Next Generation Virtual Health Capabilities (NG VHC)

DEPARTMENT OF THE ARMY U.S. ARMY MEDICAL RESEARCH AND MATERIEL COMMAND 504 SCOTT STREET FORT DETRICK, MD 21702-5012 REQUEST FOR INFORMATION: Next Generation Virtual Health Capabilities (NG VHC) DISCLAIMER In accordance with FAR 15.201(e), responses to this notice are not offers and cannot be accepted by the Government to form a binding contract. This RFI is issued solely for information and planning purposes and does not constitute a solicitation. Neither unsolicited proposals nor any other kind of offers will be considered in response to this RFI. Responses to this notice are not offers and will not be accepted by the Government to form a binding contract. Responders are solely responsible for all expenses associated with responding to this RFI. All information received in response to this RFI that is marked Proprietary will be handled accordingly. Responses to the RFI will not be returned. At this time, questions concerning the composition and requirements for future RFPs will not be entertained. ISSUED BY Virtual Health Research Task Area, Medical Assist Support Technologies (MAST), Medical Simulation and Information Sciences Research Program (MSISRP), Congressionally Directed Medical Research Programs (CDMRP), US Army Medical Research and Materiel Command (USAMRMC) BACKGROUND The Medical Simulation and Information Sciences Research Program (MSISRP), Medical Assist Support Technologies (MAST), Virtual Health (VH) Research Task Area was established in fiscal year 2019 (FY19) to provide programmatic funding recommendations for United States Army Science and Technology (USA S&T) research dollars related to the next generation of VH capabilities for Multi Domain Battle (MDB) to advance the development and integration of VH capabilities for the future battlefield. In FY20, the VH Research Task Area is expected to facilitate cutting edge, next generation scientific studies to promote significant innovation in the applied, state-of-the art research in Virtual Health (VH) technologies and approaches, including novel VH process architectures, next-generation VH multi-modal communication capabilities, and VH cyber security and electronic warfare capabilities/countermeasures in the military medical domain to dramatically advance direct and indirect support for point of injury trauma care and prolonged field outcomes. Recently there has been an exponential increase in the use of telehealth capabilities across the military and VA medical communities, with remote patient monitoring, provider-to-provider mentoring, and real-time video consults becoming embedded in the daily battle rhythms of clinics around the world. Current federal, commercial and academic partners are working diligently to expand these capabilities, and diversity of specialty practices offered across the telemedicine/virtual health spectrum. However, the vast majority of these efforts are targeted around mature, fixed facility operations and access to continuous, high bandwidth connections that will NOT be available in the future, MDB environment. Finding new ways to provide force multiplying tools for care providers on the battlefield that will assist with the assessment and continuous monitoring of sick and injured Service Members for prolong field care in a fashion that is interoperable with traditional telehealth services if, and when the communications are available is necessary to ensure that all possible resources are available to provide the best care in the future, operational environment. The transition from traditional point of injury healthcare delivery to clinical decision support and tele-mentoring aided by semi-autonomous and closed loop medical devices will occur in real time in the battlefield and will not simply be one directional. An awareness of how virtual health can exist in each of these phases will provide a critical understanding to supporting the ever-evolving bandwidth, network, and field conditions in war. The MDB predicts military operational environments involving greater dispersion and near-isolation over great distances, straining medical care delivery even more. Much like mass casualties from terrorist events and natural disasters such as floods and hurricanes, future military medical scenarios are likely to cause severe restrictions on mobility for medical missions and shortfalls in both human and materiel resources. Combat units will need to be more self-sufficient and less dependent on logistical support. Future VH solutions with intelligent, no-communication functions and dynamic integration options for the MDB will serve as force multipliers for medical operations in future causality and disaster environments. GENERAL INFORMATION This Request for Information (RFI) is targeted at organizations researching, developing, and offering cutting edge, next generation scientific studies to promote significant innovation in the applied, state-of-the art research in Virtual Health (VH) technologies and approaches, including novel VH process architectures, next-generation VH multi-modal communication capabilities, and VH cyber security