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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 NTRSDate not supplied

Coordinated NASA Development of Medical Capabilities and Technologies for Deep Space Exploration

Building upon the success of the last two decades of human spaceflight medical operations onboard the International Space Station (ISS), NASA now must start to evolve to a deep space medical operations paradigm. This new paradigm will include myriad challenges including communication delays and blackouts, infrequent or unavailable resupply, potentially significant vehicle resource constraints, and delayed or non-existent evacuation options. To overcome these challenges, two separate but highly coordinated NASA groups are working together to develop and test solutions to these problems: the Exploration Medical Capability (ExMC) Element of the NASA Human Research Program and the Exploration Medical Integrated Product Team (XMIPT) of the Environmental Control and Life Support System – Crew Health and Performance Systems Capability Leadership Team. Although the work of these two groups is very complementary, ExMC generally focuses more on research and early technology development work while the XMIPT works on maturing and integrating new medical capabilities for exploration. During this panel, these two groups together will present details on how medical capability gaps are defined and addressed, a new work plan in development to increase medical autonomy in spaceflight, a technology maturation effort to generate intravenous fluids from potable water onboard a spacecraft, multiple new technology demonstrations of in-situ laboratory analysis capabilities, and new onboard tools to advance medical care for deep space missions.

Kris Lehnhardt↗
NASA NTRS2023

Identifying and Closing Medical Capability Gaps for Human Spaceflight Missions Beyond Low Earth Orbit

BACKGROUND: Features of human space missions beyond low Earth orbit such as increasing distance from Earth, lack of real-time communication, and limited or no evacuation or resupply capability are expected to drive an increase in medical risk and require crews to operate in an increasingly autonomous fashion. A diverse set of stakeholders at NASA are seeking to fund the development of concepts of operations, medical requirements, and medical capabilities for such missions. However, a systematic approach to identification of current medical capability gaps and a strategic framework to gap closure is needed. OVERVIEW: The Exploration Medical Integrated Product Team (XMIPT) has developed a list of nine high-level medical capability gaps and associated activities required for gap closure. The list was derived based on inputs from subject matter experts at NASA including flight surgeons, other clinical providers, as well as operational and research communities regarding medical capabilities required to support human missions to the Moon and the Mars surface. Responses were reviewed and distilled to identify common themes across capabilities. To ensure alignment with established human system risks, the gap list was further refined based on inputs from NASA’s Human System Risk Board. Relevant medical gap closure activities outside of those funded by the XMIPT were identified through solicitation of inputs from Elements of NASA’s Human Research Program (particularly Exploration Medical Capability), the broader medical operations community, and other stakeholders. This medical capability gap list is reviewed and updated regularly as new information becomes available or new stakeholders are identified. DISCUSSION: The medical capability gap list has matured to include a large group of NASA stakeholders and development activities. This has enabled articulation of priorities to funding entities and programmatic stakeholders, while serving as an accessible resource summarizing gap closure activities, relevant programmatic infusion points, and opportunities for collaboration between stakeholders. This presentation will provide an overview of the nine NASA medical capability gaps and their associated gap closure activities.

