1. DIRO – 12/03/03 Virtual Soldier Or Combat Medical Support Enters the Information Age

2. DIRO – 12/03/03 Problem Medical Support is the only component that does not have a computer (information) representation of its product

3. DIRO – 12/03/03 Result Billions of dollars of software in prototyping, simulation, virtual testing & evaluation is not available to improve the health, performance, sustainability, training and equipage of the soldier Without an information representation, medical support cannot integrate into FCS

4. DIRO – 12/03/03 A total body scan of every soldier... worn on their electronic dog tag distributable to multiple of echelons of care... converted to the individual virtual soldier... from the generic model architecture to soldier specific data as baseline... is compared to the wounded status... updated real-time data and trajectory of missile/wavefront... automatically predicts injury and mortality... based upon model of empiric biologic properties taking the individual soldier baseline compared to post-injury data (entrance-exit, vital signs, etc) What difference will it make? The implementation is instant battlefield diagnosis... which upon wounding

5. DIRO – 12/03/03 The Virtual Soldier is... A computer representation in silico of a generic human Based upon computational models - molecular to body Derived from empirically measured biological properties Personalized to represent a specific solider Ubiquitously available Updatable in real time Holo graphic M edical E lectronic R epresentation ( Holomer )

6. DIRO – 12/03/03 How is medical care done TODAY and what are the limitations? NowFuture The Medic & MASH: no baseline information, injury written on a paper “toe-tag” Complete information (allegies, meds,etc) ‘best guess’ as to category of injury (immediate, delayed,etc) Decision support to automate diagnosis and triage Not integrated into other medical systems Incorporate into FCS (Scorpion) no vital signs during transportContinuously updated, especially change generates a new handwritten record in the ER, lab, etcCornerstone of a dynamically changing medical record Limitations: No baseline information Complete and personalized information to that specific soldier No way to update information – echelons, within hospital, over timeContinuously updating information No method of autonomously assisting medic in the far forward areaAid and automate diagnosis

7. DIRO – 12/03/03 Instantly & Accurately diagnose internal combat injury (heart) 3-D model from total body scan on “dog tag” (anatomy & physiology) Compare to data acquired on the battlefield after wounding (Ultrasound) Build a Virtual Soldier on an Electronic “dog tag” From Which to Diagnose and Predict Combat Injury Accurate Diagnosis & Treatment Saves Lives Predict likelihood of battlefield mortality What is the project trying to do? Why? How? Holographic Medical Electronic Representation Holomer FOR THE INDIVIDUAL SOLDIER THIS MEANS : Empowering the individual medic at the point of wounding to make a diagnosis of an injury with the same expertise as having an expert surgeon on site

8. DIRO – 12/03/03 What is truly novel? Computational model that truly substitutes for the soldier...... to accurately diagnose wounding Free spin-offs: Current status, ergonomic studies, etc Scale: gene, molecule, cell, organ. … total body... of the Integrate: structure, biochemistry, physiology, mechanics... for the Systems: heart, lung, liver, kidney, brain, muscle, bone...... The Human Genome contains less than 10% of the data of a “virtual soldier” Holomer on dog tag ultrasound, vital signs, etc Real-time data Virtual Soldier BMIS Calculate & DisplayOutcomes Baseline Update Decision Support Organs Injured ?Shock Quicker Automatic Diagnosis An entirely new magnitude and type of modeling... Medical Moon Shot

9. DIRO – 12/03/03 How to overcome limitations “Living” representation Develop a dynamic, generalizable, scalable ontology from real data Interact in multiple dimensions on a physiologic-based computational representation Display the results in an intuitive fashion for automatic diagnosis Phase I (go/no-go milestone) Demonstrate one level integration Organ level Demonstrate one system integration Cardiac Integrate automatic diagnosis Segmentation Decision support Display results BrainMuscleHeartLungKidneyLiver System Organ Physiology Cellular BioChem Gene Tissue Level System Holomer Methodology Increase accurate diagnosis of heart wounds to > 80%