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The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically- relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm of medical data management on the International Space Station. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products derived from the third MDA prototype development will directly inform exploration medical system requirements for Level of Care IV in Gateway missions. In fiscal year 2019, the MDA project developed Test Bed 3, the third iteration in a series of prototypes, that featured integrations with cognition tool data, ultrasound image analytics and core Flight Software (cFS). Maintaining a layered architecture design, the framework implemented a plug-in, modular approach in the integration of these external data sources. An early version of MDA Test Bed 3 software was deployed and operated in a simulated analog environment that was part of the Next Space Technologies for Exploration Partnerships (NextSTEP) Gateway tests of multiple habitat prototypes. In addition, the MDA team participated in the Gateway Test and Verification Demonstration, where the MDA cFS applications was integrated with Gateway-in-a-Box software to send and receive medically relevant data over a simulated vehicle network. This software demonstration was given to ExMC and Gateway Program stakeholders at the NASA Johnson Space Center Integrated Power, Avionics and Software (iPAS) facility. Also, the integrated prototypes served as a vehicle to provide Level 5 requirements for the Crew Health and Performance Habitat Data System for Gateway Missions (Medical Level of Care IV). In the upcoming fiscal year, the MDA project will continue to provide systems engineering and vertical prototypes to refine requirements for medical Level of Care IV and inform requirements for Level of Care V.

The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm. The medical system requirements are being developed in parallel with the exploration mission architecture and vehicle design. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products supported by current prototype development will directly inform exploration medical system requirements.In fiscal year 2018, the MDA project developed Test Bed 2, the second iteration in a series of prototypes with functionality focused on data security through role-based access control and encryption, integration with One Portal exercise software and ingestion of an ultrasound Digital Imaging and Communications in Medicine (DICOM) file and image display. Test Bed 2 advances the medical data system architecture framework by providing these functionalities in a scalable system that maintained a layered, modular design. The architecture framework uses a data services approach with role-based access to data in a customized medical record system suitable for space exploration. These functionalities were demonstrated as part of the Next Space Technologies for Exploration Partnerships (NextSTEP) ground test demonstrated at the NASA Johnson Space Center Integrated Power, Avionics and Software (iPAS) facility. Interfacing to a Core Flight Software (CFS) system, the MDA system, using Consultative Committee for Space Data Systems (CCSDS) protocol, transferred an exercise file from the simulated flight MDA system to a mirrored MDA system on the ground through the CFS system. The selection of data sources and demonstrations enabled the team to address stakeholder concerns throughout the development process. In the next iteration, the MDA team will work with stakeholders to identify additional relevant functionalities to further advance system data models, standards and principles that will inform the medical system requirements development.

The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm. The medical system requirements are being developed in parallel with the exploration mission architecture and vehicle design. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products supported by current prototype development will directly inform exploration medical system requirements.

The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm. The medical system requirements are being developed in parallel with the exploration mission architecture and vehicle design. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products supported by current prototype development will directly inform exploration medical system requirements.

In support of the NASA Human Research Program Exploration Medical Capability (ExMC) Element, NASA Ames Research Center (ARC) established a collaborative effort with the Canadian Space Agency (CSA). The collaboration focuses on leveraging CSA capability in the areas of biosensors and decision support that will augment future development of such components for Exploration Missions. The CSA advancement of biosensors enables NASA to focus on the integration and data management associated with these types of components through the system currently under development by the Medical Data Architecture (MDA) project. This approach has enabled the establishment of a successful collaborative working relationship between ExMC and CSA.Applying lessons learned from the fiscal year 2016 (FY16) Human Exploration Research Analog (HERA) campaign, CSA and NASA ARC developed a solution to provide real-time feedback to researchers who monitor the collection of vital signs data from a wearable Astroskin garment. The advances in the interfaces included the development of an iPad application (by CSA) to wirelessly forward the vital signs data to the MDA system, which collected the vital signs data through a receiver developed by NASA ARC. The development of these interfaces aims to provide communications between the Astroskin and the MDA system such that data may be seamlessly collected, stored and retrieved by the MDA. The first steps towards this goal were demonstrated in FY16. In FY17, ExMC will complete the first in a series of test beds that establishes a system to automate collection and management of vital sign data from the Astroskin, and other sources of data, to provide information for a crewmember to make medical decisions. In addition, the MDA Test Bed 1 will enable CSA to evaluate and optimize biosensor advancement and facilitate decision support algorithm development.

The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current International Space Station (ISS) medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable an increasingly autonomous crew than the current ISS paradigm. The MDA will develop capabilities that support automated data collection, and the necessary functionality and challenges in executing a self-contained medical system that approaches crew health care delivery without assistance from ground support.To attain this goal, the first year of the MDA project focused on reducing technical risk, developing documentation and instituting iterative development processes that established the basis for the first version of MDA software (or Test Bed 1). Test Bed 1 is based on a nominal operations scenario authored by the ExMC Element Scientist. This narrative was decomposed into a Concept of Operations that formed the basis for Test Bed 1 requirements. These requirements were successfully vetted through the MDA Test Bed 1 System Requirements Review, which permitted the MDA project to begin software code development and component integration. This paper highlights the MDA objectives, development processes, and accomplishments, and identifies the fiscal year 2017 milestones and deliverables in the upcoming year.

