20-10-COVID-19_NETCCN_TATRC

National Emergency Telecritical Care Network (NETCCN)

This program is focused on preparation for COVID-19 related critical care capability shortages.  Although the United States has more critical care beds per capita than other developed nations, emerging national and international experience with COVID-19-related critical illness suggests a high level of oncoming system stress on critical care resources and a likely potential for intensive care unit (ICU) beds and care teams to be overwhelmed.

 

Tele-critical care can be a powerful force-multiplier in the extension of limited critical care resources in both high-census urban centers and rural communities in which access to critical care (facilities, equipment and trained clinicians) is limited even under normal conditions. Many local and regional health systems have invested extensively in telemedicine capabilities, but many of these systems lack sufficient scalability, are limited both in interoperability with other telehealth systems and scope and reach of partner provider-networks and supported tele-clinical services. The vision for this program is to extend local tele-critical care capability sets to a broader, flexible network – first locally, then step-wise regionally and nationally – that can be leveraged wherever there is need.

 

The NETCCN program focuses on enhanced development of integrated technologies and clinical workflows to establish and rapidly scale virtual wards. The program will support the extension of high-quality intensive care to traditional (e.g. critical access hospitals and clinics) and non-traditional and temporary healthcare facilities (e.g. field hospitals and gymnasiums) which lack adequate critical care expertise and resources necessary for care of COVID-19-related illnesses.  This program utilizes existing technologies available for other use cases that can be rapidly adapted to establishing a National Emergency Tele Critical Care Network (NETCCN).

 

The tasks of the program include the following:

 

  • Initial system configuration and alpha testing: Awardees will bring forth systems which they have currently developed that would facilitate the capture, exchange and archiving of medical clinical information.
  • Rapid Development and beta testing: After initial alpha testing to validate system capabilities, the systems will move into the second phase of prototyping and testing. Additional minimum features include patient regulating and team coordination functions and database storage functions. Field testing with local/small cohorts of actual users is expected.
  • Reliability Testing, Deployment and Enhancement: The systems will be fielded to actual users and experience real world use for a large cohort (at least a regional geographic area) of patients. Simultaneously, new adaptations can be made to fit the specifics of the COVID-19 pandemic, so movement from generic data transmission to more specific formats and clinical practices that represent COVID-19 support.  A plan/program for “just-in-time” training for anticipated users (ideally a part of the application) should be included.
  • Automated Improvements: This task aims to incorporate automated improvements that can enhance the care as well as reduce time with consultation personnel so that they can extend their care to a larger patient population.
  • Full Scale Development and Integration: This task expands the system to incorporate the greater network and systems of the DoD and civilian workplaces using a defined interoperability standard and reference data standards.

 

The research project award recipients were selected from the Offerors who responded to MTEC’s Request for Project Proposals (20-10-COVID-19_NETCCN_TATRC).

 

 

 

Philips North America, LLC’s response to National Emergency Telecritical Care Network (NETCCN)

Project Team: Philips North America

Award Amount: $0.98M

Project Duration: 3 months

Project Objective: The project encompasses the delivery of high-quality intensive care to existing healthcare facilities, field hospitals, and patient homes across the country in support of providing care to COVID-19 patients utilizing existing technologies and solutions that have been shown effective in the care of critically ill patients. Our objectives include: (1) provision of high-quality critical care by certified professionals virtually; (2) enhancing provider productivity with clinical decision support enabling a provider to patient ratio of 1:120; (3) furnishing a provider pool of sufficient size to ensure all patients in supported facilities receive quality care; (4) enabling agile provider staffing to ensure the ability to flex up and down and load balance based upon patient demand.

 

 

 Team Avera eCARE NETCCN Proposal

Project Team: Avera Health

Award Amount: $10.77M

Project Duration: 20 months

Project Objective: Team Avera eCARE’s goal for this project is to collaborate with the government and other offerers to develop a responsive and scalable telecritical care delivery network, for which the protocols, methodologies and integrated technologies shall be equally applicable for civilian and military theaters of crisis or disaster. The overriding hypothesis is that if we provide a highly structured and realistic clinical framework for austere, remote critical care delivery, and support that framework with simple to use, proven and widely accessible technology, we can remotely leverage critical care trained clinicians to seamlessly augment onsite clinicians in several and distributed wards, serving as a force multiplier. Our study design includes rapid enhancement iterations with the capture of key performance indicators for each iteration that place an emphasis on operational and clinical outcomes.

 

 

Deloitte Proposal to Execute on the NETCCN Vision

Project Team: Deloitte Consulting

Award Amount: $9.42M

Project Duration: 34 months

Project Objective: The technology objective of this project is to rapidly develop, deploy, and test a NETCCN solution- a cloud-based, low resource, stand-alone health information management system for the creation and coordination of flexible and extendable high acuity “virtual critical care wards”. The project will investigate the technology required establish virtual hospital wards/ICUs and extend high-quality intensive care to every bedside.

