An Integrated Clinical Ensemble (ICE) for Autonomous Critical Care in Deep Space

The highly dynamic nature of Critical illness on deep space missions will require Astronaut crews to provide completely autonomous, Earth independent, Medical care. Critical care in an ideal well staffed and equipped Intensive Care Unit (ICU) hospital environment on Earth requires teams of expert caregivers function as highly coordinated teams with immediate access to telemedicine and evacuation. Critical care in space will be delivered with extremely limited resources, by a team of non-expert caregivers led by a single crew medical officer, in a small confined space. An Integrated Clinical Ensemble (ICE) that functions as a hearing, seeing, and speaking crew member will assist crews with intensive management of these complex patients when combined with the clinical reasoning ability of an Autonomous Medical Response Agent (AMRA) AMRA is a multi-criteria feedback control Bayesian clinical decision support tool developed for NASA. AMRA’s Bayesian graphs calculate post-test likelihood of possible disease states, clinical outcomes, and mission outcomes (Medical-101). Levels of expertise, inventory, and crew preferences personalize guidance, allow calculation of Equivalent system mass resource costs (Medical-201 and medical system trade space analysis (Medical-301). AMRA’s outcome graphs estimate the current and future multi-system state health from diagnostic and treatment data to provide an estimated risk prognosis. AMRA sends all data back to mission control and will reduce mission resource costs (Medical-701). The primary objective of this Phase I is to build upon AMRA to establish the feasibility of an explainable, Integrated Clinical Ensemble (ICE) that incorporates multiple streams of input to integrate Bayesian prognostic causal network, and is therefore able to explain and coordinate the simultaneous collaborative delivery of Critical Care with multiple human crew mates both on Earth and in Space as an integrated exploration medical system (Medical-501)

An Integrated Clinical Ensemble (ICE) combines multimodal sensor inputs (physiological, vision, speech, environmental, vehicle signals) with Bayesian causal and critical care intervention graphs to schedule and guide NASA Astronauts to provide immediate, autonomous, resource constrained critical care in an Earth Independent manner while on deep space missions. This core capability will enable NASA to pursue it's agenda of long duration human exploration to deep space destinations.

Military: Remote autonomous critical care is essential for warfighters in peer, or near-peer combat where casualties are expected to be far greater than current military health capacity. Civilian: Critical care is in increasing demand. Tele-ICU is currently a $7.3 billion industry, an Integrated Clinical Ensemble (ICE) will increase capacity to provide evidence based critical care globally.

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