This week, we were able to test our product’s value proposition with a couple of new users who hadn’t heard about what we were doing. This was a great opportunity to hear the questions they had for why we were involved and how our solution would really be different from what currently exists. Through these experiences, we were also able to see how many different resources and communities there are for Special Operations medics to join, but how they all speak to different aspects of the problems. This brings us back in a way to the first few weeks of this course, where we were still attempting to understand the different challenges that medics do face and how we could make a difference. But it also brings us forward to thinking about how we can actually deploy our product, including the costs and technical steps required- and how the level of security we need to develop Mediscope is certainly great and certainly not something we know a great deal about. We also have been thinking about how it might be beneficial to deploy the dual use public version before the military version to establish a proof of concept. This will require a different kind of marketing and fundraising, apart from small business and woman-owned businesses, as well as the various ways to obtain a contract from the government. These contracts could be completed through licensing the app as a SaaS (software as a service) category product, but there are different levels and different pricing structures to consider based on how much our product actually ends up costing to make.

Interview #1: Jon,  17 years as Special Forces Medical Sergeant and now instructor of 18D/SOIDC refresher course (New User)

• It seems simple but the ability to search this information would be so powerful- right now, the medical asset information might be “in an electronic form” like a Word doc, but a bunch of word documents in a folder is the same thing as a physical file cabinet- it just lives on a computer
• With technology (including in the military) advancing and information tools becoming specialized, it would be helpful to separate the medical information from everything else because it is a huge priority
• App is great, here are some cautions for development:
  • Information like number of beds can mean so much, and isn’t telling- but you wouldn’t know that unless you have experience as a medic (It seems like we really need to identify who can help us develop the assessment guidelines to be even more useful than what exists today)
  • User profiles or rewards for reviewers like on Yelp would be great because “you start to go and see who tends to be right”
• Suggestions of how to market the product:
  • SOMSA and other events where medics and other people involved in military medicine gather
  • Relying just on 18D’s to get this rolling is not feasible because there’s only about 3000 active duty and that’s not nearly enough to get towards building info on geographic coverage that you need

 

Interview #2: Rod, Currently SOF Medic Instructor, Retired after 20 years of experience in Iraq, Afghanistan, and Africa (New User)

• Seems like a Google Earth overlay of medical facilities
• Definitely uses apps for planning and health information (Relief Central)
• Crowdsourced info: this will be the difference between the resources we use that are out there (like Relief Central app) and what we have, and that could be useful if deployed properly
  • Key is getting verification of crowdsourced information right

Interview #3: Josh, Special Operations medic with MARSOC and 13 years of Navy experience in Middle East and Afghanistan, founded SOM+C (New User)

• Usage of NCMI for current medical planning needs- what gets addressed, what doesn’t get addressed
• Take a look at https://www.promedmail.org/aboutus/ for infectious disease information
  • Uses multiple sources of information, is free and anonymous to access, to display reports of health outbreaks and toxic emergencies for human and animal health
  • Uses a map format and helps encourage collaboration between medical personnel
• Example of a messy scenario:
  • “a host nation with 100 hospitals but all the assessments are 5 years old and only 1 is approved through tricare and 2 have a helipad and 1 is the only trauma capable for our guys in the country” —> where our product could be useful

Interview #4: Will, Special Forces PA (New User)

• CDC Website is what he uses currently
  • Thoughts on deploying the dual use scenario first and get an active user base, and then the military would really see the value in use (like how they use Google Maps or CDC Yellow Book to find the information they need right now)
  • The CDC would be big partners by providing mapping
  • From the get go you would have a huge mapping
• Need a clearer definition of:
  • “Are you still in the “good idea” phase or “how do we make it better” phase?”

Interview #5: Samuel Williston, Former 18D, Consultant @ Raytheon (Repeat)

• Sam has deep knowledge into the implementation and acquisition of military manuals from his 18D transition to an advisory role at Raytheon. He works with the ATAC test office to vet new vendors and capabilities
• Thoughts on acquiring users:
  • Suggests looking into consumer market for inspiration. Product must first be consumed before adopted.
  • Concerned about the compliance/legal components to the app
  • Some degree of uncertainty with implementing apps in a saturated mkt.
  • Interested in seeing if VC firms would invest in something that may be easily duplicated. Emphasize the “secret sauce” of the offering
  • Wondering if there there are similar services for doctors and if provider groups can be brought in to test
• Key to adoption is to have “power users” be advocates to the general success of the product. The cost to acquire these power users would be worth it since they have such lift towards general sentiment.

