1. Michael D. Myjak Vice President & CTO The Virtual Workshop, Inc. P.O. Box 98 Titusville, FL 32781 <mmyjak@virtualworkshop.com>

2. A MEDical Simulation NETwork Infrastructure MEDNET

3. Medical Virtual Environments The Goal: The Goal: To Develop New Technology Initiatives To Develop New Technology Initiatives –Develop Medical Simulation Technologies based on Proven Applications Research –Improve Virtual Human Modeling Technologies –Develop New Interface Technologies: Sensor Technology IntegrationSensor Technology Integration 3D Viewing3D Viewing Tactile & Haptic FeedbackTactile & Haptic Feedback Tracking and Control SystemsTracking and Control Systems

4. Virtual Medical Environments Virtual Medical Environments - Virtual Medical Environments - –To Develop Civilian Applications for Medical Synthetic Environments by Leveraging Funding and development from DoD contracts –To Develop the State of the Art in VMEs, and –To Develop Synthetic Human Models for - Research and Clinical CareResearch and Clinical Care Education & TrainingEducation & Training Emergency ManagementEmergency Management Managed Health CareManaged Health Care

5. The Genesis of MEDNet Background Concepts Background Concepts –Why MEDNET - TrainingTraining EducationEducation and Reuseand Reuse –Military Funding, to Civilian Application Time Has ComeTime Has Come –Developed a Multi-Party Consortium Many Still InterestedMany Still Interested –$26M Level of Effort Cut in Half todayCut in Half today –Multi-Disciplinary Solution Space

6. Why are we Doing this?? "If all people concerned with health care reform were of good will (which they are not), if the principal health care players could agree on a single plan (which they cannot), and if everything went smoothly (which it never does), it would still take a decade to get from where we are to where we want to be, even if we improve year by year along the way. " - DR. C. Everett Koop, Surgeon General, 1992 - DR. C. Everett Koop, Surgeon General, 1992

7. Recent Technological Advancements Recent Advancements in Federated Simulation Technology are now ready for the Medical Laboratory Recent Advancements in Federated Simulation Technology are now ready for the Medical Laboratory –Initiatives in Advanced Technology Combat Trauma Patient Simulator - STRICOMCombat Trauma Patient Simulator - STRICOM –Goal: Develop Medical Simulation Applications for example : Develop Dynamic Virtual Human ModelsDevelop Dynamic Virtual Human Models New Interface/Sensor Technology IntegrationNew Interface/Sensor Technology Integration Foster the development of a prototype environment which will then design and build 21st Century Telemedicine systemsFoster the development of a prototype environment which will then design and build 21st Century Telemedicine systems

8. MEDNET Components ADS Run-Time Infrastructure ADS Run-Time Infrastructure Network-Aware MiddlewareNetwork-Aware Middleware New “Federated” ParadigmNew “Federated” Paradigm Supports a Variety of “Federates,” User-Defined Objects, Attributes, and Interactions Through a Common APISupports a Variety of “Federates,” User-Defined Objects, Attributes, and Interactions Through a Common API –Virtual Reality Cave Integration –Ties in with Telerobotics and Teleinstrumentation for Todays Telemedicine Applications –Plugs in the Web - Internet Access

9. MEDNET Components (continued) Virtual Patient Simulator Virtual Patient Simulator –High-Fidelity Human Patient Models Accurate, High-Resolution Texture Overlays from NIH Visible Human ProjectAccurate, High-Resolution Texture Overlays from NIH Visible Human Project Follows Trauma/Casualty Scenario Database – Generates Known ResultsFollows Trauma/Casualty Scenario Database – Generates Known Results Can Be Updated with New Models and Behaviors Easily - ExtensibleCan Be Updated with New Models and Behaviors Easily - Extensible Composable, Scaleable Approach to Developing New Simulation ScenariosComposable, Scaleable Approach to Developing New Simulation Scenarios Integrated, Realistic, Physical InteractionIntegrated, Realistic, Physical Interaction

10. MEDNET Components (continued) Human-computer Interaction Human-computer Interaction –Haptics Break Through the Historically Limited Interaction of Visual Displays Force Sensation Plays Important Rolls in Recognition of 3- dimensional ObjectsForce Sensation Plays Important Rolls in Recognition of 3- dimensional Objects –Networked Virtual Environments Offer an Alternative Interaction Paradigm Active Participants With Their Data in a 4D Virtual WorldActive Participants With Their Data in a 4D Virtual World –MEDNET Is Still Relatively New, but Haptic Devices Are Already Available in Commercial-off-the-shelf Form.

