Hawaii Biotechnology Research: Interest Areas and Opportunities with the Department of Defense COL Karl Friedl, PhD Telemedicine & Advanced Technology Research Center US Army Medical.
Download ReportTranscript Hawaii Biotechnology Research: Interest Areas and Opportunities with the Department of Defense COL Karl Friedl, PhD Telemedicine & Advanced Technology Research Center US Army Medical.
Slide 1
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 2
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 3
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 4
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 5
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 6
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 7
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 8
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 9
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 10
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 11
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 12
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 13
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 14
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 15
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 16
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 17
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 18
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 19
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 20
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 21
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 22
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 23
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 24
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 25
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 26
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 27
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 28
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 29
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 30
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 31
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 32
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 33
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 34
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 35
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 36
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 37
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 38
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 39
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 40
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 41
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 42
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 43
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 44
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 45
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 46
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 47
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 48
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 2
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 3
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 4
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 5
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 6
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 7
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 8
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 9
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 10
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 11
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 12
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 13
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 14
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 15
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 16
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 17
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 18
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 19
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 20
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 21
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 22
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 23
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 24
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 25
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 26
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 27
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 28
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 29
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 30
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 31
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 32
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 33
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 34
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 35
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 36
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 37
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 38
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 39
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 40
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 41
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 42
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 43
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 44
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 45
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 46
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 47
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48
Slide 48
Hawaii Biotechnology Research:
Interest Areas and Opportunities
with the Department of Defense
COL Karl Friedl, PhD
Telemedicine & Advanced Technology Research Center
US Army Medical Research & Materiel Command
Frederick, MD
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 1 of 48
A hiatus exists between the inventor
who knows what they could invent, if
they only knew what was wanted,
and the soldiers who know, or ought
to know, what they want and would
ask for it if they only knew how much
science could do for them.
- Winston S. Churchill (1929)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 2 of 48
Agenda
• Military medical research interests
• Biomedical research in the DoD
• USAMRMC organizational structure
• Competitive funding opportunities
• Hawaii Federal Healthcare Network Program
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 3 of 48
Technology Shortfalls: Fill the Gaps
Current Operational
Concepts and
Environment
Future Operational
Concepts and
Environment
Needed S&T Work
S&T
Shortfalls
Needed S&T Work
Ongoing S&T
Work
Existing Tech or
Non-Technology
Solutions
Capability Needs
Capability Challenges
Desired Capabilities
Existing Tech or
Non-Technology
Solutions
Capability Today
Capability Today
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 4 of 48
The Linear Approach to R&D
Army Medical Product Development Life Cycle
Fed / DoD Needs
ICD
ICD
CDD
CPD
Opportunities, Gaps, & Resources
Funding
Life Cycle
MDD
6.1
A
6.2
B
6.3
6.4
Research, Development, Test, & Evaluation (RDT&E) $
DoD Funding Categories
6.1 – 6.3: Basic research, applied research, and advanced technology development
6.4 – 6.5: Program management activities
6.6: Program support including test and evaluation facilities
6.7: Improvements to existing operational systems
Joint Capability Integration & Development System Documents
ICD: Integrated Capabilities Documents
CDD: Capability Development Documents
CPD: Capability Production Documents
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Program
Management
Initiation
6.5
C
6.7
Procurement $
Ops &
Maint $
Vannevar Bush model
Basic research is a
pacemaker of technological
innovation but must be
segregated to avoid
premature thoughts of
practical use
UNCLASSIFIED
Slide 5 of 48
DoD Problem-solving Focus:
Use-inspired Medical Research
Understanding underlying science creates rule base to help solve
future problems
Low Emphasis on
Fundamental
Understanding
Revolutionary
Pure basic
research (Bohr)
Low Emphasis
on Applications
High Emphasis
on Applications
High Emphasis on
Basic Science
Pure applied
research
(Edison)
Use-inspired
basic research
(Pasteur)
Evolutionary
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 6 of 48
What are the DoD Medical
Research Priorities?
(Where do they come from?)
• National strategic plans (e.g., Quadrennial
Review – in progress!)