Interview #6: Josh Mosciwicz, 18D (SOCM instructor) transitioned from Navy SWCC (New User)

• Josh has deep knowledge into the medic training schema as a SOCM instructor. He works with the foreign medics to train them on US standards.
• Thoughts on cost/resources:
  • Suggests setting up a top user game system to reward frequent users
  • Concerned about the application of the service for all medics
  • Suggests that a pilot could be run with 18D trainees who are looking to increase their influence in the company
  • Interested in seeing if VC firms would want to invest overseas given the volatility of foreign markets
  • Wondering if incentivizing families of medics would be a good way to go. Give wife/dependants access to tools.
• Hesitant to say he would believe the data without understanding a clear system of validation and quality metrics instilled.

Interview #7: Karl Chopes, Implementation Architect, Raytheon (Tech Expert)

• Jon has deep knowledge into the development of code used for the AEGIS defense system used on DDR ships. He is currently with Raytheon working with the small liabilities innovations group that funds small pilots for the military in ad-hoc projects.
• Thoughts on cost/resources:
  • Partner with provider groups that have established systems to build off their infrastructure. Suggested Kaiser Permanente as an example.
  • Concerned about using the app in a non-secured environment. What happens if passwords or logins are compromised?
  • Reminds us to factor in maintenance and operational costs related to running an app. Software architect needed for update reboots and server refreshes. Need someone paid to handle password recovery and data backup.
  • Suggested a possible dual use would be with students studying abroad in college who look for resources and assets when injured or ill.
  • Wondering if the app can be a smaller size 50mb or less. This way it can be loaded and stored on local phones and web browsers in Humvees or other carriers easier.
• Suggests running a focus group that is representative of a particular deployment demographic to give a sense of how viable the app would be in that region.

Interview #8: Dan, Civilian EMT (Repeat)

• Certainly would use this, especially if it already has a well-populated database
• Super handy to see these things in the context of healthcare resources where if we had conflict somewhere in the last 6 hours, we may not want to go to resources there or don’t want a helicopter flying near there
• He would like access to the DOD/DOS version because of his work in conflict zones (aid groups need this access too)
• Talked about extreme sports enthusiasts being a niche segment of potential customers

Interview #9: Paul, CPT and Former Army Medic (Repeat)

• Thinks the interface is extremely well-structured
• Likes the idea of crowdsourcing information (good way to keep costs low) → definitely have to prove you can provide a solid foundation of this information refreshed regularly
• Social media portion seems confusing, what is the point? (Also not allowing him to login through Twitter function currently)

Interview #10: Justin, 18D (Repeat)

• In the user profile portion, have a way for medics to organize or ‘favorite’ assets and that way they can refer back to certain resources more customized to their personal context (area they are deployed in, resource needs)
• This is a great activation of a list of resources that is currently kept in a ‘virtual, dusty file cabinet’ — the app will allow us to do a lot more with the information that is collected
  • Definitely sees commercial value as well, loves idea of military version — “they would definitely pay money for it”

 

This week we were able to test our format of information input for Mediscope. In general, beneficiaries were excited about the format of the input. They were also enthusiastic about the idea of a game-like progression with badges or notifications to incentivize information input. Biggest concerns were around issues of security and verification of data, but they like the idea of a verification status on information of medical assets. Identified key activities include securing government subsidies or private equity funding to launch the framework of the project. We were able to identify potential key partners as well including large hospitals in operating environments, an acquisition group that created Data Miner which is currently used by Green Berets, and Spatial Networks which works with a great deal of geospatial data.

 

Interview #1: Kirk Ferguson, Former 18D/JSOC Regional Team Lead

• Says hello to Tommy!
• Strategically this product comes at perfect timing- one advantage is the widespread growth of Internet availability and usage but another is strategic regarding national security concerns
  • Return to more traditional SF missions following Iraq/Afghanistan where you never needed to really do medical planning well: this is more important than you would think
• Possible incentive for this product usage in Special Forces: Notifications or a game-like structure
  • To increase medical assessments that are actually done (not just out of immediate necessity): send an alert when you are near a clinic with 4-5 basic Y/N questions that you could fill out quickly, with the option of “Do you want to continue and complete a full medical assessment”
    • You might be able to tie in incentives to the number of assessments that are completed, or the number of clinics who are tied into this product
• Possible partner or resource: Spatial Networks, which works a lot with layout of geospatial data and guiding people through information collection per region
  • Could be useful for getting clinics involved, as well as for overall expertise- not sure if they do anything medical focused right now

Interview #2 Ethan, Cadet (New User)

• Feedback: Likes the format of the input form. Would like to see popular suppliers or most important information in a list (supplies, distance from airport/helipad).
• Enemy forces could be an addition so you can see where you wouldn’t want to fly over. Map is cluttered and would benefit from having a near me button.

