The US Department of Veterans Affairs (VA) Veterans Health Administration (VHA) area is working with IBM Watson to develop and pilot a Clinical Reasoning System to assist and accelerate decision making by primary care physicians. The $6.8 million, two-year project will concentrate on acquiring and analyzing the data generated by hundreds of thousands of VHA documents, medical records, EMRs and research papers. The second focus of the VA-Watson relationship will also include mental health–supporting veterans with PTSD who constitute 12-20 percent of US veterans from Vietnam to present. The pilot phase, interestingly, will use simulated, not real, patients.
While protection against concussive and sub-concussive head blows that lead to brain trauma (TBI) and may lead long-term to chronic traumatic encephalopathy (CTE) is being developed in several areas, by DARPA, US Army research, universities and the NFL‘s helmet providers, the final test has to involve cranial bone similar to those belonging to 20-30 year olds. Testing on humans is out of the question, deceased animal and older human crania are dissimilar and surgical implants do not react like real bone. The US Army Research Laboratory (ARL) along with university partners are developing synthetic cranial bone that behaves like real 20-30 year old bone when subjected to combat-intensity blasts, for testing devices to mitigate the adverse effects and/or track the effects of those blasts. Armed With Science
A signature injury of the Iraq and Afghanistan wars has been traumatic brain injury (TBI), as well as an outcome of all wars–post-traumatic stress disorder (PTSD). Over 270,000 veterans since 2000 have been diagnosed with TBI–along with 1.7 million civilians per year. The US Department of Defense (DOD) has been funding research in several areas to help veterans–and eventually civilians–with these traumas.
- DARPA’s RAM: Restoring Active Memory program is seeking to compensate for brain injury by developing a neuroprosthetic to aid memory function. (more…)
DARPA’s continued research on deep brain stimulation (DBS) implants to treat PTSD and TBI, as well as other neuropsychological conditions, is given the once-over in this Defense One article. New information from the time this Editor last wrote about it in December is that the SUBNETS program (Systems-Based Neurotechnology for Emerging Therapies), funded with $12 to 26 million, will work with the University of California at San Francisco, Lawrence Livermore National Lab and Medtronic to create an implant with electrodes reaching into the brain and which does not require staying still under a machine in a lab. The prototype development is expected to take five years. The article also points out the US Air Force initiative studying the effects of low amounts of electricity on the brain to boost alertness delivered by an external cap.
Online ‘ChatWithAChaplain’ service also debuts
In our focus on technology, particularly on how it can assist in determining risk or helping patients to better manage the effects of PTSD and TBI, we neglect the critical role of personal spiritual care. In the military, the first line of this type of care are chaplains. This excellent 100 page handbook issued by the US Navy’s Chaplain Corps and their Bureau of Medicine and Surgery is a brief for chaplains explaining the medical and psychological nature of PTSD and TBI, how they can provide service members with culturally appropriate spiritual care, and how they integrate it with the mental health team’s work. For those outside the military working with approaches to these conditions, it is a wealth of medical and treatment information in one place–and will influence your thinking. It was co-authored by The Rev. George Handzo, VP for Pastoral Care Leadership and Practice at The HealthCare Chaplaincy Network, a nonprofit healthcare organization which helps people in distress from illness and suffering find comfort and meaning. HCCN is a leader (more…)
This Editor, as our long-term readers know, has been following the issue and the dangers of soldier TBI and PTSD for several years. One of the problems with TBI is measuring the amount of blast a soldier has actually sustained in battle–and thus the medical danger. A cheering development is the further development of the ‘blast gauge’ developed by DARPA and the Rochester Institute of Technology (RIT), the testing of which we noted in mid-2012 [TTA 12 June 12]. It is now smaller than a wristwatch (now thumb-sized) and worn in three positions attached to a soldier’s body armor: chest, shoulder and back of helmet. As in the wristwatch model, there’s a red-yellow-green light for an instant read, in addition to the downloadable data which a medic can interpret on a laptop using a USB cable. It is now being worn by 11,000 US troops and 1000 Australian soldiers in Afghanistan. (more…)
[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/12/SUBNETS_144_144.png” thumb_width=”150″ /]The US Defense Advanced Research Projects Agency (DARPA) is investigating the use of DBS (deep brain stimulation) implants for possible treatment of several chronic neuropsychological conditions. They are seeking to evaluate neural and behavioral processes in PTSD, TBI, major depression, borderline personality disorder, general anxiety disorder, substance abuse/addiction and fibromyalgia/chronic pain through the SUBNETS program (Systems-Based Neurotechnology for Emerging Therapies). All these conditions are on the rise with service members and veterans. DBS is currently used in neurological diseases that impair motor function–Parkinson’s and dystonia–and is being researched for treatment of depression, obsessive compulsive disorder, Tourette’s and epilepsy. SUBNETS is also linked to NIH’s BRAIN Initiative. Armed With Science article, the SUBNETS pre-solicitation (Photo courtesy of DARPA)
The US Department of Veterans Affairs (VA) has signed a 12 month contract with Chicago-based Prevail Health Solutions to further develop the Vets Prevail online supportive behavioral health program in 2014. In development for five years in various pilots, it has corporate support from Goldman Sachs Gives, the Robin Hood Foundation. the Bristol-Myers Squibb Foundation and PepsiCo. Vets Prevail is an online program using Cognitive Behavioral Therapy (CBT)-based e-learning lessons and peer-to-peer support, also routing into select established Veterans Health Administration resources. Mobihealthnews profiles the 10 apps Prevail is using plus others that the VA has developed such as PTSD Coach, smoking cessation app Stay Quit Coach and Care4Caregiver.
In a joint program instituted by UCLA Health, Brooke Army Medical Center (AMC), a burn and rehab hospital in San Antonio and the Veterans Administration Greater Los Angeles Healthcare System over the past six years, wounded soldiers undergoing major facial or burn reconstruction at UCLA have had access to telemedicine consults between UCLA and Brooke AMC. This is now being expanded to include other major reconstructions, such as orthopedic reconstruction for severely damaged limbs, urologic treatment, otolaryngological care, examination and treatment of reproductive issues, repair of airways and design of new prosthetic ears. In including Fort Irwin in the Mojave Desert, the program is now including TBI and PTSD. FierceHealthIT on Operation Mend.