and electronic warfare capabilities/countermeasures in the military medical domain to dramatically advance direct and indirect support for point of injury trauma care and prolonged field outcomes. Organizations responding to this RFI must also provide novel solutions that would integrate the transmission of data as well as the ability to deliver structured instructional media in a timely fashion in situations when communications are compromised as well as provide a tiered communication capability with video being the optimal capability and text messaging being the minimal capability. This RFI encourages those working with in partnership to submit a collaborative RFI, if applicable. The ability to partner with other subject matter experts to deliver a solution set is desirable. Leveraging skill sets across multiple organizations may result in stronger proposals with unique solutions that may not be realized through a singular source of innovation. Concentration on the delivery of Clinical Practice Guidelines (CPGs), best practices for medical mentoring, and assured communication in congested environments should be strongly considered. However, additional novel communication exploration should be included in the RFI such as novel encryption capability, data compression algorithms, beyond line-of-sight communication, to include subterranean communications technologies. The NG VHC RFI is intentionally broad for the purposes of disrupting the market by allowing the organization to develop and do a preliminary evaluation of next generation capabilities that are relevant to VH. This market research may assist with the further development and/or refinement of requirements. Information will be reviewed pursuant to consideration for the development of future Requests for Proposals (RFP) or Announcements for development of products or areas of research identified in this RFI. Objectives The objectives of this RFI are as follows: - Determine novel ideas, approaches and strategies to facilitate effective VH consultations in the communication constrained MDB environment through prioritization of clinical data elements generated by the care provider and/or onsite clinical monitoring equipment. As VH technologies are leveraged in the operational environment, large amounts of physiological data can be generated; yet the ability to communicate those data fields to remote consultants will be extremely restricted. Within the MDB environment there will be large, yet highly variable, time frames without any communications; when bandwidth is available, it will be restricted to high priority data elements. Therefore determining which clinical data elements should be classified as urgent, high, medium and low priority for the windows of connectivity is critical to effectively support the care provider seeking clinical guidance and expertise. Further stratifying these clinical data into prioritization for asynchronous support solutions in the absence of/or during degraded communication resources must also be considered. Establishing novel combinations of different VH technologies and information transfer strategies that optimize patient care in context while minimizing network resources are required for effective VH within the MDB environment. - Identify novel ideas, approaches and strategies to provide VH support to a care provider when an established, synchronous (real time) teleconsultation is disrupted due to communication degradation, failure, or outages prior to completion. Because of the communication constraints of the MDB environment, it should be expected that communications may be disrupted prior to the completion of a live consultation. Therefore exploring techniques to leverage asynchronous clinical decision support tools that will dynamically be invoked as communication capabilities are reduced or fully denied is essential. Clinical decision support capabilities in numerous form factors will be key to fulfilling medical expertise gaps that exist between the caregiver qualifications and required causality care at the point of injury. The seamless scaling of VH solutions between synchronous to limited and or asynchronous communications must be achieved in real time/near real time and be accompanied with a clear protocol for the care giver. - Determine novel ideas, approaches, and strategies to identify appropriate and available remote expert consultants to aid the novice care provider in the MDB environment to support just-in-time consultation needs. The existing expert consultation network is predicated on traditional echelons of care, and assumes ready access to reliable communication resources. Providing care givers with tools to facilitate obtaining needed advice and or coaching that is based on clinical needs, connectivity options, geographic proximity, expert health consultant schedules and privacy/security considerations while still maintaining the situational awareness of the anticipated evacuation chain requires a paradigm shift from current practice. Considerations of primary, alternative, contingency, and emergency plans for obtaining necessary VH support should also