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NASA NTRS2018

Medical Data Architecture (MDA) Project Status

medical data architecture↗

NASA NTRS2019

Medical Data Architecture (MDA) Project Status

The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm. The medical system requirements are being developed in parallel with the exploration mission architecture and vehicle design. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products supported by current prototype development will directly inform exploration medical system requirements.In fiscal year 2018, the MDA project developed Test Bed 2, the second iteration in a series of prototypes with functionality focused on data security through role-based access control and encryption, integration with One Portal exercise software and ingestion of an ultrasound Digital Imaging and Communications in Medicine (DICOM) file and image display. Test Bed 2 advances the medical data system architecture framework by providing these functionalities in a scalable system that maintained a layered, modular design. The architecture framework uses a data services approach with role-based access to data in a customized medical record system suitable for space exploration. These functionalities were demonstrated as part of the Next Space Technologies for Exploration Partnerships (NextSTEP) ground test demonstrated at the NASA Johnson Space Center Integrated Power, Avionics and Software (iPAS) facility. Interfacing to a Core Flight Software (CFS) system, the MDA system, using Consultative Committee for Space Data Systems (CCSDS) protocol, transferred an exercise file from the simulated flight MDA system to a mirrored MDA system on the ground through the CFS system. The selection of data sources and demonstrations enabled the team to address stakeholder concerns throughout the development process. In the next iteration, the MDA team will work with stakeholders to identify additional relevant functionalities to further advance system data models, standards and principles that will inform the medical system requirements development.

medical data architecture↗

NASA NTRS1986

Advanced EVA system design requirements study

Design requirements and criteria for the Space Station Advanced Extravehicular Activity System (EVAS) including crew enclosures, portable life support systems, maneuvering propulsion systems, and related extravehicular activity (EVA) support equipment were defined and established. The EVA mission requirements, environments, and medical and physiological requirements, as well as opertional, procedures, and training issues were considered.

Source record↗

NASA NTRS1986

Advanced EVA system design requirements study, executive summary

Design requirements and criteria for the space station advanced Extravehicular Activity System (EVAS) including crew enclosures, portable life support systems, maneuvering propulsion systems, and related EVA support equipment were established. The EVA mission requirements, environments, and medical and physiological requirements, as well as operational, procedures and training issues were considered.

Source record↗

NASA NTRS2018

Exploration Medical System Trade Study Tools Overview

ExMC is creating an ecosystem of tools to enable well-informed medical system trade studies. The suite of tools address important system implementation aspects of the space medical capabilities trade space and are being built using knowledge from the medical community regarding the unique aspects of space flight. Two integrating models, a systems engineering model and a medical risk analysis model, tie the tools together to produce an integrated assessment of the medical system and its ability to achieve medical system target requirements. This presentation will provide an overview of the various tools that are a part of the tool ecosystem. Initially, the presentation's focus will address the tools that supply the foundational information to the ecosystem. Specifically, the talk will describe how information that describes how medicine will be practiced is captured and categorized for efficient utilization in the tool suite. For example, the talk will include capturing what conditions will be planned for in-mission treatment, planned medical activities (e.g., periodic physical exam), required medical capabilities (e.g., provide imaging), and options to implement the capabilities (e.g., an ultrasound device). Database storage and configuration management will also be discussed. The presentation will include an overview of how these information tools will be tied to parameters in a Systems Modeling Language (SysML) model, allowing traceability to system behavioral, structural, and requirements content. The discussion will also describe an HRP-led enhanced risk assessment model developed to provide quantitative insight into each capability's contribution to mission success. Key outputs from these various tools, to be shared with the space medical and exploration mission development communities, will be assessments of medical system implementation option satisfaction of requirements and per-capability contributions toward achieving requirements.