Moriah Thompson↗
NASA NTRS2024

ISS Technology Demonstrations for Future Spaceflight Medical Systems

Throughout the history of human spaceflight, crewmembers have experienced various in-flight medical conditions including illness and injury. Planned missions to the Moon and Mars will require capabilities to maintain the health of future space travelers. Mass, power, and volume available in the vehicles and habitats for these missions will be severely constrained; resupply of resources will be limited or non-existent, as will opportunities for evacuation to Earth. Furthermore, ground-based support will be hampered by communication latencies and blackouts. These vehicle and mission constraints will necessitate a medical system that has been efficiently planned, providing on-board procedural guidance in addition to a variety of medical devices and consumable resources. Medical capabilities required for the diagnosis and treatment of potential medical conditions during future spaceflight missions may include real-time health monitoring, medical imaging, and biomarker analyses ( e.g., blood or urine). Terrestrial medicine shares these needs, thus many of these medical capabilities could likely be satisfied by Commercial-Off-The-Shelf (COTS) devices and methodologies; however, in some cases the unique space environment and increased mission duration will drive the need to modify technologies and the way care is provided. NASA’s Human Research Program (HRP) Exploration Medical Capability (ExMC) Element and Mars Campaign Office’s Exploration Medical Integrated Product Team (XMIPT) are working together to decrease medical risk during exploration missions. Flight-tested medical diagnostic and treatment technologies are necessary to effectively manage medical conditions relevant to exploration missions while meeting vehicle constraints, integrating with medical decision-support tools, and enabling increasingly Earth-independent operations. Several projects have leveraged the ISS as a testbed for exploration, including 1) i n- situ blood analysis, 2) medical inventory, 3) intravenous fluid generation, and 4) autonomous medical procedure guidance. Management of several in-flight medical conditions, such as bacterial and viral infections and acute radiation syndrome, is dramatically improved with ability to assess blood cell populations, electrolytes, and metabolites. I n December 2020 and January 2021 ExMC performed an ISS technology demonstration (Tech Demo) of the HemoCue® WBC DIFF analyzer (HemoCue, Brea, CA), a COTS device that was modified to enable functionality in a spaceflight environment. This Tech Demo marked the first time that hematology measurements were successfully performed real-time in microgravity. Also modified and demonstrated was the reusable Handheld Electrolytes and Lab Technology for Humans (rHEALTH) ONE analyzer (rHEALTH, Bedford, MA), which uses flow cytometry and sheath-based hydrodynamic focusing methodologies. The rHEALTH ONE ISS Tech Demo in May 2022 demonstrated test results obtained in-flight matched those on the ground. NASA currently relies on crew self-reporting to manage and maintain medical inventory on ISS.The ability to maintain an accurate inventory becomes more critical during long duration missions since the crew will need to be increasingly autonomous in finding and utilizing medical items, including those scenarios when alternative treatments need to be considered due to limited or no resupply. HRP’s Medical Consumables Tracking (MCT) project was developed by ZIN Technologies, Inc. (Cleveland, OH), and demonstrated real-time tracking of medical supplies aboard the ISS between December 2016 and July 2018. The MCT system design utilized Radio Frequency Identification Device (RFID) technology to perform automated inventory and was installed in the Crew Health Care System (CHeCS) Resupply Stowage Rack (RSR). The challenge of limited shelf life, exacerbated by the lack of resupply opportunities, affects a plethora of medical system components including consumables, pharmaceuticals, and intravenous (IV) fluid. In 2010, ExMC funded ZIN Technologies, Inc. (Cleveland, OH), to develop the Intravenous Fluid Generation (IVGEN) system. IV fluids were successfully generated with IVGEN using the potable water supply on ISS during ISS Expedition 23. The XMIPT is in the process of developing a miniaturized version of the original IVGEN hardware for a future Tech Demo aboard the ISS. Current ISS medical operations rely heavily on preflight training and real-time remote guidance, both of which become impractical or impossible for exploration missions. The primary goal of the Autonomous Medical Officer Support (AMOS) Software Tech Demos on ISS was to confirm telemedical proof-of-concept for autonomous medical imaging in an operational setting. This novel software tool shifts emphasis from preflight training and real-time remote guidance to in-flight just-in-time instruction, a new and necessary paradigm for crew medical autonomy. AMOS introduces a novel, streamlined skill management concept for exploration missions featuring comprehensive training and guidance modules for ultrasound examinations using the ISS Ultrasound 2 (a modified GE Vivid-q™; General Electric HealthCare, Chicago, IL). With no prior crew training or remote guidance, two Tech Demos on the ISS (April 2020 and June 2022) resulted in high quality, clinically useful image sets. We will provide a review of historical, current, and planned medical devices and technologies considered for inclusion within future spaceflight medical systems and summarize hardware development activities and medical device tech demos conducted on the ISS.

Astronaut health and performance↗
NASA NTRSDate not supplied

An Automated Medical Inventory System (AMIS) to Enable Earth-Independent Medical Operations