be considered. - Explore novel ideas, approaches and strategies for identifying best practices to counteract threats from electronic warfare (EW) that can be leveraged for current and future VH technologies. The MDB is predicated on the assumption that near peer adversaries will actively attempt to obtain critical information from VH tools. Furthermore it is assumed that these adversaries will further attempt to disrupt military operations by inserting false data sets and or malicious code into VH tools to misdirect care givers and/or senior leaders. Developing effective countermeasures that can be embedded into next generation virtual health solution sets, specifically respective to health data elements and the unique attributes and properties of clinical information is an essential requirement to counteract EW threats. Relevance The information provided must be relevant, at a minimum, to one the following topic areas: 1. Determining novel ideas, approaches and strategies to facilitate effective VH consultations in the communication constrained MDB environment through prioritization of clinical data elements generated by the care provider and/or onsite clinical monitoring equipment. Focus should be on optimizing clinical outcomes while minimizing network resources consumed. 2. Identifying novel ideas, approaches and strategies to provide VH support to a care provider when an established, synchronous (real time) teleconsultation is disrupted due to communication failure or outages prior to completion. 3. Determining novel ideas, approached and strategies to identify appropriate and available expert health consultants and/or consultation resources for the novice care provider in the MDB environment to support just-in-time consultation needs while maintaining situational awareness of the anticipated evacuation chain. 4. Exploring novel ideas, approaches and strategies for identifying best practices to counteract threats from electronic warfare (EW) that can be leveraged for current and future VH technologies. 5. Information must include proposed methodology to establish and maintain VH mentorship capability to address emergent medical scenarios as well as maintenance of patients in austere environments for prolonged periods. DISCLAIMER: THIS IS A REQUEST FOR INFORMATION BEING RELEASED PURSUANT TO FEDERAL ACQUISITION REGULATION (FAR) PART 10: MARKET RESEARCH. This RFI is issued solely for informational, market research, and planning purposes only. It does not constitute a Program Announcement (PA) or a Request for Proposal (RFP) or a promise to issue a PA or RFP in the future. This RFI does not commit the Government to contract for any service whatsoever. Further, the Department of Defense, Military Health Services, Defense Health Information System is not seeking proposals at this time, and will not accept unsolicited proposals. Respondents are advised that the United States (U.S.) Government will not pay for any information or administrative cost incurred in response to this RFI. All costs associated with responding to this RFI do not preclude participation in any future PA or RFP, if any is issued. Responses to this notice are not offers and cannot be accepted by the U.S. Government to form a binding contract. It is the responsibility of the interested parties to monitor this site for additional information pertaining to the RFI. No telephone inquiries will be accepted. Regarding this RFI, direct contact or one-on-one meetings with a contracting officer, program manager, or technical parties, is not allowed. INFORMATION REQUESTED Information is requested on product technologies or proposed studies that are consistent with the identified Objectives and Areas of Relevance listed of this RFI and are related to any of the following areas. Responses to this RFI must specifically and clearly address any or all of the topics in the following three sections. Section 1 Information is requested pertaining to the categories listed in Relevance regarding existing, leading-edge products and/or services related to the Objectives of this RFI. Section 2 Information is requested pertaining to the categories listed in Relevance regarding current research and/or prototype development in support of the Objectives of this RFI. Section 3 Information is requested pertaining to the categories listed in Relevance regarding future plans for research, products, and/or services in support of the Objectives of this RFI. RESPONSE AND PROCESS Responses to this RFI should be e-mailed as either an Adobe PDF or MS Word attachment and must include the following components: 1. A cover letter on institution letterhead including the institution name, point of contact, address, phone number, fax number, DUNS number, and CAGE code. 2. Your response should not to exceed 3 pages in length, consisting of the aforementioned information for each section, as appropriate. Response to this RFI is due to U.S. Army Medical Research Acquisition Activity (USAMRAA) by the time and date specified. Please submit e-mail responses to Abraham Pottenger. No phone calls please. Responses must be identified with W23RYX-19-RFI-01.