Mindock, J.↗

NASA NTRS2017

Medical Optimization Network for Space Telemedicine Resources

INTRODUCTION: Long-duration missions beyond low Earth orbit introduce new constraints to the space medical system. Beyond the traditional limitations in mass, power, and volume, consideration must be given to other factors such as the inability to evacuate to Earth, communication delays, and limitations in clinical skillsets. As NASA develops the medical system for an exploration mission, it must have an ability to evaluate the trade space of what resources will be most important. The Medical Optimization Network for Space Telemedicine Resources (MONSTR) was developed over the past year for this reason, and is now a system for managing data pertaining to medical resources and their relative importance when addressing medical conditions. METHODS: The MONSTR web application with a Microsoft SQL database backend was developed and made accessible to Tableau v9.3 for analysis and visualization. The database was initially populated with a list of medical conditions of concern for an exploration mission taken from the Integrated Medical Model (IMM), a probabilistic model designed to quantify in-flight medical risk. A team of physicians working within the Exploration Medical Capability Element of NASA's Human Research Program compiled a list diagnostic and treatment medical resources required to address best- and worst-case scenarios of each medical condition using a terrestrial standard of care and entered this data into the system. This list included both tangible resources (e.g. medical equipment, medications) and intangible resources (e.g. clinical skills required to perform a procedure). The physician team then assigned criticality values to each instance of a resource, representing the importance of that resource to diagnosing or treating its associated condition(s). Medical condition probabilities of occurrence during a Mars mission were pulled from the IMM and imported into the MONSTR database for use within a resource criticality-weighting algorithm. DISCUSSION: The MONSTR tool is a novel approach to assess the relative value of individual resources needed for the diagnosis and treatment of medical conditions. Future work will add resources for prevention and long term care of these conditions. Once data collection is complete, MONSTR will provide the operational and research communities at NASA with information to support informed decisions regarding areas of research investment, future crew training, and medical supplies manifested as part of any exploration medical system.

Rubin, D.↗

NASA NTRS2022

Apollo Crew Loads Data Mining

INTRODUCTION Human exposure data to dynamic loads in spaceflight are sparse not only because very few crewmembers have flown in space, but also because much of the historic data is no longer readily available. Earth and Moon landings of the Apollo missions are unique and valuable for understanding human tolerance in water landing conditions for both short-duration and long-duration crewmembers as well as informing crew tolerance in standing postures during planetary landings. The goal of this task was to find relevant Apollo data to better understand human tolerance in these scenarios, in order to apply this knowledge to future missions. METHODS The goal of this task was to recover time history data from dynamic phases of flight from crewed Apollo missions. The first phase of the task was to search available records at JSC and other centers to locate the appropriate records at the National Archives in Fort Worth, TX. Once the possible data locations were located, it was planned that one researcher would travel to the National Archives in Fort Worth, TX to collect the relevant Apollo data. Once the data was retrieved, they would be digitized for future use and evaluation, and archived within the Human Physiology, Performance, Protection, and Operations (H-3PO) laboratory within the Human Health and Performance Directorate. These data would be used to assess the feasibility and acceptability of current standards and vehicle design requirements for lunar and Mars missions. Additionally, any medical monitoring required, or physiological changes noted in crewmembers based on dynamic loads would be documented for future use. RESULTS Relevant records were found at Ft. Worth, TX and College Park, MD using the National Archives Online Catalog. In addition to the online catalog, an Archives staff member was able to share an additional inventory list of NASA JSC records held in Ft. Worth, TX. Due to COVID-19, NASA has only recently allowed non-mission essential travel. In addition, the National Archives has also been closed to the public since March 2020. Because of this, travel to the National Archives to search records there has not been possible. CONCLUSION The findings include collections at the National Archives at both Ft. Worth, TX and College Park, MD that could possibly hold the data we are looking for. Unfortunately, the descriptions of each collection are very broad. Though we are hopeful that relevant data is stored in one of these collections, we cannot be sure that we will find what we are looking for. At this time, it is not clear when the Archives will reopen to the public or when NASA will allow travel. Travel to the Archives has been postponed, and will be reassessed at a future date.

T Reiber↗

NASA NTRS2004

Chronic Medication and or Monitoring for Long Duration Space Flight: What Should The Policy Be?

