Imagine the year is 2030. There are computers in every ambulance that can determine if someone is bleeding internally simply from their vital sign readings. Sounds like the introduction to a science fiction novel, right? Thanks to one man and his team, this technology is real and it’s being used everywhere from the battlefield to your neighborhood in order to save lives.
Jaques Reifman, Senior Research Scientist at the Department of the Army sat down with Christopher Dorobek on the DorobekINSIDER to talk about the Automated Processing of the Physiological Registry for Assessment of Injury Severity (APPRAISE) system that uses artificial intelligence to improve survival rates among trauma patients.
Reifman and the APPRAISE team are currently finalists in the Science and Environment category for the Partnership for Public Service’s Service to America Medals, or the SAMMIES—an award that recognizes all of the awesome people fostering innovation in the public sector.
Reifman started the APPRAISE project to save lives. In order to save lives, they took a few calculated steps. First, they looked at how Americans were dying at home and abroad. From this research, they found that both soldiers and civilians were dying unnecessarily because of uncontrolled bleeding. Reifman explained that often times in the field, it is hard to tell if a trauma victim needs to be transported to a center and how massive of a blood transfusion they will need once they make it to a trauma center. APPRAISE takes out this guesswork while sustaining the patient’s life while they are being transported.
APPRAISE uses artificial intelligence and pattern recognizing algorithms to interpret patients’ vital signs. “We have trained a computer system to understand patterns in a trauma patient’s vital signs that are associated with life threatening conditions and once these signs are identified, the system can tell the user the likelihood of the patient having a life threatening condition,” Reifman explained.
This is critical when transporting trauma patients from the scene of the accident to a trauma center. Reifman explained his team, “has deployed the APPRAISE system in the Boston area where it is able to determine from the point of injury through arrival at the trauma center the likelihood and severity of internal bleeding and alert the receiving hospital of the status of the patient.” This information helps determine if a patient needs immediate helicopter transport or if the patient is stable and does not need immediate evacuation. Essentially, “it can be used for triage in determination for immediate evacuation,” Reifman said.
APPRAISE’s capabilities are also transforming how the military approaches medical transports in war zones. Reifman identified, “the number one opportunity to save lives in the battlefield is at the point of injury.” As a result, recognizing and treating those victims who have uncontrolled bleeding is critical to saving soldiers’ lives.
Despite the incredible innovation, APPRAISE did not come about without challenges. Reifman explained, “the system had to be small but also fully automated and able to work without human inference or input.” Additionally, the system would have to be able to work if vital signs were corrupted by noise in the helicopter.
However, more significant than technological challenges were operational challenges. Reifman emphasized that the technology has to work once it leaves the laboratory and is handed off to a third party. For example, the initial computer they were using needed to be turned on with each new patient. This was impractical in the field because practitioners would forget to turn the computer on. As a result, they redeveloped the system so they computer was always on. Reifman explained, “the system would wake up when there’s a new patient and go to sleep when the patient arrives at the hospital.”
Some APPRAISE’s kinks are still being worked out but Reifman explained that it is the dedication of his interdisciplinary team that has helped overcome these obstacles. He and his team, “identify problems and put together the correct skillsets which means we went out and found clinicians, medics and other folks that were needed to complete our skillsets to solve the problem,” he said. By going outside his skillset, Reifman was able to tap into other disciplines for the most effective outcome.
In the end, civil servants working together to solve tough problems is what makes working for the government rewarding for Reifman. He explained, “for me, I cannot think of anything more worthwhile or meaningful than the work we do.” However, this work and innovation would not be possible if not for Reifman and the members of his team. He concluded, “no one does this because they are going to win an award, we do it because we have a passion and believe in the mission.”
The SAMMIES’ are right around the corner so if you haven’t already learn about the other incredible finalist and be sure to cast your vote for the People’s Choice Award to make sure your favorite govie is recognized!