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Clinical Decision Support - Overview and Update

We are entering a new era in space exploration to return to the moon and explore Mars. These ambitious goals will require significant changes to in-flight and habitat medical care due to constraints on mass, volume, power, crew time and medical evacuation capabilities. These constraints make it absolutely necessary to develop transformative solutions using new technologies. The Exploration Medical Capability (ExMC) Element of the Human Research Program (HRP) pushes the boundary of space medical systems to advance the care of astronauts on future exploration missions beyond low Earth orbit by identifying and testing next-generation medical care and crew health maintenance technologies. The Clinical Decision Support (CDS) project addresses the gap Medical-701 within the Inflight Medical Conditions risk: 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. The aim of the CDS project is to develop and provide recommended requirements for an in-vehicle CDSS that acts as an assistant for delivering optimal health and performance and medical care during exploration missions. The CDSS is envisioned as a software-based tool that will augment a crewmembers’ knowledge, skills and abilities to assist in decision-making and crew health and performance (CHP) management thus increasing CHP systems capabilities. The human interface will be context aware and lessen the cognitive load to assimilate and use information as well as combine large disparate data sets in such a manner that provides the crew with actionable insight to decisions related to crew medical, health and performance management. Crew autonomy will be provided through a CDS that presents knowledge and data in a context aware manner to augment a crew members’ knowledge, skills and abilities during the process of observation, orientation, decisions and action. The CDS project addresses the need for crew members to operate independently during long duration space exploration missions that require medical Levels of Care (LoC) V, the highest level specified by NASA-STD-3001 and described in more detail by the ExMC interpretation of LoC document (NASA/TM-2017-219290), where significant changes to in-flight and habitat medical care necessitate increasing crew autonomy in decision making and task performance. The CDS project will develop and test a series of iterative and increasingly more complex system prototypes. These annual demonstrations of the data system integration with the crew health and performance domain will inform exploration medical system requirements for an on-board Clinical Decision Support System (CDSS) through a series of use cases that guide CDS prototype functionality. CDS concepts are based on ExMC Concept of Operations documents (presented separately) and will highlight architecture extensibility to other more complex analyses and tests using core crew health and performance integrated data management, processing and visualization capabilities. This approach also establishes how externally developed analyses and approaches could be added to expand a clinical decision support system and thus highlight how a comprehensive system can be commercially and/or globally developed. The CDS project will build upon the concept of an integrated data management approach based on the Medical Data Architecture (MDA) project to more fully address challenges associated with in-flight and habitat medical, health and performance care due to constraints on mass, volume, power, crew time and medical evacuation capabilities required for medical LoC V. These requirements will be derived through systems engineering approaches and software prototype developments over the course of the multi-year CDS project to address crew health and performance decision-making and task performance, often autonomously executed by the crew, in a manner that is consistent with the appropriate medical level of care for the mission. This presentation will provide an overview of the vision for the CDS project and highlight the initial accomplishments in project planning, implementation and requirements identification in fiscal year 2020.

