The Air Force Research Laboratory has high hopes for a new, smartphone-based medical information software tool that can ingest sensor data for real-time health status monitoring for multiple patients.

Researchers launched field testing of the Battlefield Assisted Trauma Distributed Observation Kit, or BATDOK in the spring. They’ve now begun broader deployment and officials say they hope to have the tool in global use by the summer of 2018.

“We are taking legacy old school paper solutions and replacing them with a smartphone app,” said Dr. Gregory Burnett, the BATDOK program manager from the 711th Human Performance Wing, a unit assigned to the Air Force Research Laboratory at Wright-Patterson Air Force Base.

BATDOK also includes a medical library, manages electronic health records and is even interoperable with battlefield digital situation awareness maps, which can help users locate casualties. It also assists with documentation.

In the absence of such a tool, field medics have had to rely on a variety of paper-intensive processes.

“We have a ‘tactical casualty care card’ that has blank fields that they fill out with a pen. This is affected by the environment — rain, mud, blood. And then it is left to the next-stage provider to understand the chicken scratch on the card,” Burnett said.

A booming market

In seeking a digital avenue to improve care delivery, the Air Force is moving in step with the civilian healthcare industry, which has increasingly embraced the internet of things, or IoT, in the form of mobile diagnostic and record-keeping devices.

The global market for healthcare IoT should grow from $41.2 billion in 2017 to $158 billion in 2022 according to an April 2017 research report from MarketsandMarkets. Connected devices and smarter software are pushing that market forward.

Demand for mobile healthcare applications, known broadly as mHealth apps, should reach $111.8 billion by 2025, Grand View Research predicted in an August 2017 report. As in the military context, the rise on the civilian side is due to “growing penetration of smartphones … and growing focus on utilizing mobile technology to leverage healthcare delivery,” Grand View analysts note.

Medical sensor development

BATDOK developers looked to leverage commercial capabilities in developing their tool. The Android-based software can run on an Android smartphone or tablet and can be adapted for use on Windows and iOS devices. It can operate with equal effectiveness on commercial or military networks.

At the same time, some unique adaptations enable the software to deliver on the battlefield, where compute resources and network availability may be constrained. It’s been designed to manage the flow of information depending on network resources. In practical terms, this may mean sending through a written summary on a patient but keeping imagery or other data-rich details in queue until the network frees up.

When battlefields networks are congested, “it will hold back certain content and will throttle up and down to use whatever bandwidth is available,” Burnett said.

In terms of sensor input, medics can use the software to record vital signs such as heart rate, respiration, blood pressure. Developers say they built the capability on an open architecture framework, so that as new sensors come to market they can be easily incorporated. The rise in medical IoT makes this a likely scenario.

“Right now, the sensors that are used in the clinical world won’t survive when you take them out in the field, and they are expensive,” Burnett said. He foresees BATDOK supporting an emerging wave of disposal sensors and wearable medical devices in the near future.

“As a sensor aggregator, it puts all the vitals and sensors into an intuitive look and feel. That gives it an assessment mode, and you also can go into reference mode, to pull from the latest operating procedures, or a drug list, or even instructions on how to do certain procedures,” Burnett said.

BATDOK also can draw on soldier location data. Using a development tool known as ATAK — Android Team Awareness Kit, the research team has enabled BATDOK to present geolocation data, with color-coding to indicate a patient’s health status.

The software also can allow a medic to monitor multiple patients simultaneously, using automated routines monitor sensor data and send alerts in case status changes. “The medics are doing a number of things, and they need to be alerted when vitals trend upwards or downward, so they can provide more care as appropriate,” Burnett said. “This frees them up to provide care to more patients simultaneously.”