BACKGROUND: Inventory of medical consumables and durables (medications, treatment aids, diagnostic equipment, etc.) aboard the International Space Station is a manual process whereby crewmembers reach out to their flight surgeon to relay when items are used. Performing a full medical system inventory is time intensive. However, as exploration progresses to long duration missions with little to no resupply or evacuation capabilities, maintaining an accurate account of inventory and location for medical systems across the mission will become increasingly critical. A new system must be developed for future exploration missions to meet the need for a crew-facing, real time method of managing medical inventory. OVERVIEW: NASA’s Exploration Medical Integrated Product Team (XMIPT) is funding the AMIS project to mature the technology readiness level and to conduct a flight demonstration of a medical inventory capability. AMIS will leverage lessons learned from a Medical Consumables Tracking project previously demonstrated aboard the ISS in 2016 and 2017. Key components of AMIS include a database, supporting hardware and software, and interfaces to power, communications, or other vehicle or medical systems. Some medical inventory capability may be provided by the vehicle inventory management system which relies upon RFID-based technology and can track larger items such as medical kits or medical hardware. AMIS will augment these capabilities to enable tracking of individual medical kit contents. Efforts are underway to characterize the optimal solution trade space by comparing system specifications (e.g. mass and volume, etc.) across maintenance and operational use cases (e.g. crew time saved, total inventory automated, etc). DISCUSSION: The contents of a Mars Medical System have not been fully defined which poses challenges to defining an inventory system and requires assumptions regarding medical kit contents and medical system design. Other important considerations include minimizing crew time required, avoiding access restrictions to medical inventory in the event of an emergency, and ensuring that data is accessible to other medical system elements to enable crew autonomy in provision of medical care.

Automated Medical Inventory System↗
NASA NTRS2023

Intravenous Fluid Generation Mini (IVGEN Mini) Summary and Related Research

This paper assists the ongoing effort to support NASA Glenn’s mission and its Human Research Program (HRP) core competency by investigating a technology demonstration to mitigate human health and performance risks during space exploration. Crew health and performance are critical to successful human exploration beyond low Earth orbit. Four hundred forty-two medical conditions have been identified and may present and require treatment during long-duration space exploration missions. One hundred fifteen out of four hundred forty-two identified medical conditions would require medical fluid treatment, generating a need for an on-demand or continuous supply of medical fluid. Intravenous Fluid Generation Mini (IVGEN Mini) is a technology demonstration designed to demonstrate a water purification and pharmaceutical mixing system that can make intravenous (IV) fluid in microgravity and builds on the success of the original Intravenous Fluid Generation for Exploration Missions (IVGEN) experiment, which flew on the ISS in March 2010. IVGEN Mini seeks to increase the Technology Readiness Level (TRL) and the overall function of the original IVGEN experiment to reduce the dependence of a needed medical consumable and streamline the size of the device and process to generate IV fluid IVGEN Mini is funded by the Advanced Exploration Systems (AES) directorate via the Exploration Medical Integrated Product Team (XMIPT) as a part of their mission to advance exploration medical technologies to benefit the overall health and safety of crews for beyond low Earth orbit space missions. This paper discusses a collection of related research topics such as microgravity fluid mixing and studying past efforts of IV fluid usage in extreme environments to aid IVGEN Mini project scientists in developing the IVGEN Mini technology.

iv generation↗
NASA NTRS2023

Exploration Electronic Health Record (xEHR) Techport Entry

Exploration missions beyond low Earth orbit will experience significant communication delays and communication black outs that will necessitate asynchronous, increasingly Earth-independent provision of medical care to onboard crew. In this new paradigm, the Crew Medical Officer (CMO), other Crewmembers, and ground support will have to quickly, efficiently, and independently, view medical data, make decisions, and relay important information. Currently, the NASA electronic health record (EHR) is intended only for ground use and is not accessible to in-mission ISS crew for medical decision support and communication. An EHR capable of providing the crew health data, medical store-and-forward communications, and necessary medical administrative tools is critical in enabling NASA’s standard of healthcare during increasingly autonomous operations. The Exploration Medical Integrated Product Team (XMIPT) project called Medical Exploration Development and Implementation Scoping (MEDIScope) developed and reviewed objectives and concept of operations for an exploration EHR (xEHR) with project stakeholders, developed preliminary high-level requirements, and coordinated the handoff of the project to a design and implementation team at the Johnson Space Center (JSC). This JSC team will develop system requirements for the xEHR with inputs from subject matter experts. Following final requirements development, a team will be chosen to develop the xEHR and to conduct a demonstration on a future exploration vehicle such as Gateway.

