• Taking Telemedicine to the Front Lines

    Jeffrey M. Soares

    A medic from the 1st Stryker Brigade Combat Team, 25th infantry Division uses TEMPUS Pro in a tactical evacuation vehicle to assess a patient, record vital signs, and transmit telemetry and the patient’s Tactical Combat Casualty Care Card to the Brigade Surgeon at Fort Wainwright, AK, in January 2011. (U.S. Army photos by TATRC.)

    In an age of smartphones and high-tech gadgets galore, it may be surprising to hear that one of the next “big things” coming out of the electronics arena is being spearheaded by the U.S. Army Medical Research and Materiel Command (USAMRMC) at Fort Detrick, MD. 

    Since 2009, the USAMRMC has been directing, developing, and refining handheld telemedicine devices that could help save lives in theater. The culmination of this effort is drawing near for one of the candidate projects. 

    “The TEMPUS Pro is an advanced compact telemedicine system intended to support combat casualties in forward areas near point-of-injury on the battlefield,” said Dr. Gary Gilbert, Chief of the Knowledge Engineering Group for USAMRMC’s Telemedicine and Advanced Technology Research Center (TATRC). “The unit provides a capability for ‘point-of-injury data capture,’ which is a critical gap we are trying to fill.”

    A potentially important resource for medics in the field, the TEMPUS Pro combines three devices into one handheld module, allowing for immediate communication with other units, pre-hospital monitoring of patient vital signs and telemetry data, and telementoring instruction from more experienced medical providers to less experienced combat medics in theater. 

    The unit also provides real-time audio and video capability, which is extremely useful in transmitting images of the wounded patient immediately to physicians at distant locations. A transcription feature for hands-free voice data input is on the horizon.

    Born of a British commercial product developed for use on aircraft, the TEMPUS Pro is the result of a collaboration involving eight DoD organizations:  TATRC; Medical Communications for Combat Casualty Care; Defense Health Information Management System; U.S. Army Aeromedical Research Laboratory; U.S. Army Institute of Surgical Research; U.S. Army Medical Materiel Agency; U.S. Air Force Medical Evaluation Support Activity; and Office of the Command Surgeon, U.S. Joint Forces Command.

    The USAMRMC team sees the opportunity for widespread use of the TEMPUS Pro in theater. About 25 units have been distributed to Special Operations commands for trial use, and the results have been positive.

    Designed to be lightweight, mobile, and rugged, the TEMPUS Pro is intended for use with tactical communication radio networks that support Internet Protocol-based transmission, so that signals can be sent out digitally over classified and nonclassified systems. With this unit, personnel can transfer data from one device to another—from the ground to the helicopter to the hospital—keeping the patient’s medical information intact during transport out of the field. 

    Using either the standard military first responder medical data card, called the Tactical Combat Casualty Care Card, or a wireless “smart dog tag” that the Soldier could carry or wear, the patient’s vital records can be exchanged wirelessly between various systems and eventually placed into a permanent medical record. Using this secure digital system, data are neither lost nor compromised.

    While storage of patient data is important, the device’s capabilities for transmitting both still photos and live video of injuries are essential for medics in the field. 

    Using the TEMPUS Pro, medics can quickly assess severe injuries and send real-time images to experienced surgeons off-site. The physician-mentor can immediately guide the medics through life-saving techniques instead of delaying effective treatment.  

    With ultrasound and laryngoscope capabilities in the works, the effectiveness of the field medic will increase exponentially. The ability to capture and transmit internal images will afford a more complete assessment of patient trauma, leading to more accurate diagnoses and treatment.

    TEMPUS Pro was tested within tactical vehicles to monitor and transmit real-time patient telemetry data over tactical radios during the Army’s Command, Control, Communications, Computers, Intelligence, Surveillance, and Reconnaissance On-the-Move communications integration exercise at Fort Dix, NJ, in July.

    The USAMRMC team sees the opportunity for widespread use of the TEMPUS Pro in theater. About 25 units have been distributed to Special Operations commands for trial use, and the results have been positive.

    Gilbert said the estimated price per unit is “in the ballpark” of the Propaq medical device currently used by the U.S. military, although the TEMPUS Pro has additional capabilities that are potentially more useful to the field medic.

    “The medics from the USAMRMC, Special Operations Forces, Air Combat Command, and 1-25th Stryker Brigade Combat Team who have trained on this device said they like the unit and believe it would help tremendously in the field,” said Gilbert.

    The TEMPUS Pro has been selected for the Army’s Network Integration Evaluation exercise to be held at Fort Bliss, TX, beginning in April 2012. The device will be field-tested for two months to determine its operational effectiveness within infantry brigade combat teams. The TEMPUS Pro has also been chosen for testing in a Marine Corps Warfighting Laboratory limited objective experiment scheduled for August. 

    The USAMRMC team, including Gilbert, believes these two rigorous tests should help to validate the applicability and usefulness of the TEMPUS Pro. The anticipated success of the device in these exercises may help to confirm its potential for treating—and saving—wounded Soldiers on the battlefield.


    • JEFFREY M. SOARES is a Communications Specialist with USAMRMC Public Affairs. He holds a B.S. in secondary education and English from the University of Scranton and an M.A. in English language and literature from the University of Maryland.

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