11. MEDNET Components (continued) 3-Dimensional Volumetric Displays 3-Dimensional Volumetric Displays –3 Vendors to Choose From Today! Dimensional Media Associates, Inc.Dimensional Media Associates, Inc. Central Research Laboratories, Ltd.Central Research Laboratories, Ltd. Ethereal TechnologiesEthereal Technologies –Bob Andrews - POC –Latest Innovation - Deformable Mirror DeviceDeformable Mirror Device

12. MEDNET Components (continued) The Virtual Clinician The Virtual Clinician –Is an Embedded Assessment and Intelligent Tutoring System(s) Network-aware Middleware Plug-InNetwork-aware Middleware Plug-In Supports a Variety of Knowledge BasesSupports a Variety of Knowledge Bases Immediate Assessment and Feedback on Performance (uses Sensible Agents)Immediate Assessment and Feedback on Performance (uses Sensible Agents) Especially well suited for Procedural- Based ApplicationsEspecially well suited for Procedural- Based Applications –(e.g., Training Scenarios, Diagnostics, Control Procedures) –Prototype for Real-Time Intelligent Embedded Assessment Module

13. ConclusionConclusion MEDNET Will Generate an Immersive and Highly Adaptable Virtual Environment MEDNET Will Generate an Immersive and Highly Adaptable Virtual Environment –Allows Individual Participants or Teams to Train Simultaneously –The Scenes Presented Within the MEDNET Cave Can Change Front Line Battlefield, Aide Station, Combat Support HospitalFront Line Battlefield, Aide Station, Combat Support Hospital From Urban Miami to a Remote Hospital in Rural New HampshireFrom Urban Miami to a Remote Hospital in Rural New Hampshire Modeling Treatment Received in True-to- Life Situational Awareness Training - Modeling Treatment Received in True-to- Life Situational Awareness Training - A 21st Century Medical Training System A 21st Century Medical Training System

14. Michael D. Myjak Vice President & CTO The Virtual Workshop, Inc. P.O. Box 98 Titusville, FL 32781 <mmyjak@virtualworkshop.com>

15. Consortia Members –Tertiary Medical Participants The Lahey Clinic The Lahey Clinic –Bruce Nappi, Director of Advanced Technology for the Ambulatory Surgical Research Center at Lahey Clinic Dartmouth Hitchcock Medical Center Dartmouth Hitchcock Medical Center –Thomas Colacchio, M.D., Director & Chairman, Lahey Hitchcock Board of Governors/President, Hitchcock Clinic, Inc.. DHMC/Chairman, Section of General Surgery DHMC –Joseph Rosen, M.D., Associate Professor of Surgery, Department of Plastic and Reconstructive Surgery DHMC

16. Consortia Members Dartmouth School of Medicine Dartmouth School of Medicine –Joseph Henderson, M.D., Director of Interactive Media Laboratory, Professor of Clinical and Family Medicine at DHMC, and Adjunct Professor of Education and Engineering at Dartmouth College –Bill Culp, Ph.D., Assistant Dean, Dartmouth School of Medicine –Peter Spiegel M.D., Chairman of Radiology –Stephen Spencer M.D., Chairman of Dermatology –Charles Hutchinson, Ph.D., former Dean of Engineering –George Cybenko, Ph.D., Professor of Engineering, Thayer School

17. –Industry and HBCU/MI Participants Boston Dynamics, Inc. Boston Dynamics, Inc. –Marc Raibert, Ph.D. Professor of Engineering at MIT, President and Founder of Boston Dynamics, Inc. Central Research Laboratories Central Research Laboratories –Nicholas Walker, MD, Ph.D., Deputy Director, Systems and Applied Sciences Group. The Virtual Workshop The Virtual Workshop –Michael Myjak, M.S., Chief Technical Officer, and Director of the Simulation Interoperability Development Laboratory Consortia Members

18. Contract Specifics Total Award: $24 Million Total Award: $24 Million 5-Year Contract, + 3 Year Optional Extension; Total: 8 yr. 5-Year Contract, + 3 Year Optional Extension; Total: 8 yr. Will Further the Development of ADS Will Further the Development of ADS –Constructive Simulations –Virtual Simulations –Live Simulations –Integrated Simulations Estimated Manpower: Estimated Manpower: –TVW: ~12-18 People per Year Provide Feedback into the Simulation Interoperability Standards Organization Provide Feedback into the Simulation Interoperability Standards Organization

19. Michael D. Myjak Vice President & CTO The Virtual Workshop, Inc. P.O. Box 98 Titusville, FL 32781 <mmyjak@virtualworkshop.com>