While a private individual with a chronic medical condition could perhaps justifiably claim the right to become a "space tourist" through informed consent, NASA and other International crew members are national assets, trained at government expense to fulfill a mission considered essential to national goals. The medical requirements/policy for selection and certification of crewmembers for long duration missions to the International Space Station (ISS) should address: (1) Crewmembers with chronic conditions that require regular dosing of life-sustaining medication for the purposes of secondary or tertiary prevention (i.e. tumor suppression therapy or anticoagulation). (2) Crew members with conditions that will be worsened by spaceflight exposure, placing them at additional personal health risk though not necessarily increasing mission risk (i.e. previous radiation exposure or preflight osteopenia/osteoporosis) The following policies are recommended. A crewmember should not be assigned to an International Space Station mission who: (3) Requires medications to sustain life or who has a disease, which requires medical procedures or diagnostics to monitor and treat same. (4) Has medical condition, which would prevent participation as a candidate in many scientific and medical operational research studies, as their underlying condition would confound the collected data. (5) Requires specialized medical devices for monitoring or treatment of a medical condition, including conditions that require special provisions to conduct routine required countermeasure activities. (6) Who has a disease or requires treatment for same, and for which the effects of space travel may be deleterious to the short or long term health of the individual, An evidence-based approach will be used to provide rationale for policy recommendations under these scenarios. Operational impacts of allowing these medical conditions to fly on the ISS will also be presented.

Hamilton, Douglas R.↗

NASA NTRS2011

Exploration Medical System Demonstration Project

A near-Earth Asteroid (NEA) mission will present significant new challenges including hazards to crew health created by exploring a beyond low earth orbit destination, traversing the terrain of asteroid surfaces, and the effects of variable gravity environments. Limited communications with ground-based personnel for diagnosis and consultation of medical events require increased crew autonomy when diagnosing conditions, creating treatment plans, and executing procedures. Scope: The Exploration Medical System Demonstration (EMSD) project will be a test bed on the International Space Station (ISS) to show an end-to-end medical system assisting the Crew Medical Officers (CMO) in optimizing medical care delivery and medical data management during a mission. NEA medical care challenges include resource and resupply constraints limiting the extent to which medical conditions can be treated, inability to evacuate to Earth during many mission phases, and rendering of medical care by a non-clinician. The system demonstrates the integration of medical technologies and medical informatics tools for managing evidence and decision making. Project Objectives: The objectives of the EMSD project are to: a) Reduce and possibly eliminate the time required for a crewmember and ground personnel to manage medical data from one application to another. b) Demonstrate crewmember's ability to access medical data/information via a software solution to assist/aid in the treatment of a medical condition. c) Develop a common data management architecture that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all crew health and life sciences activities. d) Develop a common data management architecture that allows for scalability, extensibility, and interoperability of data sources and data users. e) Lower total cost of ownership for development and sustainment of peripheral hardware and software that use EMSD for data management f) Provide better crew health via the reduction in crew errors, crew time, and ground time.

Chin, D. A.↗

NASA NTRS2004

Medical Scenarios Relevant to Spaceflight

The Medical Operational Support Team (MOST) was tasked by the JSC Space Medicine and Life Sciences Directorate (SLSD) to incorporate medical simulation into 1) medical training for astronaut-crew medical officers (CMO) and medical flight control teams and 2) evaluations of procedures and resources required for medical care aboard the International Space Station (ISS). Development of evidence-based medical scenarios that mimic the physiology observed during spaceflight will be needed for the MOST to complete these two tasks. The MOST used a human patient simulator, the ISS-like resources in the Medical Simulation Laboratory (MSL), and evidence from space operations, military operations and medical literature to develop space relevant medical scenarios. These scenarios include conditions concerning airway management, Advanced Cardiac Life Support (ACLS) and mitigating anaphylactic symptoms. The MOST has used these space relevant medical scenarios to develop a preliminary space medical training regimen for NASA flight surgeons, Biomedical Flight Controllers (Biomedical Engineers; BME) and CMO-analogs. This regimen is conducted by the MOST in the MSL. The MOST has the capability to develop evidence-based space-relevant medical scenarios that can help SLSD I) demonstrate the proficiency of medical flight control teams to mitigate space-relevant medical events and 2) validate nextgeneration medical equipment and procedures for space medicine applications.

