new medical technology

Future Dog Tags

Tommy Morris knows the challenges of battlefield medicine. As a front-line medic with the Army's Third Infantry Division in 1993, he struggled to treat the soldiers under his care in war-torn Macedonia. Frustrated by rainstorms soaking through paper medical reports, he vowed to bring medical recordkeeping into the digital age. "I kept thinking, There's got to be a better way," recalls Morris, now 38 and chief information technology officer at the Army's Telemedicine and Advanced Technology Research Center in Fort Detrick.

In 2001, Morris created that better way by designing a new software product called BMIST, which allows medics to enter casualty information into a handheld device. Short for Battlefield Medical Information System-Tactical (and pronounced "bee mist"), the software allows medics to generate an electronic health record about a soldier for later retrieval by frontline doctors or a stateside hospital. In addition, it acts like a medical textbook, so medics can look up diagnostic and treatment information in a combat zone. Already, BMIST software has been licensed to military departments and civilian hospitals in the United Kingdom. Pilot programs are being set up in France and Canada. First responders in the United States are also using it to record medical information on victims of disasters like Hurricane Katrina.

But BMIST is only one of several advances revolutionizing the management of patient information. Since 2005, the U.S. Army Medical Research and Materiel Command has experimented with the Electronic Information Carrier. The EIC is a dog-tag-size wireless data device worn by soldiers that can store up to two gigabytes of data--literally thousands of pages of records. Rather than having to search through a soldier's uniform for information on blood type or allergies, medical personnel can easily access that information up to 30 feet away with the electronic dog tag.

At the same time, all the military branches are adopting an all-digital medical information system through an initiative called Armed Forces Health Longitudinal Technology Application (AHLTA). Its goal is to electronically track the illnesses, allergies and prescribed medicines of all 9.2 million service members and veterans. When these advances are combined, medical workers will have access to the complete health records of even unconscious soldiers. This will allow them to determine whether a person has been exposed to a chemical agent, and it will also prevent deadly drug interactions. Over the past five years, AHLTA has identified and resolved more than 200,000 potentially life-threatening drug conflicts.

But Morris believes these benefits are only the beginning. He foresees integrating BMIST with a sensor that will automatically alert a doctor when a veteran's pacemaker is malfunctioning--"like in Star Trek," he says. And medics in the near future will be able to wave a handheld BMIST device over a wounded soldier, save the patient's vital signs on an EIC, and take comfort in knowing that the medical chart will follow the patient for the rest of his life.

Smart Pain-Blockers
For over a century, doctors have treated seriously wounded soldiers with morphine, all the while knowing the narcotic's downsides. It impairs breathing, reduces decision-making abilities and, if taken over time, can be addictive. But three years ago, researchers funded by the Defense Advanced Research Projects Agency (DARPA) reported a remarkable alternative: a nonaddictive pain-blocker. While investigating the biochemical origins of pain, they developed an experimental drug--actually, a synthetic antibody known as RN624--that inhibits a molecular pain messenger called nerve growth factor. The powerful antibody keeps the brain from receiving pain messages sent by nerve endings surrounding an injury. And the drug is long-lasting; a single dose can block pain for several weeks. Best of all, it has no addictive side effects.

"A wounded soldier may get one dose on the battlefield that can take care of any pain until he's evacuated to a hospital days later," says Brett Giroir, MD, deputy director of DARPA's Defense Sciences Office in Arlington, Virginia. RN624 was developed at Palo Alto-based Rinat Neuroscience Corporation, which was bought by Pfizer last year. Pfizer is conducting clinical trials on the drug and hopes to market it. According to Dr. Giroir, "This could revolutionize the way we treat pain."

Prosthetics With Thought Control
While some of the military's medical initiatives are years away from fruition, they have astonishing promise. At DARPA, it's hoped that an ambitious four-year, $48 million Revolutionizing Prosthetics Program will result in the creation of artificial human arms and hands controlled by brain waves. Already, researchers have found success with primates. At the University of Pittsburgh, scientists taught a monkey to feed itself using thought-generated impulses picked up by the electrodes of a prosthetic arm. "The monkey was able to move the robot arm out, grab a zucchini chip and bring it back to its mouth just by thinking these motions," says Col. Geoffrey Ling, MD, program manager of DARPA's Defense Sciences Office. "It was phenomenal."

The next goal is to adapt the technology to people, says Dr. Ling, and scientists are conducting the first human trials with paraplegics and patients who have Parkinson's disease. DARPA's timetable calls for completing a working prosthetic arm and hand by the end of the year that will look, feel and perform like natural limbs. Two years later, it hopes to apply for FDA approval for a working, neurally controlled model.

Having served as a military physician in Afghanistan and Iraq, Dr. Ling knows the urgency in bringing these advances to life--"for the good of the troops," he says. But he also knows that medical breakthroughs born of war aid all humanity: Blood banks, penicillin and reconstructive surgery all emerged from past conflicts. "Perhaps thought-controlled prosthetics will be one of the miracles that comes out of the war in Iraq," says Dr. Ling. "In adversity, there's opportunity."