Military Researchers Take Up SmartAmerica Challenge Published June 11, 2014 MHS Communications WASHINGTON -- Think of a modern hospital like a video arcade, with machines beeping and flashing multicolored images. Just as the games in an arcade are independent of each other, so are hospital devices: they don't share information or work together. Military medical experts hope that's about to change. The Military Health System joins forces June 11 with academics and various companies to show how health care could be improved if electronic devices could automatically share and analyze information, improving decision support and reducing unnecessary alarms. The Closed Loop Healthcare team is demonstrating a closed-loop health care system at as part of the SmartAmerica Challenge Expo in Washington, D.C. More than 100 organizations are exhibiting 24 projects that aim to show the potential benefits of so-called cyber-physical systems, in which the same computer connectivity that drives the Internet can be used to make roads, communities, and medicine safer and better. The Military Health System is also participating in a second demonstration at the Expo to show how the connected systems and devices can help the medical professionals - medics to emergency-room doctors - diagnose and handle brain injury cases. The Expo is the culmination of the Smart America Challenge, created as part of the Presidential Innovation Fellows program to demonstrate the possibilities of cyber-physical systems, often called the "Internet of Things." The demonstration shows what needs to happen behind the scenes for patients to really benefit from all that computers can offer, said Mark Goodge, chief technology officer at the Defense Health Agency, located in Falls Church, Virginia. "It's like watching the opera," he said. "What happens behind the curtains is the business of health care. All the patient will see is what's on stage." Every piece of hardware on display is truly functional, from the mini-robot that looks like R2-D2 from the "Star Wars" films, which checks the patient who falls in his home, to the smart pill the patient swallows before he is released from the hospital that takes his vital signs and feed them back to doctors from his home. But because of real-world issues such as liability, such systems are years away from implementation, Goodge said. The goal of the demonstration is to give the world of medicine a nudge in the right direction. "We want to extend the boundary of the art of possibility," he said. The result of the synergy between health care and technology is not what happens but what doesn't: the patient doesn't develop complications and possibly die. The Closed Loop Healthcare demonstration shows Randall, a hypothetical elderly patient with high blood pressure, who is put on a beta-blocker to reduce his blood pressure after he goes to the hospital with a shoulder injury. Data on Randall's blood pressure is transmitted to a clinical decision support system, which observes that his blood pressure falls briefly but dangerously low whenever he takes the medication. The computer calls up Randall's genomic information and finds a gene variation that indicates he may have an abnormal response to beta blockers. It contacts Randall's doctor with the information, and the doctor changes his medication. The closed-loop system aims to address three major challenges facing health care, said Capt. Hung Trinh of the U.S. Public Health Service, who facilitated the demonstration. The first problem is to get health care equipment and systems to communicate. Second is the need to prevent illness and injury rather than treating it after it happens. Third is the need to manage health care for retiring baby boomers, who want to age in their homes rather than in a nursing facility. It took more than a dozen entities to develop the closed-loop system, Trinh said. Among the academic partners are Harvard University, University of Pennsylvania, Vanderbilt University, University of Missouri and Worcester Polytechnic Institute. Hospitals include Beth Israel Deaconess Medical Center and the MD PnP Interoperability Program at Massachusetts General Hospital/Partners Healthcare. Companies include DocBox, Intel Corporation, Nonnatech, PrismTech, RTI International and Talend. Nonprofit partners are UL and the Institute of Electrical and Electronics Engineers. In addition to the Defense Department, other federal partners are the National Institute of Standards and Technology, National Science Foundation and Department of Veterans Affairs. For a complete listing, visit smartamerica.org. "Medical device interoperability is an industry-wide challenge," Trinh said. "It takes all of us working together to make a difference."