SRI is working on a mobile healthcare platform that aims to improve healthcare access and health outcomes across rural America.
Rural healthcare in the United States is at a tipping point. According to the federal Advanced Research Projects Agency for Health (ARPA-H), more than 100 hospitals in primarily rural areas have closed in the past 10 years, while another 600 (30% of all rural hospitals) are at risk of closing due to budgetary challenges. At the same time, data show that rural populations experience worse health outcomes than their urban counterparts.
To reduce this troubling gap in health outcomes, ARPA-H launched the Platform Accelerating Rural Access to Distributed and Integrated Medical Care (PARADIGM) program. The vision for PARADIGM is ambitious: a vehicle-based platform that can provide advanced hospital-level healthcare services — from cancer screenings to CT scans to prenatal services — in remote locations.
SRI was recently awarded an ARPA-H contract to provide two key components of the PARADIGM platform: A software system that connects the platform’s medical devices to electronic health records (EHRs) and a task guidance system that provides real-time decision support to help a caregiver perform clinical procedures.
The PARADIGM vision
According to ARPA-H, the components of the PARADIGM platform will be designed to solve multiple challenges around delivering healthcare in rural areas.
Satellite-based internet, for example, will create a secure data pipeline between the vehicle and the larger healthcare system. The platform’s software systems will also be designed to rapidly onboard new medical devices and integrate with patient electronic health records (EHRs). Smaller radiology equipment (think miniaturized stationary CT scanners) will fill what the agency calls “rural radiology deserts.” AI-powered intelligent task guidance tools will enable the platform to be operated by a single healthcare worker rather than multiple doctors and nurses.
Ultimately, these systems should cohere into a platform that cost-effectively delivers hospital-level care that is as convenient as telehealth.
Solving the healthcare data portability challenge
One of the challenges PARADIGM addresses is the complexity of patient medical records. Even when two healthcare systems operate with the same enterprise software platforms, they struggle with seamlessly exchanging data. Each implementation tends to be highly customized, and data field mismatches are rampant.
When a system consisting of numerous medical devices needs to connect with an array of EHR systems, the difficulties only compound.
To solve this problem, SRI, in collaboration with BayLibre, is building a new medical IoT (Internet of Things) system called POET for the PARADIGM platform. It explores new ways to consolidate disparate health data, building on SRI’s decade-long experience in AI, automation technologies, and providing software solutions for the interoperability of systems at the Department of Defense. POET aims to provide simple “plug-and-play” onboarding for many medical devices, while also building in cybersecurity protocols designed to protect a healthcare system that is increasingly being targeted by bad actors.
Boosting care efficiency through task guidance
The mobile care unit envisioned by the PARADIGM program won’t be cost-effective if it requires multiple doctors and other medical staff to spend hours on the road.
To address the challenges, SRI, in collaboration with Mayo Clinic and the University of Florida, is developing an intelligent task guidance system using the latest AI technology, which enables general healthcare workers to perform clinical procedures using various medical devices without involving experts. This solution, designed for easy use and adaptable to diverse clinical procedures, will reduce training requirements, increase accessibility in rural areas, and enhance healthcare efficiency, ultimately lowering costs while improving patient outcomes.
A bright future for rural healthcare
No one solution can plug all of the gaps in rural healthcare, but it’s clear that proximity is key. To take advantage of today’s world-class healthcare technologies, individuals need solutions that meet them where they are. Geographically distributed clinics and hospitals will help. For the many healthcare situations that will inevitably fall through those cracks, PARADIGM presents a compelling path forward.
This research was funded, in part, by the U.S. Government. The views and conclusions contained in this document are those of the authors and should not be interpreted as representing the official policies, either expressed or implied, of the U.S. Government.
