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Surgency Hacking for Defense 2017

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mission model, mission model canvas, customer development, Hacking for Defense, lean startup, stanford, startup, steve blank, Pete Newell, Joe Felter, minimum viable product

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Surgency Hacking for Defense 2017

  1. Team Surgency Supporting time-critical combat care during mass casualty response Week 0: Problem: Developing the capability for forward deployment of robotic telesurgery in order to reduce the ‘Golden Hour’ critical time window with early surgical intervention Solution: Solve signal latency for robotic telesurgery Week 10: Problem: Addressing triage and treatment bottlenecks during mass casualty situations at a Role 1 Battalion Aid Station Solution: improve situational awareness and intra-BAS communication 90+ Interviews
  2. Chris Sebastian Software Engineering & Product Andrew DeClerck Machine Learning & Software Engineering Negin Behzadian Analog Circuit Design & Signals Abbey Cutchin Tissue Engineering & Orthopedic Surgery Mentors and Sponsors Rafi Holtzman Dr. Steve Hong Amanda Love, USAMMA The Team
  3. Who We Interviewed 58+ Experts 20 Users 12 Buyers
  4. 0 1 2 3 4 5 6 7 8 9 EmotionalState 10 Robotic Telesurgery ? What is the Problem? It’s a Management Problem! Who is this for? Beneficiary Buy-In Development Next Steps Our Journey
  5. Develop capability for robotic telesurgery that would allow physicians to provide time-critical treatments for injured patients from remote geographic distances. The Original Challenge
  6. “People are scared to move a daVinci down a hallway, let alone use it on the battlefield” - Anonymous Stanford Hospital Trauma Surgeon
  7. 0 1 2 3 4 5 6 7 8 9 EmotionalState 10 Robotic Telesurgery ? What is the Problem? It’s a Management Problem! Who is this for? Beneficiary Buy-In Development Next Steps Our Journey
  8. Where can we add value? Evacuation Forward CarePOINT OF INJURY Role 2 Role 3
  9. Visit to 129th Rescue Wing at Moffett Airfield
  10. 90% before arrival to medical treatment facility
  11. 25% of those fatalities were deemed survivable
  12. Where can we add value? Evacuation Forward CarePOINT OF INJURY Role 2 Role 3
  13. “[Mass casualty triage] is not a patient care problem, it’s a management problem.” - 129th Rescue Wing Pararescuer
  14. 0 1 2 3 4 5 6 7 8 9 EmotionalState 10 Robotic Telesurgery ? What is the Problem? It’s a Management Problem! Who is this for? Beneficiary Buy-In Development Next Steps Our Journey
  15. Civilian Mass Casualty Training Simulation
  16. “It’s a waste of time to try and diagnose — it’s all about prioritization.” - Timothy Browder, MD; Stanford Trauma Surgery
  17. Justin Roberto Davis Clute Nicolas Lozano MVP 1.0 A Potential Solution for Automating Pre-Evacuation Mass Casualty Prioritization
  18. UWB Network Zephyr Vitals Sensors Leveraging FDA-approved physiological monitoring system, already deployed in several high-stress operational environments
  19. “The first time extensive triage takes place is at the Battalion Aid Station.” - LtCol Hasseltine, former Commanding Officer, 2d Battalion, 7th Marines,1st Marine Divison
  20. 0 1 2 3 4 5 6 7 8 9 EmotionalState 10 Robotic Telesurgery ? What is the Problem? It’s a Management Problem! Who is this for? Beneficiary Buy-In Development Next Steps Our Journey
  21. Battalion Aid Station? EXPECTANT STAGING AREA BLACK MEDEVAC: Medical Officer TRIAGE TREATMENT INCOMING CASUALTIES MEDEVAC To Role II/III
  22. Current Prioritization at Battalion Aid Stations White Board TrackingTriage Card
  23. “There is a continuous stream of communication at a BAS supporting triage, treatment, and EVAC of casualties across medical and tactical personnel. This chain could easily break down in the chaos of a mass cal.” - MAJ Michael Holloway, former BAS Physician Assistant
  24. 0 1 2 3 4 5 6 7 8 9 EmotionalState 10 Robotic Telesurgery ? What is the Problem? It’s a Management Problem! Who is this for? Beneficiary Buy-In Development Next Steps Our Journey
  25. MVP 2.1: Triage Manager Interface
  26. MVP 2.2: Physician Assistant Interface
  27. Final MVP: Evaluating Product-Mission Fit at the BAS TRIAGE TREATMENT CAS. INFO INPUT: Secondary Triage Officer OUTPUT: Physician Assistant EXPECTANT STAGING AREA BLACK SENSOR INPUT: Field Medics MEDEVAC: Medical Officer