MEDIScope↗
NASA NTRS2023

Automated Medical Inventory System (AMIS) TechPort Entry

The current medical inventory paradigm on the International Space Station (ISS) requires crew to report use of medications and supplies to be manually decremented by ground teams. This method is not only tedious and time consuming for both the crew and ground teams but also results in inaccuracies in location and availability of medical supplies over time. Fortunately, the ISS is frequently resupplied by cargo launches and crew expeditions, and an accurate inventory count is less critical. However, for exploration missions, resupply will be greatly limited or unavailable entirely, and increasing communication latency will impair crew-ground communications. On longer missions, with large medical systems and time constrained crew, NASA needs a method of accurately managing medical inventory without reliance on ground teams and with as little crew time and effort as possible. The Exploration Medical Integrated Product Team (XMIPT) project called Medical Exploration Development and Implementation Scoping (MEDIScope) prepared a concept of operations and preliminary requirements for an Automated Medical Inventory System (AMIS) and completed a market survey and trade study of potential inventory management technologies in partnership with the market research firm, yet2. The products from the MEDIScope effort, including the market survey results, preliminary functional requirements and a concept of operations, have been handed off to a development team at Glenn Research Center (GRC) and ZIN Technologies for technology maturation. In the development phase, the AMIS team will finalize system requirements, down select technologies, integrate with a future exploration Crew Health and Performance Integrated Data Architecture, and conduct design reviews. The project will culminate in an ISS technical flight demonstration in FY27.

MEDIScope↗
NASA NTRSDate not supplied

Exploration Atmosphere Demonstration of A Multi-Functional Integrated Medical Device (Tempus Pro)

INTRODUCTION The Exploration Medical Capability (ExMC) element within the Human Research Program and the Exploration Medical Integrated Product Team (XMIPT) within the Mars Campaign Office seek to advance medical system design and risk-informed decision-making for exploration missions. This includes assessment of candidate devices and their compatibility within a variety of increasingly Earth-independent medical scenarios. The Tempus Pro (Remote Diagnostic Technologies, Ltd., Philips Corp., Farnborough, UK) is a commercial-off-the-shelf (COTS), multi-functional integrated medical device capable of vital signs monitoring, with built-in procedure support (iAssist), patient record and telemedicine communication features, and medical imaging (e.g., camera, laryngoscope, ultrasound) that meets multiple exploration medical capability needs. One of several hypobaric atmospheres being considered for exploration vehicles is 8.2 psi with 34% oxygen. To assess the useability of the Tempus Pro in such environments by individuals without formal medical training, the unit was tested in May and June of 2023 at the Johnson Space Center 20-Foot Exploration Atmosphere Chamber in conjunction with the Exploration Atmospheres-2 (EA-2) study. TECHNOLOGY DEMONSTRATION Eight subjects in the EA-2 study were assigned roles as the caregiver or patient – or both in the case of a self-exam – and caregivers were asked to place sensors for 3-Lead ECG, non-invasive blood pressure (NIBP), pulse oximetry (SpO2), and temperature using Tempus Pro’s iAssist. Depending on the procedure, additional tasks included an oropharyngeal exam of the throat with the laryngoscope and capturing ultrasound images of a cardiac subxiphoid view or of the user’s choice from a pre-specified list. Scenarios ranged from remote-guided to fully autonomous operations and surveyed the effectiveness of support, amount of support desired, and importance of support by type (e.g., written crew procedures, iAssist and device guidance, remote console guidance, etc.). Feedback from the subjects and the support personnel was also gathered to inform future designs for training and support and to determine what operations are plausible given different levels of each. An unweighted NASA task load index (TLX) was used to profile the demands of using the device, however the sample size does not support statistics. The research was exploratory in nature and qualitative information was the main goal. Calibration checks on the Tempus Pro were conducted before and after chamber testing to ensure the device was in useable condition. RESULTS All subjects performed their tasks successfully and found the Tempus Pro easy to use with the support provided. The calibration checks outside the chamber showed that the Tempus Pro remained unchanged and measurements inside the chamber were within normal values. Caregivers taking the NASA TLX reported mean scores ≤ 41/100 showing the tasks to be undemanding and less demanding with repeated use (~20/100). Novice users were able to easily connect sensors and take vital signs with the guidance from Tempus Pro’s iAssist feature. For more complex tasks, such as the oropharyngeal exam and ultrasound image acquisition, guidance beyond iAssist was needed, primarily from a supporting physician. Feedback on the importance of support types varied by person and scenario but greater than 50% of the support used by each was non-native to the device. Overall opinions were positive, but the ultrasound users expressed a lack of confidence in their results and 3 out of 4 desired more time, training, or support. Subjects found the sensors to be comfortable and comparable to prior experiences with such devices, except for the blood pressure cuff, which squeezed too tightly for uncomfortably long periods. Many observations provoked discussion, especially regarding ultrasound, that will aide decisions about future demonstrations.

