of building the IMM adheres to Probability Risk Assessment (PRA) techniques described in NASA Procedural Requirement (NPR) 8705.5, and uses current evidence-based information to establish a defensible position for making decisions that help ensure crew health and mission success. The IMM quantitatively describes the following input parameters: 1) medical conditions and likelihood, 2) mission duration, 3) vehicle environment, 4) crew attributes (e.g. age, sex), 5) crew activities (e.g. EVA's, Lunar excursions), 6) diagnosis and treatment protocols (e.g. medical equipment, consumables pharmaceuticals), and 7) Crew Medical Officer (CMO) training effectiveness. It is worth reiterating that the IMM uses the data sets above as inputs. Many other risk management efforts stop at determining only likelihood. The IMM is unique in that it models not only likelihood, but risk mitigations, as well as subsequent clinical outcomes based on those mitigations. Once the mathematical relationships among the above parameters are established, the IMM uses a Monte Carlo simulation technique (a random sampling of the inputs as described by their statistical distribution) to determine the probable outcomes. Because the IMM is a stochastic model (i.e. the input parameters are represented by various statistical distributions depending on the data type), when the mission is simulated 10-50,000 times with a given set of medical capabilities (risk mitigations), a prediction of the most probable outcomes can be generated. For each mission, the IMM tracks which conditions occurred and decrements the pharmaceuticals and supplies required to diagnose and treat these medical conditions. If supplies are depleted, then the medical condition goes untreated, and crew and mission risk increase. The IMM currently models approximately 30 medical conditions. By the end of FY2008, the IMM will be modeling over 100 medical conditions, approximately 60 of which have been recorded to have occurred during short and long space missions.

Fitts, M. A.↗

NASA NTRS2010

Performance Support Tools for Space Medical Operations

Early Constellation space missions are expected to have medical capabilities similar to those currently on board the Space Shuttle and International Space Station (ISS). Flight surgeons on the ground in Mission Control will direct the Crew Medical Officer (CMO) during medical situations. If the crew is unable to communicate with the ground, the CMO will carry out medical procedures without the aid of a flight surgeon. In these situations, use of performance support tools can reduce errors and time to perform emergency medical tasks. The research presented here is part of the Human Factors in Training Directed Research Project of the Space Human Factors Engineering Project under the Space Human Factors and Habitability Element of the Human Research Program. This is a joint project consisting of human factors teams from the Johnson Space Center (JSC) and the Ames Research Center (ARC). Work on medical training has been conducted in collaboration with the Medical Training Group at JSC and with Wyle that provides medical training to crew members, biomedical engineers (BMEs), and flight surgeons under the Bioastronautics contract. Human factors personnel at Johnson Space Center have investigated medical performance support tools for CMOs and flight surgeons.

Byrne, Vicky↗

NASA NTRS2016

Are Medications Involved in Vision and intracranial Pressure Changes Seen in Spaceflight?

Some crewmembers have experienced changes in their vision after long-duration spaceflight on the ISS. These impairments include visual performance decrements, development of cotton-wool spots or choroidal folds, optic-disc edema, optic nerve sheath distention, and/or posterior globe flattening with varying degrees of severity and permanence. These changes are now used to define the visual impairment/intracranial pressure (VIIP) syndrome. The reasons for these potentially debilitating medical issues are currently unknown. The potential role of administered medications has not yet been examined, but it is known that many medications can have side effects that are similar to VIIP symptoms. Some medications raise blood pressure, which can affect intracranial pressure. Many medications that act in the central nervous system can affect intracranial pressures and/or vision. About 40% of the medications in the ISS kit are known to cause side effects involving changes in blood pressure, intracranial pressure and/or vision. For this reason, we proposed an investigation of the potential relationship between ISS medications and their risk of causing or exacerbating VIIP-like symptoms. The purpose of this study was to use medication usage records for affected and unaffected crew to determine if use of particular medications seemed to correlate with VIIP occurrence or severity.

Wotring, V. E.↗

NASA NTRSDate not supplied

Derivation of Capabilities and Resources for Treating Medical Conditions in Deep Space

