MITRE Helps Deliver Lifesaving Innovation in Remote Critical Care

At the height of the pandemic, nearly 90 percent of respiratory care leaders believed there was a shortage of respiratory therapists in their regions, a new study finds. And COVID-19 was defined by respiratory transmission, which meant each entry into a patient’s room put nurses and operators at risk.

They needed the ability to manage these devices through a single source—ideally, a remote source. Fortunately, it’s being developed, and MITRE was recently recognized for work helping make it a reality.

Creating Critical Care in Austere Conditions

At the start of the pandemic, MITRE worked with the U.S. Army Telemedicine and Advanced Technology Research Center’s (TATRC’s) Technology in Disaster Environments (TiDE) program to determine ways to bring the power of telemedicine to frontline and remote locations.

The goal: Create the ability to remotely control infusion pumps, ventilators, and other vital devices in areas with insufficient local support.

By connecting this equipment to remote operators around the country, overwhelmed field hospitals and disaster sites could tap into off-site expertise to treat more patients more efficiently.

This technology could literally save lives—if the systems could connect and communicate.

The TiDE program, which includes the National Emergency Tele-Critical Care Network (NETCCN) project, manages almost a dozen government contractors aimed at creating a remote-control emergency room in an austere environment. Unlike other government contracting projects where each step is managed individually and sequentially, these contracts are simultaneous and overlapping.

“NETCCN addresses a fundamental challenge during the pandemic, disasters, and large-scale combat operations: where there aren’t intensive care units, there aren’t the kind of specialized clinicians needed to care for severely wounded or sick patients. And during surges, even the most well-equipped health systems are resource constrained,” said Matt Quinn, science director for TATRC.

TATRC turned to MITRE for expertise for help managing the process to develop the remote-control capabilities and integrate these capabilities with NETCCN through the new Device Interoperability and Autonomy Coordinating Center (DIACC). The DIACC is a unique collaboration among public and private entities focused on delivering products designed to work in a complete ecosystem, preventing the creation of individually developed, one-off products, as happens in traditional government contracting environments. The end goal: a single operating system comprised of different devices at different hospitals from different manufacturers and operators.

Building in Cybersecurity for a Safer Future

Using telemedicine to manage critical care unsurprisingly generates fears about cybersecurity. The idea of hackers holding patients’ literal air supply hostage is a major concern.

As operator of both the National Cybersecurity and Health FFRDCs, MITRE is uniquely equipped to tackle the medical cybersecurity challenge. We’ve long worked with the Food and Drug Administration (FDA) and the MITRE ATT&CK^® framework to plan threat modeling, testing, and identification of cyber risks to the healthcare system. MITRE has even developed cyber security playbooks focused on the unique threat posed to medical devices.

For the DIACC, we’re working with the FDA, the Department of Health and Human Services, device manufacturers, healthcare workers, critical care technicians, and others to ensure they can collaborate. It means ensuring that devices are compatible within a single system, operators know how to use them, and commercial companies can trust we will protect their valuable data. It’s the type of project MITRE specializes in.

“MITRE acts as that objective third party,” project lead Amy Cotter said. “Companies can collaborate and share product development information through the DIACC and with MITRE, without worrying about competitors gaining an advantage.”

A Disruptive Idea Delivers Results and Recognition

The potential of developing an innovative, safer, and more efficient lifesaving system is driving the team forward, and the potential continues to grow.

The innovative ideas have already garnered high praise from the sponsor and from outside groups. The DIACC won Fed Health IT’s Disruptive Tech Program Award for 2022.

“It’s exciting to be part of something that’s such a game changer for healthcare delivery. To have that acknowledged by a body that recognizes innovative disruption is fantastic,” said Alice Isenberg, the DIACC task lead.

“What’s also been great,” she added, “is to see the excitement of our sponsor and how engaged they are in the work. It fuels us to want to keep going and do bigger and better things.”

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