R. S. Miller↗
NASA NTRSDate not supplied

Pilot Study of Medications Exposed to Vacuum

Background Few studies have been conducted regarding the effects of vacuum on medications and their packaging. While relevant on the International Space Station, understanding these effects becomes even more critical as future NASA missions venture farther away from Earth. Vehicles supporting the Artemis missions will have dedicated, vehicle-specific medical kits as well as crew medical accessory kits. Although most of the kits will be stored in a pressurized, climate-controlled volume, there are specific scenarios in which they may become exposed to vacuum. These include the vehicle being brought to vacuum to enable clearance of atmospheric contaminants, and on Human Landing System (HLS), in the airlock (in which kits may be stored) during extravehicular activities. Overview The Exploration Medical Integrated Product Team (XMIPT) in collaboration with the Department of Defense is conducting a pilot study to assess the effects of vacuum on the medications and their packaging to be used in exploration missions. Phase A of this study will focus on manufacturer’s package integrity and Phase B on identifying chemical changes through active pharmaceutical ingredient (API) testing of the medications at 0, 4.5 and 9 months post exposure. Two exposure durations, 1 hour and 8 hours were selected to represent the expected time at vacuum for an Orion contaminated atmosphere vent/repress and the time at vacuum for a lunar surface EVA. The medications for this study were identified based on those currently being considered for future Artemis missions and represent the types of pharmaceuticals and formulations that are likely to comprise an exploration formulary. Discussion The results from this pilot study will aid in decision making related to the development of medical kits, medication packaging and stowage for long duration lunar and Mars missions, and inform the direction of future medication in vacuum studies.

Vacuum↗
NASA NTRS2024

Crew Health and Performance Integrated Data Architecture (CHP-IDA) Project

BACKGROUND: Future Human Exploration missions introduce a new paradigm as crews move further from the resupply and near real-time ground support typical of Low Earth Orbit missions today. Without immediate support from ground-based personnel, exploration crews will be more reliant on inflight data and technology to respond to emergencies and anomalies. A data architecture to support a new generation of technologies, employing advanced analytical and predictive modeling techniques, is needed to enable crew autonomy. OVERVIEW: The Crew Health and Performance Integrated Data Architecture (CHP-IDA) project funded by NASA’s Exploration Medical Integrated Product Team (XMIPT) is laying a foundation for future in-flight informatics by providing a back-end architecture for collecting, storing, and integrating multiple sources of data generated by and around the crew. CHP-IDA provides a platform for common data models and Application Programming Interfaces to access, integrate, process, and display CHP data (e.g., environmental, exercise, medical, sleep, performance, etc.). This will facilitate the increased situation awareness and decision support required by the crew and remote support of exploration missions. This presentation will describe the currently ongoing effort to develop and evaluate a path-to-flight concept of the CHP-IDA software and its core capabilities. Current integrations will be discussed, including analytics for Extravehicular Activity metabolic rate and data ingestion from a multi-functional integrated medical device. The presentation will also provide examples of scenarios used to demonstrate the CHP-IDA through human-in-the-loop test bed activities as well as examples of appropriate system performance metrics. DISCUSSION: Today, in-flight data is often siloed, unsynchronized, and largely inaccessible in real time. Many data sets require manual entry and/or data transfer between vehicles and the ground. These issues contribute to risks in supporting exploration medical capabilities. The CHP-IDA is a back-end data system providing core capabilities needed for timely and meaningful data insights across CHP domains to crew and remote personnel to enable increased crew autonomy. Future work includes collaboration with additional CHP domains, new technology integrations, and further demonstrations of the IDA within different vehicle and communication latency contexts. LEARNING OBJECTIVES 1. The audience will understand that the CHP-IDA is a back-end system, providing a platform to facilitate access, promote decision tools, and provide meaningful insights to crew and to remote stakeholders during exploration missions. 2. The audience will gain insight into human-centered research and activities used to discover CHP domain data needs and pain points and how this information is used to guide development of the IDA.