Bacal, Kira↗

NASA NTRS1991

Determining the IV fluids required for a ten day medical emergency on Space Station Freedom - Comparison of packaged vs. on-orbit produced solutions

To aid planning for the storage of supplies onboard Space Station Freedom, an estimate was made of the amount of intravenous (IV) fluid required to support a patient who has suffered a medical emergency for a period of up to 10 days. Six different medical scenarios were evaluated, and the volume of IV fluids required for each scenario was estimated. Up to 220 liters of fluid would be required to support a patient for all of the scenarios. When optimizing the volumes to support any single scenario, a total of 123 liters is required. Use of a water polishing system to produce sterile water for injection from potable supplies and on-station formulation of IV fluids results in a smaller mass and volume requirement for the Fluid Therapy Subsystem than carrying prepackaged bags of fluid.

Creager, Gerald J.↗

NASA NTRS1964

Biomedical and Human Factors Requirements for a Manned Earth Orbiting Station

This report is the result of a study conducted by Republic Aviation Corporation in conjunction with Spacelabs, Inc.,in a team effort in which Republic Aviation Corporation was prime contractor. In order to determine the realistic engineering design requirements associated with the medical and human factors problems of a manned space station, an interdisciplinary team of personnel from the Research and Space Divisions was organized. This team included engineers, physicians, physiologists, psychologists, and physicists. Recognizing that the value of the study is dependent upon medical judgments as well as more quantifiable factors (such as design parameters) a group of highly qualified medical consultants participated in working sessions to determine which medical measurements are required to meet the objectives of the study. In addition, various Life Sciences personnel from NASA (Headquarters, Langley, MSC) participated in monthly review sessions. The organization, team members, consultants, and some of the part-time contributors are shown in Figure 1. This final report embodies contributions from all of these participants.

EARTH ORBIT↗

NASA NTRS2017

Defining Medical Levels of Care for Exploration Missions

NASA medical care standards establish requirements for providing health and medical programs for crewmembers during all phases of a mission. These requirements are intended to prevent or mitigate negative health consequences of long-duration spaceflight, thereby optimizing crew health and performance over the course of the mission. Current standards are documented in the two volumes of the NASA-STD-3001 Space Flight Human-System Standard document, established by the Office of the Chief Health and Medical Officer. Its purpose is to provide uniform technical standards for the design, selection, and application of medical hardware, software, processes, procedures, practices, and methods for human-rated systems. NASA-STD-3001 Vol. 1 identifies five levels of care for human spaceflight. These levels of care are accompanied by several components that illustrate the type of medical care expected for each. The Exploration Medical Capability (ExMC) of the Human Research Program has expanded the context of these provided levels of care and components. This supplemental information includes definitions for each component of care and example actions that describe the type of capabilities that coincide with the definition. This interpretation is necessary in order to fully and systematically define the capabilities required for each level of care in order to define the medical requirements and plan for infrastructure needed for medical systems of future exploration missions, such as one to Mars.