Interview #3 Rose Ann, Ret. Army Reserves Nurse (Repeat)

• Need to figure out how to get past ArcGIS blocking because it’s hard to just tell what it can do from the pictures we sent.
• Information that would be helpful includes operation hours, address, phone number, names of doctors, or website. Also, knowing what services certain assets have is essential.

Interview #4, Samuel Williston, Former 18D, Consultant @ Raytheon (Repeat)

• Sam has deep knowledge into the implementation and acquisition of military manuals from his 18D transition to an advisory role at Raytheon. He works with the ATAC test office to vet new vendors and capabilities
• Thoughts on cost/resources:
  • Suggests looking into the AITI (Army Innovation and Technology Initiative) for funding and participants/resources
  • Concerned about the compliance/legal components to the app
  • Cost/benefit model not viable here because the benefit is hard to measure in the short-term
  • Interested in seeing if PE firms would mind setting up infrastructure and fund initial resources
  • Wondering if there there are similar services for doctors and if provider groups can be brought in to test
• Good start to a complex problem, will likely need to obtain extensive approval from Army legal and compliance offices before use

Interview #5, Ben Davies, 18D (retired) transitioned from BCT ranger school (New User)

• Ben has deep knowledge into the implementation and acquisition of military manuals from his 18D service. He works with the VA system to implement TriCare for all military retirees.
• Thoughts on cost/resources:
  • Suggests looking into gov’t subsidies to help fund the product. Several gov’t subsidies such as the TriCare Tech Grant to create tools to help 18Ds
  • Concerned about the application of the service for all medics
  • Cost/benefit model not viable here because the benefit is hard to measure in the short-term
  • Interested in seeing if PE firms would mind setting up infrastructure and fund initial resources
  • Wondering if incentivizing families of medics would be a good way to go. Give wife/dependants access to tools.
• Suggests a key partner would be the acquisition group that invested in Data Miner (current tool adopted by green berets) as a proof of concept

Interview #6, Jon Carpenter, Implementation Architect, Raytheon (Tech Expert)

• Jon has deep knowledge into the implementation of military software architecture. Previously he worked with the US Navy on the AEGIS defense system used on DDR ships. He is currently with Raytheon working with the small liabilities innovations group that funds small pilots for the military in ad-hoc projects.
• Thoughts on cost/resources:
  • Suggests finding a key advocate to vouch for the product. Says he’s never seen a successful pilot without a key advocate. Person must be someone of influence and doesn’t have to be military. He’s had Dr. Sanjay Gupta as advocate for a Army EHR system through partnering with CNN.
  • Concerned about the application of the service for all medics
  • Cost/benefit model not critical because implementation in a relevant environment isn’t going to require too much lift.
  • Interested in providing peripherals as hand-outs to gain users and incentivize adoption of product. Suggests giving out branded bandages, fanny packs, water bottles as peripherals
  • Wondering if the app can be a smaller size 50mb or less. This way it can be loaded and stored on local phones and web browsers in Humvees or other carriers easier.
• Suggests a key partner would be large hospital systems in the area that have large patient base. This way it can be validated and tested on wide range of civilians without needing to involve and incentivize many military. Civilians are easier to incentivize.

Interview #7 Jeremy, Captain (New User)

• Senior leadership within AFRICOM said that his job does so many things that are classified and real world missions so could not share information in an open source manner.
• Indicated that the medical information we’re working with could be classified to a difficult extent during product development.