Exploration↗
NASA NTRS2024

Crew Health and Performance Integrated Data Architecture (CHP-IDA) TechPort May 2024

Future exploration missions to Mars will have increased need for crew autonomy. Crew Health & Performance (CHP) related data on the ISS is currently, manually downlinked and in disparate locations, which limits crew autonomy for future missions. The CHP-IDA project is developing a backend data system platform that grants the ability to seamlessly collect, store, process, and display CHP-related data for exploration missions. This platform allows for integration of data and advanced analytics that offer crew and ground teams better insight into the crew’s health and performance. It also enables applications that can improve the crew’s ability to provide more autonomous medical care during exploration missions. Data will be collected automatically to reduce crew and ground team time and effort and will synchronize across all in-mission vehicles, habitats, and ground as communication delay permits. The Human Research Program’s (HRP) Medical Data Architecture (MDA) project focused on this backend data architecture but for medical data only. The CHP-IDA project, a joint effort between HRP’s Exploration Medical Capability (ExMC) element and the Exploration Medical Integrated Product Team (XMIPT), expands this capability to all relevant CHP-related data. The additional inputs from nutrition, environment, exercise, radiation, and any other relevant sources will give more insight into crew’s health and performance. Currently, the Human Systems Engineering and Integration Division at Johnson Space Center (JSC) is designing the system. The team completed a system requirements review (SRR) in FY22 and now the focus is on core software development, testbed buildup, and use case scenario demonstration. An end-to-end demonstration with multiple data sources across CHP domains is schedule for the end of FY24 where all three focus areas will be displayed. Following this ground demo, the software will be completed, tested, and validated for flight.

Courtney M Schkurko↗
NASA NTRS2025

Limitations and Feasibility of Mini X-Ray Devices in Space Environments

LIMITATIONS AND FEASIBILITY OF MINI X-RAY DEVICES IN SPACE ENVIRONMENTS As space exploration advances toward long-duration missions, reliable medical diagnostic tools become increasingly critical. The miniature x-ray (XR) technology demonstrations by the Exploration Medical Capability (ExMC) and the Exploration Medical Integrated Product Team (XMIPT) aim to assess the feasibility and utility of miniature XR devices in spaceflight. This abstract explores the limitations of current miniature XR systems, the challenges of training crew members, the potential role of clinical decision support systems (CDSS), and the feasibility of ground-based image interpretation. We also propose the integration of miniature XR into other ExMC efforts aimed at identifying the capabilities and resources needed for future exploration class missions. One of the primary challenges with miniature XR devices is the ability to achieve specific anatomical views, particularly in the confined and weightless conditions of a spacecraft. Operators may struggle to acquire diagnostic-quality images when space is limited for proper patient positioning and the volume of the imaging device. Since space radiation and detector limitations may further impact image quality, the flexibility of the operating procedures of these devices will be critical for their success in space applications. CHALLENGES IN TRAINING CREW TO OPERATE IMAGING DEVICES Training in the skills necessary to acquire diagnostic-quality scans may be a barrier for non-clinician crewmembers. The curriculum developed for crew medical officers (CMOs) will require simplification and adaptation to fit into the highly truncated pre-flight training period. Therefore, hands-on familiarization and simulation, both pre-flight and just-in-time training during missions, will be crucial to ensuring the crew can operate the devices in real-life situations. The ability to adjust acquisition parameters must be simplified or made automatic through exam selections on equipment user interfaces, and subject and operator positioning should be assisted with laser guidance and pictorial guides. POTENTIAL FOR CDSS OR ARTIFICIAL INTELLIGENCE (AI)-ASSISTED CDSS CDSS and AI-assisted CDSS offer significant promise in assisting crew members with limited medical training. These systems could provide real-time feedback on image quality and interpretation, helping to mitigate the risks of human error during space missions. Integrating procedural guidance tools, such as virtual and augmented reality, will support crewmembers in accurately positioning patients and obtaining high-quality images. However, the success of such systems will depend on the development of robust training datasets, integration with spaceflight-rated hardware, and the medical decision-making capabilities of operators. FEASIBILITY OF GROUND INTERPRETATION AND DATA TRANSMISSION Reliance on ground-based interpretation may prove difficult for acute care during exploration class-missions due to delays in transmission with increasing distance from Earth or complete communication blackout periods. In such instances where immediate interpretation for clinical intervention is required, crew must be able to interpret the images independently or utilize AI-based assistance to do so. File sizes for XR exams can also be large if numerous images are acquired and bandwidth constraints may limit data transmissions for both radiography and ultrasound exams. FUTURE WORK AND INTEGRATION INTO THE EVIDENCE LIBRARY Future work proposes integrating miniature XR devices into NASA’s Evidence Library to address medical conditions identified as significant contributors to crew morbidity and mortality. The possibility of combining miniature XR with other imaging modalities, such as ultrasound devices, is also under investigation. In conclusion, while miniature XR technology holds potential for extraterrestrial medical systems, there are significant challenges to overcome. Training, integration of AI tools, dedicated exam protocols for microgravity, and improved data transmission systems will be key to realizing the full benefits of miniature XR technology in space.