Hailey, M.↗

NASA NTRSDate not supplied

A Model-Based Systems Engineering Journey to Developing a Concept of Operations

Starting in 2017, NASA’s Human Research Program (HRP) Exploration Medical Capability (ExMC) element began a systems engineering transition from traditional, document-centric development to model-centric development when defining its foundation medical systems. These foundation medical systems define a Concept of Operations (ConOps) and identify the generic requirements for a medical system based on assumptions about a generic crew and mission environments and guidance from NASA standards (e.g., Medical “Levels of Care”). By making the transition, ExMC intends to improve communication among stakeholders about foundation medical system requirements and content. In addition, this transition will enable ExMC to lower both development and crew treatment risks for future, mission-specific medical systems. ExMC followed a Model Based Systems Engineering (MBSE) paradigm when developing the foundation medical systems. A model-based approach provides several advantages over a traditional, document-centric approach. First, when Systems Engineers (SE) develop diagrams in a model using a standard modeling language, they produce information dense pictures that facilitate understanding much more efficiently with less room for misinterpretation than text. Second, due to the evolving nature of projects, documentation becomes out of date the minute it is published. This can result in people making decisions based on information that is no longer current, especially if they are referencing a locally-stored copy of a document. A model, on the other hand, is always up to date with the latest approved changes and information. It serves as a single point of truth. Third, a model-centric approach centralizes all important information in one place. Rather than having to flip through separate ConOps documents, design specifications, requirements specifications, and the like to coordinate information, a model captures the content in one, integrated spot. This integration makes tracing information from end-to-end easier with greater reliability. The ExMC Systems Engineering Lifecycle follows a well-defined process. ExMC Systems Engineers perform all major steps of the process, regardless of the development methodology. One of the first steps in the process is developing the ConOps that describes the operation of the system from the point of view of the users. It includes a list of the users and their needs, the goals of the medical system, key assumptions about the system, and definitions of the medical system’s operational environments. For this development effort, ExMC chose to replace the traditional text-based ConOps document with a model. While the decision to change the development workflow was not difficult, implementing the structural and organizational workflows were. It required showing ExMC’s users, most of whom are not Systems Engineers, how the information they require would be presented in the model and to gain their acceptance of this approach. This paper documents key lessons learned during the ConOps transformation by focusing on how the model represents information, the agile workflow used by SEs when developing the model and how it integrates into a project plan, how leadership influenced key users to accept the transformation, and how the users interact with the model information.

Jeffrey Robert Cohen↗

NASA NTRSDate not supplied

ExMC Systems Engineering Developments

The Exploration Medical Capability (ExMC) Element within the Human Research Program (HRP) applies systems engineering (SE) principles along with the use of Model-Based Systems Engineering (MBSE) tools to identify and communicate the requirements for medical and crew health and performance (CHP) systems. In the past fiscal year, the MBSE approach sought to advance the digital engineering toolset for medical and CHP system representation. These digital artifacts provide enhanced views of the relationships among requirements, standards, functions, and capabilities, to name a few, that is best suited for a user’s objectives. The MBSE tools and SE practices were applied to the development of the revised Earth Independent Medical Operations (EIMO) medical system and the Artemis III and IV CHP System models. In addition, a System of Systems concept was integrated into the EIMO model to facilitate the identification of system interfaces that interact with the medical system. Finally, the ExMC SE team has initiated several efforts to bring operationally relevant digital engineering practices to the Human Health and Performance Directorate (HHPD). This included the development of a pilot program within the directorate to help foster utilization of tools such as MagicDraw for system modeling and Power BI for visualizing extracted data in an easily accessible dashboard format. Additionally, with the increase in complexity of the integration effort for Artemis missions, ExMC has endeavored to bring digital engineering strategies to potentially increase efficiency in review processes. This talk will provide a high-level overview of the ExMC SE team accomplishments since the last Investigators’ Workshop, an introduction to upcoming SE talks, and the ongoing systems engineering work.