Interview #8 Shengquan Zhang, Medical Insurance Analyst  of CCT in Morocco (Repeat)

• The percentage of resident who own the smartphone is about 70%.
• Except for private users, many institutions are also interested in the updated medical information in Morocco, such as homecare companies

Interview #9 Liz, Captain (Repeat)

• “The progress on the user form for putting in medical information is HUGE! I love it.” Emphasizes that the user component of the app should be expanded on further with points or some kind of acclamation given to users when they put in information that is verified and up-to-date.
• Emphasis on visual aspect of the user component of the app
• Color code users based on how many assets they have verified

Interview #10 Chris, Former 18D Medic (New user)

• This is “a very logical solution in this day and age to a problem like this one”
• Can user profiles be differentiated based on whether a person is a private citizen, military officer, hospital, NGO, etc? (The military officer ID should only show up for the “mil-ium” version of the app of course). This will help understand the context of information for military officers making plans.
• Can’t access map yet because it was blocked but make sure to be able to move around map with ease

One of the important hypotheses we tested this week was the concept that we can build this data input to accommodate all users. This was an important hypothesis to test because we have kind of determined that the most valuable way of using this product would be to extend it to all users. We wanted to describe how we can regulate it, and understand if our current interface prototypes address those needs- and especially understand if beneficiaries like our “Freemium” idea. So we heard that idea basically answered questions of access for our beneficiaries, and they were happy we had thought through the issues of security and classification. Next steps on that would focus on how the data is stored on a tech level, and deciding to delineate user input based on features of medical facilities rather than users themselves.

 

We also got a better understanding of concerns medical planners might have with our product, in that we tested if it would be valuable for users to be able to access data input right after they finish a medical facility assessment. Planners may feel that information needs to be vetted- so we need to reconcile with the fact that we cannot cover all aspects of the medical planning process, but at least we can make the information gathering easier from an unclassified standpoint.

 

For deployment, we are considering creating some testing with North Carolina facilities for users to test during training in a low-risk environment, and then slowly releasing it to Special Forces groups that can add info and bring back updated versions as they return. These would be possible deployment options to explore, based on tech readiness levels. Though with our product all of the components do exist from a technology standpoint, such as location services, cloud data storage, etc, we would need to build the app so that these parts all come together seamlessly. That integration is the major technological challenge.

 

Interview #1: Eric, 18D (New User)

 

• Product would help refine processes and consolidate information that would normally take “an extraordinary amount of time and effort to consolidate” because while it is reported post-mission, it is difficult to access or find across multiple sources
  • The way it works right now, you complete a medical assessment and submit it in X form post deployment and it’s basically an input system only- no one knows where that information goes
  • Part of the problem is that the information is stored by agencies (like the Defense Health Agency) whose whole job is to manage that information, so they have never felt the need to simplify user interfaces for accessing it- no one outside the organization has success using it
  • Example: Like if someone’s entire job was to surf the internet, the army would have Internet Explorer as a career field, whereas we use it as a tool, it’s someone’s 9-5 so you can imagine how complex it could be to explore the internet if that was a job in itself,
• Would suggest expanding usage to NGOs, private companies, State Department, etc. both to cast widest net of input for that refresh and to mask metadata of input
  • Include not just medical capabilities but also info on each asset’s previous records of success working with local populations- things like how many patients they see per period of time, etc.
• Organizationally – the DoD is very protective about health information, who can input it, who can access it, who possess it etc…. so it will need to work within our current permission protocols
  • Authenticity measures, SIPR servers, etc. for tech readiness considerations

 

Interview #2: Darrell, PA (Repeat)

• Biggest concern is how we would populate this information and feed this database, and then how it would be maintained to have regular information
  • Likes the Freemium solution for classified versus unclassified kind of information, and being able to build something like that definitely mitigates a lot of the geo-based risks associated with medical information
  • Going through the interface, he can see a lot of value in this product being easy to populate the information and returning that information output back to the users much more quickly
• Traditionally, medical information has always been sensitive and on a need-to-know kind of basis, like with the forms you mentioned- an 18D might go through all the work of filling out an assessment, submit it, and because their deployments are short, never see it again
  • Involves Environmental Service Officers (preventive medicine or force protection)
  • The assessment form is evaluated at a higher headquarters level to look for completeness and presence of appropriate information
  • Then it is “put into a couple different systems” on the secret side
  • Knows this process works and at some point the information becomes searchable on JRAMP- but it takes several months
• Could definitely be useful in environments other than austere like in Africa
  • Based on his past experience, places like Kosovo where they relied heavily on civilian medical assets for specialty evaluations, etc. even in the conventional army

 

Interview #3: Dr. Yang (Repeat)

• 20$ for one assessment will be a huge incentive for updating information of healthcare facility, especially for individuals.
• Technical training and supports could be more attractive to those managers of clinics.