• Secretary of Defense & other authoritative
sources in the DoD and Services
• Armed Services Biomedical Research
Evaluation and Management
• Near-term problems identified by field
commanders & COCOMs
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 7 of 48
Secretary Gates' Press Briefing
May 3, 2007
Apart from the war, this department
and I have no higher priority than to
ensure wounded servicemembers
have the best care and facilities and
ample assistance navigating the next
step in their lives. That is what we
intend to give them.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 8 of 48
Current Priorities:
Secretary Gates' Budget Briefing
April 6, 2009
Recognize the critical and permanent
nature of wounded, ill and injured,
traumatic brain injury, and
psychological health programs.
This means institutionalizing and
properly funding these efforts in the
base budget and increasing overall
spending by $300 million. The
department will spend over $47 billion
on healthcare in FY10.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 9 of 48
Enduring Challenges:
Old Medical Threats, New Science
LIMB LOSS
SHELL SHOCK
HEMORRHAGE
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 10 of 48
Core Medical R&T Responds to Threats
to Soldier Health and Performance
Endemic Disease Threats
• Parasitic Diseases
• Bacterial Diseases
• Viral Diseases
Operational Stressors
• Sleep Deprivation
• Traumatic Stress and
Situational Stressors
• Physical Work Load
• Cognitive Burden &
Operational Complexity
Chemical/Biological
Warfare Threats
• Bacterial Threats
• Viral Threats
• Toxin Threats
• Nerve Agents
• Vesicant Agents
• Blood Agents
Environmental Hazards
• Heat and Cold
• Altitude
• Toxic Industrial
Chemicals & Materials
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Combat Injuries
• Hemorrhage
• Head Trauma
• Blast Injury
Inadequate
Medical C4ISR
UNCLASSIFIED
Systems Hazards
• Laser
• Blast
• Biomechanical
Insults and Stresses
• Noise
Slide 11 of 48
Pharmaceutical Advanced Development
Pipeline at USAMMDA
Pre-Clinical
Phase 1
Phase 2
Phase 3
Licensed
VACCINES
(License
Submitted)
(Proof-of-Concept Completed)
Adenovirus Type 4 & 7
HIV Prime-Boost
(Proof-of-Concept)
Dengue Tetravalent
ANTIPARASITIC DRUGS/Dx
Leish Drug, PentostamTM
Antimalarial-IV Artesunate
Topical Leishmania Drug
Antimalarial-Tafenoquine
(Proof-of-Concept)
Leish Rapid Diagnostic
COMBAT CASUALTY CARE
Intranasal Ketamine
RBCs Extended Life
Cryopreserved Platelets
Freeze-Dried Plasma
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 12 of 48
Joint Force Health Protection Capability
Gap Medical R&D
OVERARCHING
NEEDS:
Maintain a Healthy & Fit Force
Protect Personnel in the Field
Military Infectious Diseases Research Program
Medical Biological Defense Research Program
Vaccines and pre-treatments
Small molecule therapeutics
Next generation diagnostics
Animal model development
Broad-spectrum therapeutics
Vaccines
Prophylaxis/treatment drugs
Diagnostics/prognostics
Vector control
HIV countermeasures (Congressional mandate)
Medical Chemical Defense Research Program
Combat Casualty Care Research Program
Nerve agent pre-treatments
Therapeutics for nerve agents
Therapeutics for vesicant injury
Diagnostic assays/technologies
Meet Demands on First Responders
Reduce the Number of Deaths on the Battlefield
Limit Brain Damage
Improve Medic, Provider, and Team Training
Restore Full Function
Improve En Route Care
Reduce Morbidity and “Died of Wounds” Rate
Clinical Trials
Clinical and Regenerative Medicine Research Program
Improve Prosthetic Function
Enhance Self Regenerative Capacity
Improve Limb/Organ Transplant Success
Create Fully-Functioning Limbs/Organs
Military Operational Research Program
Blast Injury Program Coordinating Office
Prevent, Detect and Treat Mental Health Problems and mTBI
(Concussion)
Prevent/Mitigate Blast, Blunt, Ballistic, and Impact Injury
Reduce Attrition in Basic Combat Training Due to Injury and
Mental Health Problems
Prevent/Mitigate Injury from Environmental Exposures to
Heat/Cold/Altitude and Toxic Chemicals and Materials
Sustain
Soldier
Performance(301-619-7967) (DSN 343)
COL Karl
Friedl/MCMR-TT
Develop Medical Standards for Individual and Combat
Vehicle Crew Blast Protection Systems
Elucidate the Mechanism of Blast-Induced Brain Injury
Improve Diagnosis of mTBI
Effectively Communicate Blast-Related Research Across the
DoD
Reset
Advance Treatment Options
UNCLASSIFIED
[email protected]
Diagnosis for Early Treatment
Rapid Return to Duty
Slide 13 of 48
Key Blast Injury Research Topics
(FY07-10 Investments)
Injury Prevention ($183M)
•Existence and mechanism
of non-impact, blastinduced mTBI?
