Military Health System Research Symposium (MHSRS) 2016 General Report
Tuesday, August 30, 2016
Posted by: Kate Oesterle
Below is an overview the MHSRS and some of the key presentations. We also provide G2G’s insights and recommendations from this year’s conference in Orlando, Florida August 14-18th. It includes a summary of key presentations, top FY2017 priorities, and current military requirements needing innovation. Please let us know if you have any questions or would like additional information.
This year, MHSRS focused on 4 topics through the breakout sessions and poster presentations. These topics highlight current DoD health priorities: Infectious Disease, Psychological Health, Traumatic Brain Injury, and Injury Prevention, each with subcategories that further break down the areas. While not a designated topic, Health Informatics and Information Technology was also given a lot of attention during breakout sessions and plenary sessions, demonstrating DoD’s focus on improving technologies, data acquisition, analytics, and secure systems to share data in a unique field setting.
Keynote – Dr. Karen Guice, MD, MPP – Deputy Assistant Secretary of Defense for Health Affairs
- Dr. Guice presented on Military Medicine Preparedness, stressing that the DoD must be more agile in its response to changing medical needs and where it puts research resources in order to more efficiently cater to changing medical priorities.
- She urged the scientific community to engage her: @DrGuiceMHS – Tweet her if your work is presented, if you do a poster, or publish your results and she will post it.
- A top DoD goal is to expand the collaboration between academia, industry, and a range of government agencies in order to find solutions faster and limit redundancies.
• 2016 Priorities and Current Research Initiatives
o Cancer Moonshot: John P. Murtha Cancer Center at Walter Reed Bethesda, NCI, EPA, NIH, FDA, Department of Energy, Department of Commerce, VA – all working together to improve the patent process, make the FDA approval process more streamlined and effective, and use EPA data to broaden our knowledge of environmental factors that lead to cancer.
o Precision Medicine – government wide partnerships, including the DOD and VA, to expand data acquisition, storage, and analysis of genomic information.
o Antibiotic Resistant Bacteria: Started as a 2015 White House Initiative. The DoD is making this a priority along with its global partners.
o NCAA-DoD Grand Alliance on TBI – Concussion Assessment Research Education (CARE) Consortium. This program focuses on the diagnosis and treatment of mild TBI.
o Next Generation Resuscitation – Working to create more portable, field-deployable solutions for hemostasis, monitoring vitals, and other systems that will bring innovations to the current standard of care.
o Adenovirus-related Research – Due to close quarters in barracks, there is a DoD specific need to address vaccines, prevention, and treatment of adenoviruses.
John Holcomb, MD – The Center for Translational Injury Research, The University of Texas Health Science Center at Houston, Houston
- Focused on the need for improved trauma care, not just for DoD healthcare but also for the civilian population. With 47,790 US trauma deaths in 2014, trauma remains the #1 cause of death for those 1-47 years old, far outpacing cancer. During the war in Iraq, there were 1,000 potentially preventable deaths and each year, there are 150,000 potentially preventable civilian deaths.
- Recommends better leadership structure to assess traumatic injury, creating a White House-level organization that is dedicated to diagnosis, prognosis, and treatment of these injuries through a more streamlined R&D approach, and can create a national plan with a goal of zero preventable trauma deaths.
- Recommended National Academy of Medicine’s trauma report, esp. 4-page summary.
RADM Colin G. Chinn, USN – Director of Research, Development and Acquisition, DHA and MG (ret) Richard Thomas, MD, DDS – President, Uniformed Services University of the Health Sciences
- He said Military Health System (MHS) needs to find ways to accelerate innovation and more agilely respond to emerging healthcare threats. New areas to watch for include directed energy weapons, sonic weapons, emerging infectious diseases, prolonged field care and en route care, burns, and environmental hazards like smoke inhalation. With over 150,000 deployed to 100 countries in 5 named operations, including combat, humanitarian, and relief missions, the health threats are diverse so need to be ready.
- As part of National Capital Consortium, the Uniformed Services University is training 171 medical students, psychology students, and doctors. He is also collaborating among the 3 DoD Centers of Excellence: the Defense and Veterans Brain Injury Center, the Deployment Health Clinical Center, and National Center for Telehealth and Technology, which have $300M in research funding.
- He emphasized a need to save money in R&D, which means that DoD needs to get more products to field, share knowledge more broadly, and receive better return on investments to report back to Congress in order to maintain and grow funding levels.
Key Take-Aways from MHSRS:
Medic Training & Lack of Personnel:
- Lack of access to ample medical training and often understaffed medical personnel, coupled with harsh environments and the need to provide Prolonged Field Care (72 hours), make innovations for field use that can enhance first responders’ abilities to diagnost and treat as close to POI as possible with the least amount of training possible in high demand. Specifically, MHS wants systems that can aid in monitoring, diagnosing, and treating traumatic injuries in theater and in hospital and throughout chronic care continuum.
- Only 1% of current data acquired is being analyzed, and that percentage is expected to go down as more data is acquired and analysis fails to keep up. This is a huge priority.
- Currently, Defense Health Agency (DHA) is working collaboratively to find a vaccine for Zika and is close to human trials.
- With infectious disease, outbreaks die down and with that so does the opportunity to test on human cases. DoD has noted that they must have faster response time to emerging threats to find vaccines and cures for these outbreaks.
- HIV/AIDS is a continuing concern within DoD. Even though the overall number infected is small (300-500), the cost is $417M over their lifetimes for the MHS. MHS is working on two vaccines that could slow down and even prevent the outbreak of HIV/AIDS in the future.
- Skin and soft-tissue disease is also a priority. The need for cleaning wounds and treating infections, esp. fungal infections, in the wake of antibiotic resistance is essential—any solutions that avoids the usage of drugs and drug resistance are a high priority.
- The TBI diagnostics and treatment continue to be a challenge, although the breakout sessions offered insights into some new treatment options. The DoD still struggles with detecting mild TBI in images. Also, with the inconsistent outcomes of different levels of TBI and the patient’s ability to recover, more research needs to go into predicting recovery times and improving the overall ability to determine a prognosis for each patient.
- The funding for TBI R&D has gone up and down in recent years due to the budget deal and sequestration. Appropriations totaling $300M—$150M each for TBI and psychological health (including PTSD)—were initially assigned to the CDMRP for research and development, but this has faced significant cuts. In talking to DoD Program Managers, it is clear this is still a high priority and they are pushing back against these cuts in FY16, FY17 and FY18 budgets.
- Psychological health is also a priority, and alternative therapies are being studied.
- Sleep deprivation and its role in PTSD and other disorders are of high concern to the DoD.
- Many leaders at the conference noted too many injuries and deaths occur during training, which opens up the physical area where innovations are needed to improve the healthcare of warfighters.
- Monitoring innovations that collect data on and analyze warfighter performance, vital signs, hydration, BMI, sleep deprivation, and muscle strength and fatigue are all high priorities for DoD.