 

 

 

ReCCaMP – Remote Critical Care Management Platform

Project Team: Oregon Health & Science University

Award Amount: $0.18M

Project Duration: 1 month

Project Objective: Leveraging existing collaborative partnerships between OHSU and GE Healthcare for development of a Virtual ICU platform and inclusion of Microsoft to ensure universal integration and communication, we will develop a fully integrated and rapidly deployable tele-critical care network. Our agile University team will develop the education, validate key performance indicators through high fidelity simulation, and perform real world beta-testing through regional partner institutions. Patient monitoring, electronic health record management, and complete integration to experienced remote management critical care teams will be executed by GE Healthcare. Secure network integration and collaboration/communication will be supported by Microsoft’s suite of products and solutions.

 

 

 

National Emergency Telecritical Care Network Solution

Project Team: Expression Networks

Award Amount: $6.56M

Project Duration: 34 months

Project Objective: Team Expression will demonstrate that the Mercy Mobile Platform and Virtual Control Center is configurable and extendable for use as the NETCCN. We will demonstrate that the telemedicine platform m.Care is easy to use yet flexible for different levels of care, and that the solution and virtual care approach is sustainable for both short term and long-term national crises. We will further demonstrate that virtual wards can be easily and quickly configured as patient surges occur, and will demonstrate, that critical care expertise can be extended to appropriate levels of care and to patients requiring that expertise. We will also demonstrate that a healthcare provider can receive expert step-by-step mentoring from a critical care intensivist to include the proper setup, configuration and use of a ventilator.

 

 

 

Unissant Advanced White Paper for National Emergency Telecritical Care Network (NETCCN)

Project Team: Unissant

Award Amount: $0.17M

Project Duration: 1 month

Project Objective: Unissant’s overarching goal is to support the mission of NETCCN in the rapid development and deployment of a Tele-ICU solution to meet a surge of COVID-19 patients. Our focus is on patient flow, patient information, continuity of care, and communication among providers. Unissant, Inc. (Unissant) and our technical partners, along with our clinical partners, collectively understand the challenges and requirements for this initiative based on having deployed similar turn-key solutions and clinical staff throughout the world. Team Unissant’s overall objectives and mission for this project are to bring forth novel and proven technologies that can be rapidly deployed for the NETCCN to meet the ICU needs of the COVID-19 crisis. This will be accomplished by the use of a cloud-based, low-resource intensive, stand-alone health information management platform that is patient-centric and user-friendly to both clinicians and non-clinicians supporting “virtual critical care wards.”

 

 

 

A Robust Emergency Critical Care Telemedicine System for Military and Civilian Use

Project Team: University of Pittsburgh

Award Amount: $0.35M

Project Duration: 3 months

Project Objective: We propose to develop a flexible, scalable, and sustainable emergency critical care telemedicine system for immediate deployment as part of a nascent National Emergency Telecritical Care Network (NETCCN). Our proposed project will build off an existing emergency telemedicine system that is currently providing remote critical care services for the COVID-19 pandemic across two states. Our system will include: (a) secure synchronous and asynchronous cellular-based communication via a simple mobile application; (b) a flexible staffing model for virtual ICUs; (c) a robust operations algorithm for management of the virtual ICU workforce and each clinician’s individual workflow; (d) a HIPAA-compliant, HITRUST-certified computing platform; (e) just-in-time education modules for training users in system administration, communication, and basic clinical care; and (f) a process for rapid-cycle performance evaluation and improvement via user feedback.

 

 

 

 

Disaster Telemedicine Response System (DISTRESS)

Project Team: The Geneva Foundation

Award Amount: $15.40M

Project Duration: 34 months

Project Objective: The architecture of the Integration of Omnicure’s TCC platform and DocBox’s medical IoT platform forms DISTRESS. Initially, DISTRESS will complete teleconsults and telementoring but, with the integration of medical devices and sensors, will evolve into a comprehensive telemonitoring solution. The system will also be able to gather data from environmental sensors and other nonmedical sensors in order to provide additional context to the scenario. The collected and aggregated standardized data is readily available for real time analysis and dashboards aiding in emergency management during the crisis, and provides information for retrospective analysis, quality assurance and training to improve care during future events.

 

 

 

 

Portable Remote Operational Wireless Enabled Surge Specialist ICU (PROWESS-ICU): Remote ICU Surge Capacity in Collaboration with Clinical Care Providers

Project Team: Medical University of South Carolina

Award Amount: $0.29M

Project Duration: 1 month

Project Objective: The goal of PROWESS-ICU is to establish critical care surge capacity for rapid deployment that extends the critical care resources in US geographic regions. The approach is designed to scale and create a coordinated system of care for critically ill patients based on the Incident Command System with modular expansion capacity in a Surge ICU linked to a regional critical care leader (the Mothership). PROWESS-ICU has deep linkages between the Mothership and Surge ICU(s), including data linkages with clinical and operational supervision, creating a coordinated system of care. The Team offers a socio-technical solution to the problem of scalable delivery of telehealth surge capacity for critical care. The solution includes networking, devices, device integration, documentation and management, and quality tools, as well as clinical workflows, organization structures, and policies/procedures to support operations.