Mission constraints will challenge the delivery of medical care on a long-term, deep space explorationmission. This type of mission will be restricted in the availability of medical knowledge, skills, procedures and resourcesto prevent, diagnose, and treat in-flight medical events. Challenges to providing medical care are anticipated, includingresource and resupply constraints, delayed communications and no ability for medical evacuation. The Medical DataArchitecture (MDA) project will enable medical care capability in this constrained environment.The first version of thesystem, called Test Bed 1, includes capabilities for automated data collection, data storage and data retrieval to provideinformation to the Crew Medical Officer (CMO). Test Bed 1 seeks to establish a data architecture foundation and developa scalable data management system through modular design and standardized interfaces. In addition, it will demonstrateto stakeholders the potential for an improved, automated, flow of data to and from the medical system over the currentmethods employed on the International Space Station (ISS). It integrates a set of external devices, software andprocesses, and a Subjective, Objective, Assessment, and Plan (SOAP) note commonly used by clinicians. Medical datalike electrocardiogram plots, heart rate, skin temperature, respiration rate, medications taken, and more are collectedfrom devices and stored in the Electronic Medical Records (EMR) system, and reported to crew and clinician. Devicesintegrated include the Astroskin biosensor vest and IMED CARDIAX electrocardiogram (ECG) device with INEED MDECG Glove, and the NASA-developed Medical Dose Tracker application.The system is designed to be operated as astandalone system, and can be deployed in a variety of environments, from a laptop to a data center. The system isprimarily composed of open-source software tools, and is designed to be modular, so new capabilities can be added. Thesoftware components and integration methods will be discussed.

For future human exploration missions, NASA needs a health monitoring system composed of hardware that is compact, fully interoperable with an integrated data management system, and requires minimal consumables. Such a system will be achieved through the integration of small, easy to use biomedical sensors that will have the ability to measure, store and transmit physiological parameters during operational and ambulatory activity. Since 2012, the Canadian Space Agency (CSA) has been active in funding the development of wearable biomonitoring sensors. The Astroskin is the first prototype and consists of a shirt-based garment and headband with embedded sensors, and associated software and technology that measure vital signs, sleep quality and activity level of the wearer. NASA and CSA have been collaborating since 2014 to test and validate this system in a lab environment at Ames Research Center and more recently in the Human Exploration Research Analog (HERA) located at Johnson Spaceflight Center. Specific objectives of the HERA study were: 1) to assess the performance of the Astroskin biosensor system for long-term health monitoring (24-hours) capabilities and during exercise as a measure of crew fitness; 2) to obtain crew feedback on comfort and usability of the Astroskin system; 3) to demonstrate performance of Bluetooth communication during real-time transmission and for verification of data in this environment; and 4) to obtain baseline data for further development of algorithms and tools that facilitate decision support for diagnosing and monitoring of a sick or injured crewmember. HERA Campaign 3 included four missions (each 30-days in duration) with four crewmembers assigned to each mission. A total of 9 men and 7 women participated in the Astroskin evaluation that included continuous physiological monitoring (24-hours) on mission days MD-11, MD1 (high workload), MD15 (low workload), MD19, MD29, and MD+7. Mission days 19 and 29 also included 30 minutes of sub-maximal exercise on a cycle ergometer. Following each 24-hour monitoring session crew physiological data were downloaded to laptops and each crewmember completed a 28 question survey on their experiences with the Astroskin hardware and software. This presentation will focus on lessons learned from the HERA missions. Specifically it will address Astroskin system performance in terms of data loss and data quality (no comparison to lab standard devices), wireless communication with the onboard mobile device, crew usability and comfort, and future development of a next generation biomonitoring system.

Mission constraints will challenge the delivery of medical care on a long-term, deep space exploration mission. This type of mission will be restricted in the availability of medical knowledge, skills, procedures and resources to prevent, diagnose, and treat in-flight medical events. Challenges to providing medical care are anticipated, including resource and resupply constraints, delayed communications and no ability for medical evacuation. The Medical Data Architecture (MDA) project will enable medical care capability in this constrained environment. The first version of the system, called "Test Bed 1," includes capabilities for automated data collection, data storage and data retrieval to provide information to the Crew Medical Officer (CMO). Test Bed 1 seeks to establish a data architecture foundation and develop a scalable data management system through modular design and standardized interfaces. In addition, it will demonstrate to stakeholders the potential for an improved, automated, flow of data to and from the medical system over the current methods employed on the International Space Station (ISS). It integrates a set of external devices, software and processes, and a Subjective, Objective, Assessment, and Plan (SOAP) note commonly used by clinicians. Medical data like electrocardiogram plots, heart rate, skin temperature, respiration rate, medications taken, and more are collected from devices and stored in the Electronic Medical Records (EMR) system, and reported to crew and clinician. Devices integrated include the Astroskin biosensor vest and IMED CARDIAX electrocardiogram (ECG) device with INEED MD ECG Glove, and the NASA-developed Medical Dose Tracker application. The system is designed to be operated as a standalone system, and can be deployed in a variety of environments, from a laptop to a data center. The system is primarily composed of open-source software tools, and is designed to be modular, so new capabilities can be added. The software components and integration methods will be discussed.