•Drugs to prevent and treat
blast-related hearing loss
•Analysis of combat injuries
and PPE performance
(JTAPIC)
•Multi-effect blast injury
models to improve
protective equipment
•Resilience enhancement
and prevention of PTSD
Acute Treatment ($437M)
•Diagnostics and neuroprotectant
drugs for TBI
•Hemorrhage control & blood products
•Treatment of psychological trauma
•Damage control orthopedics
•Pain management
Hair Cell
Antioxidan
t Defenses
CFD Simulation
Observed
Blast LoadingTest Conditions Pathology
FEM Simulation
Reset ($141M)
•Tissue engineering and prosthetics
•Return-to-duty Standards
•Recovery of function
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Before
UNCLASSIFIED
After
Slide 14 of 48
DoD Blast Injury Research Extends
Back to World War II
Nuclear &
conventional explosions
Los Alamos & Albuquerque
Cave blasts
Armored Med Res Lab
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 15 of 48
New Science and Technology Options:
Modernization of Military Medical R&D
Prevention
(Mitigate Risk)
Acute Treatment
(Mitigate Injury)
Reset
(Mitigate Disability)
Systems Biology Methods
Personalized Medicine
Diagnostics
Regenerative Medicine
“Laying the tracks for the train”
Advanced Training Technologies & Neuroplasticity
Individual Resilience
Provider Training
Individual Retraining
Computational Bioengineering, Biomaterials & Nanotechnologies
Biomedical Standards
Wound Care
Advanced Prosthetics
Electronic Health Record Outcomes Research
Injury Surveillance
Optimized Interventions
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Return-to-Duty
Standards
Slide 16 of 48
Chemical Biological Defense Program
Threat Focus
• Advanced Threats
– pathogens engineered to increase resistance, transmissibility,
and virulence
• Traditional Threats
– intracellular bacterial pathogens (e.g., plague)
– viral hemorrhagic fevers (e.g., ebola)
• Enhanced Threats
– “bioprospecting” of virulent strains in nature
– cultivating virulent strains in the laboratory
• Emerging Threats
– natural diseases (e.g., pandemic flu, malaria)
– multidrug and vaccine resistant pathogens
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 17 of 48
Chemical Biological Defense Program:
Transformational Medical
Technologies Initiative
• Develop broad-spectrum countermeasures and novel
technology platforms (one drug, many bugs)
• Pursue countermeasures targeting common disease
pathways or enhance the host’s immune system
• Integrate best efforts within government, academia,
DoD, biotech industry, and small and large
pharmaceutical corporations
• Provide seamless “end-to-end” product development
• Eliminate capability gaps by adding promising
candidate technologies to the pipeline
www.tmti-cbdefense.org; ww.fedbizops.gov
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 18 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 19 of 48
The Changing Operational Environment
“Low level Persistent Conflict”
General Casey, 14 Aug 07
Stability Operations
& International Health
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 20 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 21 of 48
Medical Research and Related Programs
in the DoD
Services
ARO
ONR
AFOSR
DCoE for PH and TBI
DCoE for Vision
USAMRMC
NMRC
ONR
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
SOCOM (BISC)
VA-DoD sharing
(e.g., JIF)
AFRL
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Other Agencies
AFMOA
UNCLASSIFIED
NIH joint efforts
Slide 22 of 48
Armed Services Biomedical Research
Evaluation & Management
The ASBREM Committee shall:
• Review medical RDT&E program plans and