clinical decision support system↗
DOE OSTI2025

Williston Basin Resource Study for Commercial-Scale Subsurface Hydrogen Storage

The Energy & Environmental Research Center (EERC), in partnership with the U.S. Department of Energy (DOE) National Energy Technology Laboratory (NETL), the EERC’s State Energy Research Center (SERC), MPLX Operations LLC, and TC Energy Development Holdings Inc. (a subsidiary of TC Energy Corporation), studied the potential for subsurface hydrogen storage and recovery in the Williston Basin of western North Dakota. The project’s goal was to evaluate the feasibility of large-scale, secure geologic H 2 storage to support future hydrogen generation, storage, and use. This work included laboratory testing, H 2 –rock–fluid exposure experiments, literature reviews on H 2 embrittlement, and reservoir modeling and simulations. The study included an assessment of storage potential across three types of storage reservoirs using both reservoir simulation and DOE’s web-based tool SHASTA-HELP (Subsurface Hydrogen Assessment, Storage, and Technology Acceleration – Hydrogen Estimator for Logistical Planning), as well as investigation of potential H 2 production and markets for commercial-scale deployment. Building on prior EERC gas storage research, three storage options were selected for detailed evaluation: the Broom Creek Formation (a clastic saline reservoir), the Dickinson Lodgepole Mounds (DLM) complex (carbonate mud mound structures) of the Lodgepole Formation (an active oil and gas producing reservoir), and the Dunham Salt Interval of the Piper Formation (to be used for engineered salt cavern development). These targets were prioritized based on prior EERC research using datasets related to seal capacity, reservoir quality, mechanical integrity, and injectivity. Exposure tests on Broom Creek and DLM samples showed mineral dissolution and precipitation that increased brine salinity and altered reservoir rock surfaces. Although these results provide useful insight, they are limited by small sample sizes and short-term (30-day) exposure, requiring further study to assess long-term storage integrity. Salt formations were not tested because of their known nonreactivity and established mechanical stability. Results of reservoir simulations performed for a single site demonstrated that the Broom Creek Formation may be capable of receiving up to 42,000 tonnes of injected H 2 over 7 months via one well. H 2 recovery took place over 5 months, resulting in approximately 26,000 tonnes (~62% without cushion gas [CG]). This work suggests water production may be important and subsequent cycles of injection and production may perform more efficiently; however, significant site-specific work in the future is needed to assess actual reservoir performance of injection and withdrawal of H 2 storage. For oil reservoir potential, a multiple-well model was used to simulate injection of approximately 32,000 tonnes of H 2 into a single wellbore while simultaneously producing in place reservoir fluids from four offset wells to maintain reservoir pressure. The simulation results suggested a high recovery (~98%); in addition, cost advantages through existing infrastructure could be realized. Challenges in this reservoir include vi managing gas purity and leakage risks. In both scenarios, production of H 2 takes place in a single-well scenario with 10 cycles (7 months of injection and 5 months of production) over 10 years. Finally, the use of engineered caverns in the Dunhan Salt was evaluated, and the results suggest that while they have a smaller capacity (<1000 tonnes per cavern), they exhibit nearly complete gas recovery (>99%), fast response times, and low purity risk. While caverns in North Dakota may be smaller in capacity, fields can be developed in galleries to accommodate the volumetric needs and rapid turnaround times necessary to meet market demands. Geographic limitations and thin salt intervals in North Dakota may represent less total storage potential than salt domes elsewhere, but significant opportunities exist to expand this market for gas storage in North Dakota. A basinwide assessment was performed to estimate a first-of-its-kind value for H 2 storage on a large scale. DOE’s SHASTA-HELP, combined with EERC simulation work, was used to perform the assessment. Estimated H 2 storage potential varied widely for each formation type. The Broom Creek saline formation was estimated to have a storage potential of approximately 1.7–90.5 million tonnes (MMt). The DLM oil reservoirs were estimated to have 0.07–0.19 MMt of capacity. Notably, each of these estimates relies on significant assumptions regarding reservoir thickness, porosity, permeability, and CG needed for operation. Much research is needed to understand the true site-specific storage resource potential of each formation. Using the Dunham Salt Interval for cavern development may result in as much as 4.79 MMt (up to 2.87 MMt working gas) of H 2 storage potential. An important note for consideration is that the values presented here need significantly more geological characterization and engineering assessments prior to gaining confidence in performance. This will be a focal point for future research and development needs. The basinwide evaluation also indicated that North Dakota has significant H 2 generation potential, with estimates up to a possible 13 MMt annually, suggesting a substantial opportunity for H 2 market development and thus the need for commercial-scale H 2 storage to facilitate growth and resilience. Key Recommendations 1. Conduct detailed site characterization (3D seismic, well logs, core sampling) to reduce geologic uncertainty. 2. Perform techno-economic analyses incorporating market, regulatory, and incentive frameworks. 3. Investigate long-term interactions among H 2 , CGs, well materials, and formations to assess risks. 4. Develop pilot- and field-scale demonstrations to validate models and establish best practices.

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