BACKGROUND: Medical care in spaceflight requires the adaptation of terrestrial standards to the constraints of the space environment. However, there is often conflict between the ideal resources required for treatment and diagnosis of a medical condition, and the constraints on their mass, volume, data needs, etc. This optimization of trades between medical risk and resources will be a significant challenge for deep space medical system design. METHODS: A team of physicians with a broad range of expertise reviewed the 120 medical conditions on the condition list for NASA’s Informing Mission Planning via analysis of Complex Tradespaces Medical Database (IMPACT-MD). Each team member was assigned a subset of conditions based on their experience and training. The assigned physician generated a proposed list of capabilities, definitions, and resources required to treat each condition based on terrestrial practice guidelines, medical literature, and subject matter expertise. Additional specialists were consulted for conditions where expertise was not present within the main group. The proposed list was then reviewed by the broader team and modified as needed to achieve consensus. Each capability and resource was then assigned parameters to define quantity required per medical event, necessity, training level required, and primacy order of any alternative resources. These capabilities and resources were placed into condition specific tables and delivered to a team of engineers who added mass and volume data for each specific resource and converted the table into a database for use as input to a computational model to simulate spaceflight (IMPACT) DISCUSSION: This process ensures that a minimum of three subject matter experts review and agree upon the scope of practice, medical diagnostic tools, and treatment modalities that would be necessary to address emergent and non-emergent conditions that may arise during spaceflight to inform requirements during the vehicle design phase. The method is scalable to any design reference mission and permits modification of the existing database as information, conditions or experience are added. By including specialists, generalists, and those with subject matter expertise in the spaceflight environment on the team, we ensure that the included capabilities represent a realistic and actionable foundation for planning deep space missions.

D R Levin↗

NASA NTRSDate not supplied

Introduction to the IMPACT Probabilistic Risk and Tradespace Analysis Tool for Medical System Design

Background: Probabilistic risk analysis (PRA) is a method for estimating risk in complex engineered systems that, at a basic level, focuses on what can go wrong and the likelihood and consequences of those occurrences. NASA has used PRA as an integral component of medical system risk estimation and design for spaceflight. IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a novel tool to meet these goals for exploration missions. Overview: IMPACT performs hundreds of thousands of Monte Carlo simulations of missions to build aggregate pictures of medical risk. These simulations are based on 120 possible medical conditions (the IMPACT Condition List) selected in a consensus-based process because they are of highest likelihood and/or consequence for exploration spaceflight. The conditions are then tied to clinical capabilities which can be used for management (e.g., inserting an IV) and then to over 600 specific resources needed to deliver a capability (e.g., an angiocath or an ultrasound). Different mission profiles can be simulated with user-specified inputs such as mission duration, destination, number of crew and pre-existing medical conditions, and EVA frequency. While the IMPACT evidence base is designed for exploration environments, these user inputs allow the tool to be used across a broad range of missions. IMPACT’s primary outcome metrics include loss of crew life (LOCL, a measure of in-flight mortality due to medical conditions), need for evacuation (RTDC, return to definitive care), and crew disability (TTL, task time lost based on how medical conditions impact the ability to perform over 1000 specific exploration mission crew tasks). In addition to modeling medical risk, IMPACT also accepts user-specified constraints, such as limitations of mass or volume, and will output a recommended clinical capability set and specific medical resources that meet the mission constraints. Discussion: This abstract will provide an introduction to IMPACT and describe the nature of the underlying medical evidence. It will also detail potential use cases for how this tool can be utilized by NASA or commercial spaceflight providers.

Ben Easter↗

NASA NTRS2023

IMPACTing Medical System Design with a Risk Analysis Tool [“IMPACT” sur la Conception du Système Médical avec un Outil d'Analyse des Risques]

Background: Following the success of Artemis I, NASA is preparing for human extended duration missions. Ongoing efforts are focused on mitigating mission-related risks, including those affecting crew health and performance. Communication latency, logistics of resupply and time frame of medical evacuation are barriers to provision of healthcare for these missions, especially with respect to constraints in mass, volume, and crew training. An in-depth assessment of medical risks, capabilities and resources for a specific mission design is necessary to determine an optimal balance that maximizes likelihood of mission success. Overview: IMPACT (Informed Mission Planning via Analysis of Complex Tradespaces) is a dynamic tool designed to estimate medical risk and outcomes for a specific mission design. In its current iteration, a list of medical conditions selected based on likelihood of occurrence and/or consequence was linked to a set of clinical capabilities and resources necessary for diagnosis and management. A probabilistic risk analysis tool was then used to identify and estimate the likelihood and consequence of risks through the following outcome metrics: loss of crew life (inflight mortality due to medical conditions), need for medical evacuation (return to definitive care), and crew disability (task time affected based on how medical conditions influence the ability to perform specific exploration mission crew tasks). Finally, the model’s optimization algorithm provides recommendations for medical capabilities that maximize risk mitigation relative to mass and volume constraints. In the Spring of 2023, IMPACT was utilized to estimate outcome metrics for a design reference mission that would be representative of an extended duration Artemis mission. Notional data generated were then used to determine a recommended set of medical capabilities and resources relative to user-defined mass and volume constraints. A multidisciplinary team has also been updating IMPACT to strengthen the model’s fidelity. Figure 1 shows how updates to outcome metric inputs for the conditions resulted in different capability and resource allocation recommendations. Discussion: This presentation will discuss the IMPACT tool and share the latest data generated for a representative extended duration Artemis mission. Efforts to improve the fidelity of data generated by the model’s algorithm will also be discussed.