A M Nelson↗
NASA NTRSDate not supplied

Custom Integration of Multiple Medical Functionalities

INTRODUCTION: Previous spaceflight experience and results from probabilistic risk assessment of spaceflight medical risk have highlighted the need for vital sign measurements, medical scopes, and clinical imaging tools for managing medical conditions during spaceflight. The Human Research Program’s Exploration Medical Capability (ExMC) Element and the Mars Campaign Office’s Exploration Medical Integrated Product Team (XMIPT) have performed ground-based evaluations of two Commercial-off-the-Shelf (COTS) Multi-functional Integrated Medical (MIM) devices, which integrate various medical capabilities together in one device. The key findings from these evaluations are presented in a complementary presentation, leaving this presentation to focus on forward recommendations for customized integration of multiple medical functionalities. KEY COMPONENTS: The key features of a custom integration of multiple medical functionalities includes devices and capabilities that optimally reduce medical risk. The COTS MIM devices incorporated functionality for best supporting Earth-based, emergency, pre-hospital care. Our custom integration will use probabilistic risk assessment tools, such as the Medical Extensible Dynamic Probabilistic Risk Assessment Tool (MEDPRAT), to determine the optimal functionality to include based on medical risk minimization. An additional feature of custom integration includes the ability to adapt to different requirements within different vehicles and/or missions. The COTS MIM devices store data in patient specific records, however, the format of the records is not modifiable, and data are not easily transferred from the MIM device to a central data architecture outside of the manufacturer’s established system. Our concept for custom integration will use devices that have an open application programming interface, which can easily connect to independent data architectures and third-party visualization software. The ultrasound capabilities included within the COTS MIM devices did not satisfy many of the Artemis Research and Operations Working Group’s ultrasound functional needs, and therefore, incorporation of higher quality ultrasound capabilities within a customized integration will be beneficial. The COTS MIM devices included minimal procedural guidance and clinical decision support tools. Supplemental tools of this type would need to be supplied along with the COTS MIM devices if they were to be used operationally, so another advantage of customization is the ability to integrate these support tools along with the medical functionality, for a more streamlined user experience. CONCLUSION: Investigation of a customized integration of medical functionality provides a method for further understanding the needs of a long-term exploration spaceflight medical system. The crew members of these exploration missions will need to operate more and more independently from Earth-based ground support. Therefore, having an optimized, streamlined medical system, which contains the functionality and supporting information needed, while remaining within mission and vehicle constraints, will help to maintain crew health and performance, which is necessary for achieving high levels of mission success.

B E Lewandowski↗
NASA NTRSDate not supplied

Exploration Medical Integrated Product Team Clinical Decision Support Market Survey

NASA’s Exploration Medical Integrated Product Team (XMIPT) has identified Clinical Decision Support (CDS) technology as a critical need for future human space exploration. Such technology will support real time diagnosis, monitoring, and treatment of spaceflight medical conditions. The need for such tools and support systems is critical for in-mission clinical decision-making, especially when Earth-based support is unavailable due to communication delays or blackouts. Supporting technologies may or may not involve Artificial Intelligence (AI), and would support astronaut crew with minimal clinical training, or even those with advanced training if they are, for example, in need of a refresher, experiencing multiple stressors, or temporarily overloaded with tasking. This need traces to the Development of Earth Independent Operations Technologies for NASA’s Mars Campaign Office. The CDS Market Survey purpose, methods, outcomes thus far, and near-term steps will be discussed.

Decision support↗