Interview #4: Mark Thomas, Librarian for GIS, Economics, Maps, & Geography (Tech Expert)

• Helped with the visualization of the map we have so far, discussed how to make it search just one country and gave several resources to use for political boundaries
• Showed how to join attribute data and add columns within the dataset more specific to hospitals (beds, surgery, emergency, etc.)

 

Interview #5: Rickardo, Former Medical Logistics Officer (New User)

• Told us that the medical brigade puts together a plan, briefs it, and provides oversight of the plan
• Not a need for our product because there is a Combat Service Support Plan so all medical echelons of care are planned

Interview #6, Samuel Williston, Former 18D, Consultant @ Raytheon (New User)

• Sam has deep knowledge into the implementation and acquisition of military manuals from his 18D transition to an advisory role at Raytheon. He works with the ATAC test office to vet new vendors and capabilities
• His insights on the MVP:
  • Enjoys the visual interface but feels icons can be cluttered when zoomed far out
  • Concerned about the compliance/legal components to the app
  • How can I trust the same asset will be there when I return?
  • Interested in seeing if there can be a rating system implemented instead of a yes/no appraisal
  • Wondering if there is a fail-safe if data is wrong or corrupt
• Good start to a complex problem, will likely need to obtain extensive approval from Army legal and compliance offices before use

Interview #7, William Dahl, 18D transitioned from BCT ranger school (Repeat)

• William has graduated the Special Operations Combat Medic (SOCM) program in June 2013 as part of pipeline to become a Ranger Medic. This is a condensed evaluation of the course to give any other Rangers an insight into what to expect.
• His insights on the MVP:
  • Asks if it is allowed to pay $ incentive to active users. Unsure if other 18Ds have received a $ incentive before
  • Interested in seeing if this works in enemy territories
  • Wondering if there is a fail-safe if data is wrong or corrupt?
  • Considers this tool as a “supplementary” feature as opposed to critical to mission success
• Good start to a complex problem but only valuable if good in enemy zones
• Wouldn’t use it himself until it’s been thoroughly tested

Interview #8, Robert Washington, Implementation Architect, Raytheon (Tech Expert)

• Larry was formally a engineer at Google Innovations working primarily on the deployment of autonomous car sensors before switching to defense and helping hte DoD design the data transfer protocols for military innovative projects. His most recent project has been implementing a pilot data transfer protocol on creating a system to help the F-35 fighter transfer sensor data back to mission control in a real-time manner.
• His insights on the MVP:
  • Love the use of location services (says that is next step for military)
  • How does this data get updated?
  • How can I trust another user will use it the way I want it to?
  • Interested in seeing if implementing a pilot of the service on a broader set of Army medics might make more sense. Test reach rate and general approval of tech before drilling into specific set of beneficiaries.
  • Interested in seeing if data inputted can be on a “delayed” refresh meaning there is a 3-5 day delay in uploading data points so they can be verified and vetted before someone accidentally uses a false/unproven medical asset.
• Wants to see if the infrastructure of this database can be combined with existing military systems. Might be lower barrier of entry if it can be interoperable with current tech.

Interview #9, General John Kelly, Retired US Marine Corps General and Former Chief of Staff, Raytheon (New User)

• Very excited by this question: “these are the best questions I’ve heard tonight”
• Deployment: effective deployment in the military means implementing it into our training mechanisms → tools for information management need to become part of the learning process for new, young military recruits
• If you are open sourcing this, the guard against security threats needs to be strong, especially because medical asset information is highly sensitive
  • How can you make sure updates are uncompromised and accurate? I like the idea of having another version for military men specifically that draws from and focuses on verification of all information, just think about who would be in charge of that verification process and how often they could do that job.
    • Every few months of refreshed data seems like a reasonable goal (and helpful timespan for military forces)

Interview #10, Kevin Schwartz, SOFAC Instructor, (Repeat)

• Gave us a new (pay) site: Travax that has good information but said the resources we’re using are similar if not the same ones that they use
• Doesn’t want it to turn into a “Wikipedia”, so want to make sure there’s a verification process
• Absolutely would use it and it wouldn’t be a problem to get it into a training or present it to a few people (More of a casual encounter – roundtable discussion where there’s education and training with open dialogue)
• Possible to update via military but really the only incentive would be to make sure that it needs to be as easy as possible – like the map function on iPhone