accomplishments for quality, relevance, and
responsiveness to military operational needs, the needs
of the Military Health System, and the goals of Force
Health Protection
• Review program plans and budgets in support of the
various guidance documents relevant to National
Security and to the missions and functions of the
Department of Defense
• Provide coordination, recommendations, and support to
DoD Executive Agencies and other DoD officials as
requested, directed, or otherwise appropriate
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 23 of 48
Medical Research and Related
Programs in the DoD
ASBREM
Joint Technical Coordinating Groups
1
2
3
4
5
6
7
8
Med Training Systems & Information Tech
Military Infectious Diseases
Chemical Defense
Biological Defense
Military Operational Medicine
Combat Casualty Care
Radiation Effects
Clinical and Rehabilitative Medicine
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 24 of 48
Defense Health Program: GDF Enhancement
MISSION DESCRIPTION AND BUDGET ITEM JUSTIFICATION: This Program
Element (PE) funds Advanced Component Development of medical products
that are regulated by the U.S. Food and Drug Administration (FDA) and the
accelerated transition of FDA licensed and unregulated products and medical
practice guidelines to the military operational user through clinical and field
validation studies. Projects in this PE are designed to address areas of
interest to the Secretary of Defense and to close medical capability gaps
associated with the Joint Force Health Protection Concept of Operations
(JFHP CONOPS) and are complementary to research conducted by the Army,
Navy and Air Force in analogous PEs. Projects include Trials for Accelerated
Transition of Modeling and Simulation Technology for Medical
Training/Education/Treatment; Trials for Accelerated Transition of Medical
Technology, Practice Guidelines and Standards; Medical Products –
Advanced Component Development; and Medical Information Technology
Development.
$198 M
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 25 of 48
Congressional Special Interest (CSI)
RDA Programs
About 50% of USAMRMC Funding Each Year Is Congressionally Directed
Function of Congressional Special Interest (CSI)
Research:
• Sponsor good science using Congressional
appropriations that are not in the President’s budget Advanced Development 9%
• Responsive to the intent of Congress, managed to
Core R&T 33%
maximize military relevance
Process:
Core
• Proposals peer reviewed for scientific merit prior to
Effort
award
39%
• Programs executed by extramural awardees and
USAMRMC laboratories and acquisition offices
Program Managers:
• USAMRMC Research Area Directorates (33%)
• U.S. Army Medical Materiel Development Activity
(USAMMDA – 9%)
• Congressionally Directed Medical Research Programs
TATRC 29%
CDMRP 32%
• Telemedicine and Advanced Technology Research
Center
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 26 of 48
Medical Advanced Development
Supporting Commands
USAMMDA
USAMMA
U.S. Army Medical
Materiel Development
Activity
U.S. Army Medical
Materiel Agency
Defense Medical Logistics Center
Pharmaceutical
Systems
Applied Medical
Systems
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Integrated Clinical
Systems
UNCLASSIFIED
Medical Devices
Slide 27 of 48
Core Medical R&T
Supporting Laboratories
USAARL
USAISR
U.S. Army Aeromedical
Research Laboratory
U.S. Army Institute of
Surgical Research
USARIEM
U.S. Army Research Institute
of Environmental Medicine
Combat
Casualty
Care
18.3%
Military
Operational
Medicine
17.1%
Medical
Biological
Defense
