Proceed or Pivot: Week 5

This week, we faced the mounting competition in the field of military telemedicine. We had realized previously that there were several other developments in the works that were attempting to do the same thing with acute care telemedicine in austere settings, but we didn’t realize the extent of their efforts. What we learn have made us think more about the direction of this project, and whether we should continue down the path of creating an app for collecting data, or pivoting to another communication avenue that connects existing and future programs.

In the meantime, we have begun a mockup and a separate Android app demo to simulate what our app would look like if we continued down our current trajectory. Similarly, we continued to seek advice through interviews, as we debate the direction of our project in the next few weeks.

For next week, we are going to begin to test our mockup of the app, and determine if we will stay on our current track.

Team 3

Jeremy Pamplin: Deputy Director, Telemedicine and Advanced Technology Research Center
– There are at least 10 apps in the works that are trying to solve the same problem that we’re solving, e.g. TATRC, JOMIS, OmniCare, mHealth, TempusPRO, etc.
– Automated documentation would be ideal to help facilitate record keeping
– HIPAA compliance is required, but non-HIPAA compliant apps are both being developed and currently used in the military for telemedicine. Whatsapp is not HIPAA compliant. HIPAA problem has not been solved.

Joe Blanton:  AD Army Officer (SOCOM Acquisitions);  Counterterrorism & Public Policy Fellow (Sanford)
– Introduction/ background on .mil acquisitions process, including subjects like funding, RFPs, development/ testing/ product support
– Barriers to entry for competing for .mil/ .gov contracts – specifically w/in the joint environment (SOCOM)
– Strategies for identifying both unit-level advocates & “snakes in the grass” as we iterate our MVP.

Josh DicksonLifeLight Paramedic
– Current documentation feels laborious and redundant
– Fewer the buttons, the better
– Half the work is in the documentation: documentation and logistics

Amy Holcomb: Accenture healthcare consultant
– Bite-sized training to prevent need for telemed consult in offline case
– What are the numbers? Quantify medics in SF, of ex: 1:20 medic/patient ratio, Quantify error at patient handoff

Dan Buckland: Emergency physician at DUHS, Director of Duke Acute Care Technology
– Blood-given, mental status → important medical info for doc
– Trends are consistent until they aren’t…. Not key metric, relatively speaking
– Value add is small with some of this tracking
– Value is not in patient management, but purely in info sharing

Rod Greco: CMO of Aquila Med
– Provided thought process for how to convince others that our app has value.
– Cost of change/transition to this solution must be less than the gain it creates — I.e, you need to quantify this gain
– Does it come from productivity? Is there a cost incentive?
– “Every time you save time, you save money” → look into doctor/physician time

Mark Palmeri: Associate Professor of Practice at Duke University
– Burner phones create anonymity, while VPNs “bounces” stuff. Require a combination of encrypting and VPN Bouncing, but order of magnitude of slowing down every time you bounce. Reception and retransmission creates overhead
– Previously, sending a picture sends a ton of redundant data. “What are degrees of freedom for a given entry into a card?” Example: stable/unstable = binary (0,1). We need to map card to all data points. “Encryption scheme is your encoding”
– PGP: foundation for public key cryptography


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