systems engineering↗

NASA NTRS2015

Human Research Program Advanced Exercise Concepts (AEC) Overview

Exercise countermeasures provide benefits that are crucial for successful human spaceflight, to mitigate the spaceflight physiological deconditioning which occurs during exposure to microgravity. The NASA Human Research Program (HRP) within the Human Exploration and Operations Mission Directorate (HEOMD) is managing next generation Advanced Exercise Concepts (AEC) requirements development and candidate technology maturation to Technology Readiness Level (TRL) 7 (ground prototyping and flight demonstration) for all exploration mission profiles from Multi Purpose Crew Vehicle (MPCV) Exploration Missions (up to 21 day duration) to Mars Transit (up to 1000 day duration) missions. These validated and optimized exercise countermeasures systems will be provided to the ISS Program and MPCV Program for subsequent flight development and operations. The International Space Station (ISS) currently has three major pieces of operational exercise countermeasures hardware: the Advanced Resistive Exercise Device (ARED), the second-generation (T2) treadmill, and the cycle ergometer with vibration isolation system (CEVIS). This suite of exercise countermeasures hardware serves as a benchmark and is a vast improvement over previous generations of countermeasures hardware, providing both aerobic and resistive exercise for the crew. However, vehicle and resource constraints for future exploration missions beyond low Earth orbit will require that the exercise countermeasures hardware mass, volume, and power be minimized, while preserving the current ISS capabilities or even enhancing these exercise capabilities directed at mission specific physiological functional performance and medical standards requirements. Further, mission-specific considerations such as preservation of sensorimotor function, autonomous and adaptable operation, integration with medical data systems, rehabilitation, and in-flight monitoring and feedback are being developed for integration with the exercise countermeasures systems. Numerous technologies have been considered and evaluated against HRP-approved functional device requirements for these extreme mission profiles, and include wearable sensors, exoskeletons, flywheel, pneumatic, and closed-loop microprocessor controlled motor driven systems. Each technology has unique advantages and disadvantages. The Advanced Exercise Concepts project oversees development of candidate next generation exercise countermeasures hardware, performs trade studies of current and state of the art exercise technologies, manages and supports candidate systems physiological evaluations with human test subjects on the ground, in flight analogs and flight. The near term goal is evaluation of candidate systems in flight, culminating in an integrated candidate next generation exercise countermeasures suite on the ISS which coalesces research findings from HRP disciplines in the areas of exercise performance for muscle, bone, cardiovascular, sensorimotor, behavioral health, and nutrition for optimal benefit to the crew.

Countermeasures↗

NASA NTRS2023

Enabling Human Space Exploration Missions Through Progressively Earth Independent Medical Operations (EIMO)

Goal: Current Space Medicine operations depend on terrestrial support to manage medical events. As astronauts travel to destinations such as the Moon, Mars, and beyond, distance will substantially limit this support and require increasing medical autonomy from the crew. This paper defines Earth Independent Medical Operations (EIMO) and identifies key elements of a conceptual EIMO system. Methods: The NASA Human Research Program Exploration Medical Capability Element held a 2-day conference at Johnson Space Center in Houston, TX with NASA experts representing all aspects of Space Medicine. Results: EIMO will be a process enabling progressively resilient deep space exploration systems and crews to reduce risk and increase mission success. Terrestrial assets will continue to provide pre-mission screening, planning, health maintenance, and prevention, while onboard medical care will increasingly be the purview of the crew. Conclusions: This paper defines and describes the key components of EIMO.

ExMC↗

NASA NTRSDate not supplied

Performance Risk Model (PRisM) Proof-of-Concept: An Operational Decision Support Tool to Predict Crew Performance in Space from Available Performance Tests

The Crew Health and Performance-Probabilistic Risk Assessment (CHP-PRA) team at NASA Glenn Research Center has developed a range of tools to evaluate astronaut health during spaceflight and to optimize the medical set required for missions. Among these, the Performance Risk Model (PRisM) represents a novel advancement, extending CHP-PRA’s focus beyond medical systems into the domain of human performance. Such tool could be pivotal in optimizing astronaut capabilities during space travel, thereby enhancing overall mission success. PRisM leverages data from well-established performance assessments conducted during previous crewed space missions and Earth analogs to strategically predict outcomes for planned tasks, even when direct performance testing has not been conducted for those specific tasks. To evaluate performance, PRisM references the various metrics outlined in NASA-STD-3001 and employs a methodology to integrate different performance scales. This framework analyzes the contribution of various human system task categories (HSTCs) to task execution and compares these contributions to the HSTCs’ involvement in other known tests. The model further employs a Monte Carlo simulation to sample performance scores from their distribution in operationally relevant tests such as those in Mulavara et al. (2018) and, by leveraging similarities in HSTC involvement, transfers this knowledge to actual mission tasks, such as those outlined in the "Human Exploration of Mars: Preliminary List of Crew Tasks”. The current PRisM proof-of-concept includes analyses of the impact of exercise and specific medications on astronauts’ performance, with provisions to incorporate additional countermeasures as data becomes available. Furthermore, the tool is customizable to include any system necessary to fully encompass the domain of human systems and can be adapted to evaluate performance for any spaceflight activities as requested by operational stakeholders. PRisM has the potential to assist the Human Research Program in exploring the capabilities trade space for optimized crew performance.

performance modeling↗