25.5%
Military
Infectious
Diseases
23.6%
Medical
Chemical
Defense
15.5%
USAMRIID
U.S. Army Medical
Research Institute of
Infectious Diseases
USAMRICD
U.S. Army Medical Research Unit - Nairobi, Kenya
Armed Forces Res Inst of Med Sci, Bangkok, Thailand
US Army Medical Research Unit, Heidelberg, Germany
US Army Dental and Trauma Research Detachment
US Army Medical Research Detachment
WRAIR
Walter Reed Army
Institute of
Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
U.S. Army Medical
Research Institute of
Chemical Defense
US Army Center for Env Health Med
Slide 28 of 48
http://cdmrp.army.mil/
FY09 Funding Opportunities:
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 29 of 48
http://cdmrp.army.mil/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 30 of 48
Medical Research and Related
Funding Programs in the DoD
Services
ARO
DCoE for PH and TBI
DCoE for Vision
USAMRMC
Other Agencies
DARPA
(e.g., DSO)
CBDP/DTRA
(e.g., TMTI)
NMRC
Small
Business
Innovative
Research
SOCOM
(BISC)
ONR
ONR
Small Business Technology
Transfer
VA-DoD sharing
(e.g., JIF)
(SBIR/STTR)
AFRL
AFOSR
http://www.acq.osd.mil/osbp/sbir/
NIH joint efforts
AFMOA
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 31 of 48
KEY TATRC Initiatives and Portfolios
• Cell phone-based systems
• Remote biomonitoring
• Global Biosurveillance
• Health information portal
unified EHR
• Research data cube/
medical outcomes
• Pharmacovigilance
• Virtual environments
• Computational models
& tools
• Human/soldier phenome
• Performance & injury
prediction models
e-HEALTH
• Robotic rescue & evacuation
• Shelf stable diagnostics & vaccines
• Blood products & blood safety
MEDICINE IN
AUSTERE
ENVIRONMENTS
HOSPITAL
OF THE
FUTURE
DIGITAL
WARRIOR
INTEGRATIVE
MEDICINE
• Operating room of the
future
• Prosthetics and human
performance
• Regenerative medicine
& biomaterials
• Optimal healing environments
• Advanced pain management
• Complementary and alternative
medicine
• Neuroplasticity/resilience
• Genomics/personalized medicine
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
• Natural orifice
transluminal endoscopic
surgery
• Advanced medical
imaging
• Distance medical training
& simulation
UNCLASSIFIED
Slide 32 of 48
TATRC Portfolios
Joint Technical Coordinating Group
1. Medical Information & Training Technologies
4. Infectious Diseases
Human
Performance
Optimization
Psych Health
Dr. Shore
Dr. Cardin
Resilience &
Retraining
MAJ
Brininger
Simulation
& Training
Technology
International
Health
Medical
Imaging
Technologies
Health
Information
Technologies
Ms. Stanley
Ms. Barrigan
Dr. Pacifico
LCDR Steffensen
Medical
Logistics
Blood Products
& Safety
Dr. Carney
Mr. DePasquale
Mr. Malloy
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Bio-Monitoring
Technologies
Medical
Robotics
Advanced
Prosthetics
Dr. Lai
Dr. Gilbert
Mr. Turner
Mr. Wiehagen
Genomics
/ Proteomics
Infectious
Disease
5. Military Operational Medicine
6. Combat Casualty Care
8. Clinical & Rehabilitative Medicine
Trauma
Dr. Broderick
Computational
Biology
Nano-Medicine
&
Biomaterials
Regenerative
Medicine
Dr. Reifman
Dr. Grundfest
Dr. Lai
Head
& Spinal Cord
Injury
Dr. Curley
UNCLASSIFIED
Vision
Acoustic
Trauma
Mr. Read
Dr. Holtel
Slide 33 of 48
Slide 33 of 12
Hawaii Federal Health Care Network
(AKAMAI II) – FY10 Competitive RFP
AKAMAI II supports applied research, development and
deployment of telehealth and healthcare technology,
biotechnology, clinical informatics, VA/DoD systems
interoperability, to improve access and the quality of care to
service members, their families, and impacted communities.