  28. Surgency: Mission Model Canvas - UI/UX Design MVP - Software Engineering - Interface/integrate w/ Zephyr sensors - Purchase/support Zephyr supply - Gain buy-in from JTS and incorporate in standard practice - Continued sponsorship by military beneficiary - Industry (wearable sensors, H2Care, Zephyr Technologies) - Course faculty and staff, military liaisons, DIUx, SOFWERX, In-Q-Tel - Problem Sponsors: USAMMA - DoD organization with interest in medical device research (USAMRMC, TATRC, DARPA) - Joint Trauma Registry -Primary: Physician Assistants at Role 1 BAS - Secondary: other BAS medical officers (i.e., triage medics), and potentially tactical officers - Tertiary: Care providers at higher echelons of care - Increase situational awareness: Constant vital monitoring provides PA with greater awareness of patient status. - Improve efficiency of communication among BAS roles: Augmenting PA access to communication flow from medical officer -> PA -> Platoon Sgt for quicker, more informed decisions - Improve efficiency of MEDEVACs from BAS: More accurate prioritization during MEDEVAC requests prevents unnecessary allocation of MEDEVACs and crew -Medical force multiplier: With more efficient allocation of MEDEVACs, allow for increased access to shared resources between different teams. - Improved medic-supported triage of combat injuries at POI in mass casualty situations - Widespread adoption & trust from DoD medical team and DoD command - Lives saved / Improved Quality of Care / Time to MEDEVAC / MEDEVACS sent vs patients transported - Test case in mass casualty situation with advanced medical first responders (18D trained) - Test case in mass casualty situation with standard combat medics Fixed: - Software design & engineering - Robotics/Surgery Suite Costs Variable: - Customer acquisition/sales - USAMMA procurement /sustainment resources - Medical Advisors - Testing facilities - AI/ML advisors - Need demand signal from BAS medical officers responsible for triage, treatment, and EVAC decisions - Need execution and active use by medics and first responders at BAS -Need implementation direction from DoD leadership Beneficiaries Mission AchievementMission Budget/Costs Buy-In/Support Deployment Value PropositionKey Activities Key Resources Key Partners
  29. Value Propositions and Beneficiaries Automated Continuous Monitoring Improved Intra-BAS Communication Increased Situational Awareness @BAS Medical personnel at a BAS Care providers at higher echelons of care Increased Situational Awareness/Preparation at higher Roles of Care Tactical personnel at a BAS
  30. “I have dozens of anecdotes of patients that have died or had poor outcomes, because the number of casualties overwhelmed capability to monitor or treat...” - LtCol DeLellis, Deputy Surgeon at the United States Army Special Operations Command
  31. “...active monitoring would likely have changed the outcome, for the better, for many of those patients.” - LtCol DeLellis, Deputy Surgeon at the United States Army Special Operations Command
  32. Mission Achievement: Save lives deemed survivable, where they are often lost
  33. 0 1 2 3 4 5 6 7 8 9 EmotionalState 10 Robotic Telesurgery ? What is the Problem? It’s a Management Problem! Who is this for? Beneficiary Buy-In Development Next Steps Our Journey
  34. Development - Data Entry Application
  35. Development - PA Interface
  36. Development - PA Interface
  37. Testing our Final MVP: 23rd Marine Regiment
  38. “[The MVP] would effectively eliminate the standard 15 minute interval between vital re-measurements by enabling continuous vitals monitoring.” - 23rd Marine Regiment Corpsman
  39. 0 1 2 3 4 5 6 7 8 9 EmotionalState 10 Robotic Telesurgery ? What is the Problem? It’s a Management Problem! Who is this for? Beneficiary Buy-In Development Next Steps Our Journey
  40. Internal Readiness Level Prototype of low- fidelity Minimum Viable Product
  41. Immediate Next Steps Hacking for Defense Spring 2017 Open Source GitHub
  42. Where do we go from here? - Secure funding sources for further development i.e. the AAMTI Award - Interface with Zephyr biopatch sensors - Work with USAMMA to develop formal requirement upon MVP screening - Explore field testing with a unit in a frequent deployment cycle i.e. the 101st Airborne
  43. Acknowledgements: - USAMMA: Amanda Love, Jay Wang, Nita Grimsley - TATRC: Daniel Kral, James Beach, Nathan Fisher - Mentors: Steven Hong, David Zinn, George Hasseltine, Seth Krummrich, Rafi Holtzman, Tammer Barkouki - MVP Feedback: Stephen DeLellis, Jeffrey Oliver, Michael Holloway, Erwin Villeros

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