Deployment: Week 9

This week, we got to experience the SF telemedicine use case first hand – by observing a live training exercise taking place across North Carolina known as “Mountain Path”.

Huddled in a dark wing of a fifth floor office renovation in Raleigh, we exchanged discussion points and collected key insight that will be shaping the next phase of our product development.

Of the major takeaways from this week, this “out-of-the-office” experience allowed us to realize, and then discuss, a point of iteration for our mobile telemedicine platform. In brief, we need to get deeper into the actual telemedicine needs and shift our focus around providing an all-out clinical care app. This epiphany is not yet considered a “pivot”, as our base ideas are still intact. However, we are walking away from this week of customer discovery with a sharpened problem scope and new design considerations for smoother SF telemedicine in remote conditions.

Below, we share some key takeaways from the people we met:

Interviews conducted at 3SFG “Mountain Path” Exercise:

Ryan Maves: SOCOM instructor; Associate Professor USUHS
– Telemedicine best deployed after team has stabilized the patient, after 2nd survey.
– Sometimes it is best for physician to follow patient’s vitals to stay ahead of the complications even when the team hasn’t called the physician.
– Small complications in routine procedures can complicate the treatment, and having a physician to guide the team through would be great.

Doug Powell: Former 4BN 3SFG Surgeon; current Staff Intensivist, First Health Physicians Group
– App ideally can be downloaded in the US that can then be uploaded onto a burner phone bought locally.
– Need a way for physician to monitor each action that the team has performed.
– Simplicity and usability is key.

Jeremy Pamplin: Deputy Director, U.S. Army’s Telemedicine and Advanced Technology Research Center
BATDOK will inevitably be successful; all other (working solutions) are a waste of time and resources.
– Focused on the “big Army,” enterprise level development, adoption, and integration of technologies.

William Vasios: Former command physician assistant, Special Operations Command – Africa
– Discussed his role in advancing the field of pre-hospital care/ critical care research.
– Discussed trends he has seen in previous PFC exercises, and areas of the exercise where our team might derive the most value.

Roger Dail: Former 18D;  CEO & Founder – Ragged Edge Solutions
Teams usually have the phone attached to their chest in landscape that they can then flip down to type and read.
– Current methods of paper and pen are inefficient because paper gets torn, ink gets washed off.
– BATDOK works great when used by the techs demonstrating its usability, but few people can use it after they leave.

Rich Salve: Former 18D; RN, DUHS;  Ragged Edge Solutions cadre
-BATDOK is improving usability and can select different capabilities in settings to limit the amount of phone capacity needed for usage.
– Very few deltas receive the training that we observed at Mountain Path
– Fewer use it as a refresher course.

DW (name withheld): Former 18D; Ragged Edge Solutions cadre
– Batdok usually fails after a few clicks and often freeze when all options are selected in settings, especially voice recording and voice recognition
– It is necessary to remember the specific steps needed to get to a specific function.
– Ideal would be to have redundancy in the buttons so that there are more than one intuitive paths to reach the same function.

PL (name withheld): 18D; SOMA PFC Working Group member
– History behind the drive to standardize PFC training, protocols, and resources (ADVISOR Line).

CK (name witheld): 4-3SFG Signals Detachment
– Any solution must meet minimum requirements that ultimately protect a units digital/ electronic signature.

Brad Hayes: Founder & CEO, Aerial Inspection & Mapping Images, LLC
– Provided insight into current efforts to leverage drone technologies during PFC scenarios; talked through strategies his company has taken to overcome the limited communication environment.

David VanWyck: 4BN 3SFG Surgeon; “Mountain Path” OIC
– Need to have a Batdok-like app that works
– Physicians provide advise at around hour 4-5 after injury
– Batdok wanted to test out usability with the deployments, but haven’t been as responsive

JW (name withheld): 18D; “Mountain Path” NCOIC
– Provided candid discussion on why SOCOM and Army Special Forces has stumbled when working to adopt different technological solutions.

Stacey Shackelford: Director, Joint Trauma System (Defense Health Agency)
– Discussed JTS’s role in navigating Title 10 and establishing joint requirements for medical training.
– Discussed JTS’s current efforts to standardize PFC scenario training across the different services.

Sean Kennan: Former SF Battalion, Group, and Theater Surgeon;  pre-hospital care SME
– What do these guys (medics) really need? Focus development on that; teams need an easy way to digitize the tele consult transcript.
– Don’t try and replicate BATDOK

“Kat”(name withheld): PA; 4-3SFG “Mountain Path” team leader
– Provided insight into operational considerations, clinical decisions, and personal feelings around her teams first tele consult experience.

JW (name withheld): 18X, 4-3SFG “Mountain Path” assistant team leader
– Provided insight into operational considerations and personal feelings around his teams first PFC exercise/ teleconsult experience.

NP (name withheld): 18X, 4-3SFG “Mountain Path” team leader
– Provided opportunity to observe and listen to actual tele consult between his team and ADVISOR line.

Other Interviews:

Michael Jelen: Director, Berkley Research Group; experience in software consulting
– Reviewed team progress on system architecture plan, advising new efficiency plan for communicating system needs during our final pitch

Matt McGuire: Software Architect & Developer, Protectwise, Inc.
Provided technical advice on different ways of building a back-end system for TUPAC, and some of the current commercial solutions available in the market.

Drew Hinnant: 18A; S3A, 3SFG
– Reviewed high-level plan for remainder of semester, including Mountain Path exercise and how we could grow from it.
– His outsider perspective of the event, but insider knowledge of how training exercises occur was a major part of our preparation plan.
– Discussed next steps for reconnecting with 18E’s as we build our system requirements document.



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