K A Shair↗

NASA NTRSDate not supplied

Assessing Crew Medical Officer Preparedness for International Space Station Missions

INTRODUCTION Astronaut crew medical officers (CMO) undergo additional, specialized training to provide medical support onboard the International Space Station (ISS). CMO training focuses on utilizing resources on-station and optimizing communication with ground-based expertise to manage both common minor conditions as well as emergency/trauma situations. As NASA moves towards future Artemis and exploration class missions, we sought CMO perspectives on past, present, and future CMO training and medical resourcing to help inform mission planners regarding medical risk mitigation considerations. We present an interview-based qualitative assessment of CMO preparedness for the International Space Station with the aim to help iterate future training flows for Low Earth Orbit, Artemis, and exploration-class missions. METHODS A semi-structured interview tool was developed to assess CMO experience and their recommendations for future mission training considerations. Participants were recruited from former or current US astronauts who were designated as CMO and subsequently flew to the International Space Station. 10 former CMOs took part in the study. Interview transcripts were deidentified and evaluated for qualitative thematic analysis by two independent coders with NVivo Software suite (Lumivero, Denver, CO), and emergent themes were compiled. RESULTS Former CMO crew expressed appropriate preparedness for current ISS medical capabilities and requirements. They identified the role of the CMO as serving as a healthcare extender to ground-based flight surgeons for ISS and other LEO missions. Individuals with prior medical experience were preferred though not felt to be necessary for LEO missions. For exploration class missions with limitations in ground communication, a physician-as-CMO and more rigorous training curricula for both the CMO and astronaut crew were desired. DISCUSSION Former NASA astronaut crew were interviewed to retrospectively assess their preparedness as ISS crew medical officers and hypothesize future medical knowledge, skill, and ability needs. Along with medical operations subject matter expert opinion and advanced probabilistic risk assessment modeling, past CMO experience can help inform future CMO training considerations and responsibilities for future Artemis and exploration class missions.

M A Labarbera↗

NASA NTRSDate not supplied

IMPACTing Medical System Design with a Risk Analysis Tool

Background: Following the success of Artemis I, NASA is preparing for human extended duration missions. Ongoing efforts are focused on mitigating mission-related risks, including those affecting crew health and performance. Communication latency, logistics of resupply and time frame of medical evacuation are barriers to provision of healthcare for these missions, especially with respect to constraints in mass, volume, and crew training. An in-depth assessment of medical risks, capabilities and resources for a specific mission design is necessary to determine an optimal balance that maximizes likelihood of mission success. Overview: IMPACT (Informed Mission Planning via Analysis of Complex Tradespaces) is a dynamic tool designed to estimate medical risk and outcomes for a specific mission design. In its current iteration, a list of medical conditions selected based on likelihood of occurrence and/or consequence was linked to a set of clinical capabilities and resources necessary for diagnosis and management. A probabilistic risk analysis tool was then used to identify and estimate the likelihood and consequence of risks through the following outcome metrics: loss of crew life (inflight mortality due to medical conditions), need for medical evacuation (return to definitive care), and crew disability (task time affected based on how medical conditions influence the ability to perform specific exploration mission crew tasks). Finally, the model’s optimization algorithm provides recommendations for medical capabilities that maximize risk mitigation relative to mass and volume constraints. In the Spring of 2023, IMPACT was utilized to estimate outcome metrics for a design reference mission that would be representative of an extended duration Artemis mission. Notional data generated were then used to determine a recommended set of medical capabilities and resources relative to user-defined mass and volume constraints. A multidisciplinary team has also been updating IMPACT to strengthen the model’s fidelity. Figure 1 shows how updates to outcome metric inputs for the conditions resulted in different capability and resource allocation recommendations. Discussion: This presentation will discuss the IMPACT tool and share the latest data generated for a representative extended duration Artemis mission. Efforts to improve the fidelity of data generated by the model’s algorithm will also be discussed.

K A Shair↗

NASA NTRS2017

Medical Data Architecture Project Status

The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current International Space Station (ISS) medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable an increasingly autonomous crew than the current ISS paradigm. The MDA will develop capabilities that support automated data collection, and the necessary functionality and challenges in executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. To attain this goal, the first year of the MDA project focused on reducing technical risk, developing documentation and instituting iterative development processes that established the basis for the first version of MDA software (or Test Bed 1). Test Bed 1 is based on a nominal operations scenario authored by the ExMC Element Scientist. This narrative was decomposed into a Concept of Operations that formed the basis for Test Bed 1 requirements. These requirements were successfully vetted through the MDA Test Bed 1 System Requirements Review, which permitted the MDA project to begin software code development and component integration. This paper highlights the MDA objectives, development processes, and accomplishments, and identifies the fiscal year 2017 milestones and deliverables in the upcoming year.

Data management↗