Medical Device Daily

Automated medical treatment on the front lines of battle, requiring no human medical personnel.

That's one of the current visionary goals – almost sci-fi-like in scope – of the Defense Sciences Office (DSO) of the Defense Advanced Research Projects Agency (DARPA).

And the agency said it has taken a "significant step" toward the goal with a two-year, $12 million award to SRI International (Menlo Park, California), a pioneering developer of telesurgery systems now given the task of leading a multi-organization team to develop this revolutionary system for the battlefield.

This groundbreaking program is "an important step," SRI said yesterday, toward ensuring a future generation of battlefield-based, unmanned medical treatment systems – called "trauma pods" – to stabilize injured soldiers within minutes after a battlefield injury. The pods will be used to administer life-saving medical and surgical care prior to and during evacuation.

The two-year contract is for the first phase of the program, which is designed for proof-of-concept, said John Bashkin, SRI's director of business development for the program.

"It's really a phased development, and what we're trying to do in this first phase is take components – at least from an engineering standpoint – that don't all exist today, but they're readily achievable in that timeframe," Bashkin told Medical Device Daily. "The goal is to use those components to demonstrate proof-of-concept."

The "harder engineering challenges," he said, will come in later phases of the program.

The initial phase – which, if successful, will then lead to further work – is an effort to develop the robotic technology of the unmanned trauma pod. Though essentially an OR, the pod will be small enough to be carried by a medical ground or air vehicle.

Using a system of surgical manipulators, a human surgeon will conduct all the required surgical procedures from a remote location. The system's actions are communicated wirelessly to the surgery site, and automated robotic systems will provide the necessary support to the surgeon to conduct all phases of the operation.

The program will leverage substantial technology and expertise from a team of companies.

Besides SRI as the leading system integrator of the project, the other organizations of the team include:

  • General Dynamics Robotic Systems (Westminster, Maryland), a leader in unmanned ground vehicle systems and developer of the automated pharmacy system;
  • Oak Ridge National Laboratory (Oak Ridge, Tennessee), a leader in weapons and material handling robotics;
  • University of Texas (Austin), focused on software control systems for material disposal and space manipulators;
  • University of Washington (Seattle), a research leader in surgical robotics;
  • University of Maryland (College Park), a research leader in the Operating Room of the Future; and
  • Robotic Surgical Tech (New York), developers of the first robotic nurse systems for the operating room.

The team held a kick-off meeting at the "Medicine Meets Virtual Reality" conference in Long Beach, California, in January. The group now communicates via conference calls and collaboration management tools.

"The actual system will be assembled and tested and demonstrated here at SRI, so all the different members of the consortium will be developing their components, they all have deliverables and timelines, and we're managing all of that with DARPA," Bashkin told MDD.

All of these components then will be assembled around Intuitive Surgical's (Mountain View, California) da Vinci Surgical System, a robotic surgical system, first approved in the FDA in July 2000 for abdominal and pelvic procedures (MDD, July 13, 2000). Various other FDA approvals have since followed.

"DARPA has defined for us the demonstration milestone that we have to achieve that will show that the overall concept is feasible," Bashkin said.

According to Bashkin, there is nothing even distantly similar to an automated surgical unit being used today.

"The closest thing," he said, "is the LSTAT [which] is a gurney that is used to carry soldiers, and it has a lot of instrumentation on it. So, you can get vital signs, for example, and electronic patient records, and so there's a lot of information about the patient and his condition available for the next level of medical care when the patient is delivered."

It will be through such a system that the patient will be delivered to the trauma pod, though SRI is not directly involved in that component.

"What we hope to have is, along the way, bits and pieces of the technologies to be developed that will be applicable for the commercial or civilian or the military environment," he said.

It won't happen overnight, Bashkin added, noting that full development of the system, as envisioned, will take about 10 years.

The Trauma Pod program is being funded by DARPA through the Telemedicine and Advanced Technology Research Center, a subordinate element of the U.S. Army Research and Materiel Command.

In other awards news:

Child Health Corp. of America (CHCA; Overland Park, Kansas), an alliance of 41 of America's children's hospitals with $11 billion in annual revenues, has signed a preferred provider contract for Omnicell (Mountain View, California) medication dispensing and pharmacy and supply chain automation products.

The contract allows CHCA-member hospitals to purchase Omnicell's MedGuard comprehensive suite of solutions for every step of the medication-use process, from the central pharmacy to the nursing unit, using bar code and Internet technology to reduce medication errors, operate more efficiently and reduce costs.

Cheryl Shaw, pharmacy inventory management coordinator of Texas Children's Hospital (Houston, Texas), one of the hospitals that will utilize the contract with Omnicell, said that Omnicell's MedGuard products "will help us reach our primary goal of maximizing patient safety."

Mike Bomstead, CHCA vice president of purchasing services, added, "we also expect to improve staff productivity which gives us more time for patient care."