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PROJECT at a glance

Who: Telemedicine and Advanced Technology Research Center.

Mission: To provide military medics with a one-stop device for treating and diagnosing wounded soldiers, and storing and transmitting that information wirelessly to Army base medical facilities.

What was: A paper-based manual system, in which medics could only jot notes and detail medical sessions. Soldiers' medical records were stored in central paper repositories and not available to first responders.

What is: A small handheld electronic device that lets medics document medical sessions in seconds in real-time and provide diagnostic care'all at the click of a button. An electronic dog tag stores soldiers' records so first responders can review a patient's medical history, even if that patient is unconscious.

Users: As of early September 2005, 5,000 units were in use by Army medics and first responders around the globe. Less than two percent have failed.

Impact: TATRC's Battlefield Medical Information System'Tactical, simply, has saved lives. The device lets medics diagnose and treat soldiers instantaneously, while reducing tedious paperwork responsibilities, leading to fewer human errors. The system also contains veterinary records for military animals and diagnostics on military vehicles.

Duration: TATRC did an initial market analysis in 2001 for the BMIS-T system. The final product was released in 2003'in time for the Iraq conflict.

Cost: Congress in 2001 funded the BMIS-T development program for two years, costing $250,000.

With success abroad, DOD sends device to Gulf Coast

Following its tremendous success helping the wounded overseas, the Defense Department sent its one-stop handheld medical devices to the Gulf Coast after Hurricane Katrina ravaged the region.

Tommy Morris, director of mobile computing at the Telemedicine and Advanced Technology Research Center said the Battlefield Medical Information System'Tactical was supporting DOD teams working with the Federal Emergency Management Agency in assisting Katrina victims.

TATRC, a part of the Army's Medical Research and Materiel Command, developed the BMIS-T device, a handheld system that has revolutionized how medics collect, store and transfer medical data from the front lines, as a durable storage and treatment unit that would stand the test of battle.

But as the military was called to the Gulf Coast as part of the unprecedented Hurricane Katrina response, the device quickly found another purpose as well'treating civilians displaced and injured by the storm.

The device will help keep track of the hurricane victims and 'take better care of them,' Morris said.

NO PAPER TRAIL: The Army's BMIS-T handheld reduces the paperwork burden as well as the potential for human error.

Courtesy of Army Telemedicine and Advanced Technology Research Center

Handheld tool gives Army a quick look into a soldier's medical history

When a soldier's life is at stake, every second counts. Tommy Morris, a former Army medic, knows that in the line of battle, there are no substitutes for speed and accuracy. But when a medic must fumble with a Rolodex and document medical sessions through a laborious paper system, speed and accuracy do not always go hand-in-hand.

Morris, director of mobile computing at the Army's Telemedicine and Advanced Technology Research Center, and his TATRC team spearheaded a project that, only two short years after receiving congressional funding in 2001, revolutionized the way medics treat wounded soldiers.

Instead of lugging around paper files and clunky medical forms, the Battlefield Medical Information System-Tactical uses a handheld device to let medics store, retrieve and transmit medical information electronically while on location.

The tool, a point-of-care diagnostic handheld that runs on Hewlett-Packard Co.'s iPAQ Pocket PC, not only helps medics make quicker and more accurate diagnoses and treatment decisions, but it also significantly reduces the paperwork requirements when the soldiers are moved to military hospitals.

BMIS-T makes 'the right information available to the right people at the right time,' said Morris, based in Fort Detrick, Md.

Morris spent more than 10 years as a medic in dangerous places such as Bosnia, Kosovo and Macedonia. While treating soldiers in the early 1990s, he started thinking about compartmentalizing military medical data.

'I was on the field and taking care of soldiers, and I didn't have the information I needed,' he said.

Morris' time in the service'he is a civilian now'helped him reach a simple conclusion: 'There's got to be a better way of doing this.'

Finding a better way took on heightened importance in 1997 when Congress mandated that the military services upgrade their medical documentation procedures.

Military officials and lawmakers also wanted to ensure that injured service members re- ceived the follow-up and long-term care they needed, and to guarantee that veterans could document their medical benefits eligibility.

The BMIS-T handheld tool does all that.

Morris said his team started its work in 2001 by talking to first responders about 'how they do their job [and] what they need.'

Choosing a handheld

From there, TATRC performed market analyses of handheld technologies and settled on the iPAQ Pocket PC, determining that the off-the-shelf hardware was cost-efficient, low-risk and provided the flexibility needed to support data storage and communication configurations.

The software runs on Microsoft Windows Mobile operating system. HP Itanium 2 servers anchor the back-end infrastructure. The system gives medics 72 hours of normal use and about 100 hours of standby power.

The Army has deployed nearly 5,000 BMIS-T devices globally since 2003. They are being used in conflicts in Afghanistan and Iraq, and, in response to Hurricane Katrina, the Gulf Coast. Of that deployment, Morris said the success rate has been very good, with only 2 percent having failed or been lost.

The dangerous environments the device is usually deployed in have 'made it clear to me that the quality of the device is a necessity'it must work,' said Tina Scott, federal mobility sales specialist for HP.

The device's endurance is critical also because of what each unit stores. Medical records for individual patients, including information from the day they enlisted to in- juries suffered in harm's way, are loaded onto a sort of electronic dog tag so a medic can view the soldier's medical history'even if that soldier is unconscious.

This e-tag is called a Personal Information Carrier, a flash memory device carried on the same chain as a soldier's dog tag. A medic equipped with the BMIS-T interfaces with the PIC and reviews a soldier's medical history, including immunizations, dental and ophthalmic records, before providing treatment.

The records are transmitted wirelessly to a central clearinghouse via an existing com unications network, and if there is no network, the data can be stored locally and later synchronized with the HP servers wirelessly, via a cradle or through an Internet connection.

Saving crucial time

Medics enter information with a stylus and can document a clinical session with a soldier in seconds, saving crucial time that could be life-saving. Inputting the data electronically also cuts down on mistakes, Morris and Scott said. Filing out paper medical forms can be difficult and time-consuming and, given the stress of battle, medics can make mistakes.

The BMIS-T 'virtually eliminates [note-taking mistakes] because you're putting the information in on the spot,' Scott said.

And because a first responder's job is not limited to medical care, the BMIS-T also contains technical data about the vehicles they use in case of a breakdown or if they are ambushed.

'It is really critical to have access to that info,' Morris said, speaking from his own experience. BMIS-T 'empowers the medics with the critical information they need and when they need it.'


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