With a focus on programs that align closely with military
medical requirements, a competitive process will be used to
provide funding in Hawaii to develop advanced medical
technologies and biotechnology research critical to our nation's
military medicine and the warfighter. Priority will be given to
innovative collaborations between Hawaii-based industries and
the Department of Defense. Outside partnerships that help to
bring unique expertise to research in Hawaii to solve military
medical problems will also be an important factor.
http://inouye.senate.gov/Congressional_Initiatives/
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 34 of 48
Basic Steps to Innovation in the
Hawaii Federal Health Care Network
1. Come up with a concept that would be
immensely important to the DoD, if successful
2. Secure the intellectual property
3. Publish the seminal supporting article in peer
reviewed literature
4. Conduct the initial risk mitigation studies (e.g.,
toxicity) that will encourage investors
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 35 of 48
Hawaii Biomedical Research Advantages
and Dual Use Applications for DoD
• Stable population (~1.2M)
• Unique healthcare system and DoD-VA sharing of
facilities (great starting point to optimize practices)
• Distributed across islands (e.g., model of remote
health care access)
• Chronic health care concerns, even though a state
with the best longevity (e.g., preventive medicine
interventions and personalized health care/personal
empowerment opportunities)
• Modest size makes manageable testbed and model
system and increases cooperation in the islands
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 36 of 48
AAMTI: Pediatric Telecardiology Referrals
with Echocardiographic Validation
AMEDD ADVANCED MEDICAL TECHNOLOGY INITIATIVE
Pacific Rim Pediatric
Heartsounds Trial:
Store and Forward
telcardiology with
echocardiographic
validation
Pediatric Multi-site
Phonocardiography:
Automated
interpretation of
pediatric heartsounds
Simultaneous
Multi-site
Phonocardiography: A
simplified heartsound
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
Improved heartsound
signal analysis using
simultaneous
multi-site
phonocardiograms in
children
UNCLASSIFIED
Telecardiology
evaluation of
newborns with heart
murmurs using
simultaneous,
multi-site
phonocardiography
Slide 37 of 48
Janus – DoD and VA Common Data View
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 38 of 48
Pacific Asynchronous Tele-Health (PATH)
Teleconsultation
Telehealth Services
-VA Pacific Islands
Health Care System
(VAPICS)
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 39 of 48
ICU Multipoint
Military Pacific
Consultation Using
Telehealth
(IMMPACT)
Telehealth Voice
Therapy in Remote
Regions in the Pacific
Basin
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 40 of 48
Environmental Medical Surveillance
(CBI “wet ware” / “canary”)
Cell Matrix Chips for
Air/Water Monitoring of
Toxic Chemicals
Principal Investigator:
Kevin Chinn, PhD; Cellular
Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 41 of 48
Cell-based Treatments
Treatment of Peripheral Vascular Disease by
Adipose Derived Stromal Cell Injection
Development of Technologies for
Bioengineered Tissue Repair
Principal Investigator: Paul Kosnik PhD;
Tissue Genesis, INC.
Principal Investigator: Mark Mugiishi, MD;
Cellular Bioengineering, Inc.
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 42 of 48
Nanotechnology Capabilities
RAIDER: Rapid Adverse Identifier for Drugs and Evaluation
Resource
Principal Investigator: Joanne S.M. Ebesu, Ph.D.; Oceanit
SEM image of nanoarray functionalized with antibodies
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 43 of 48
Development of the versaHSDI
system – Colon
• Automated disease detection
• Video reconstructed colon model
• Local 3D rendering
3-D rendering software
development to enable and
develop Computer Aided
Diagnosis and in situ
pathology for colon cancer
detection
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 44 of 48
Neurophysiologically-based Performance
Monitoring and Enhancement Devices
Intelligent PTSD Classification
and Treatment-Augmentation
Technology
The device will utilize off the shelf
technology and Archinoetics developed
hardware to produce an integrated,
unobtrusive monitoring/communication
capability.
Warfighter Physiologic
System Interface Research
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 45 of 48
Broadband Respiratory Virus
Surveillance
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 46 of 48
SimCenter Hawaii Technology
Enabled Learning
and Intervention Systems
Virtual Reality Applications for
Health Care Education and
Training
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 47 of 48
TATRC Science & Engineering
Research Support
Dr. Stan Saiki, Chief, TATRC Hui
Dr. Chuck Peterson, Chief Scientist
Ms. Jessica Kenyon, Chief, TATRC West
Mr. Ron Marchessault, ORTA
www.tatrc.org
COL Karl Friedl/MCMR-TT (301-619-7967) (DSN 343)
[email protected]
UNCLASSIFIED
Slide 48 of 48