As militaries are expected to operate in diverse environments – from Arctic to urban landscapes – developing materials, technologies and capabilities that enable soldiers to survive and thrive has become ever more important. The most critical component to success on the battlefield is the warfighter, therefore around the world, armies are recognizing the importance of maximizing the effectiveness of Soldiers physically, perceptually, and cognitively. Some of the missions the soldiers perform can take weeks, away from in difficult terrain like deserts and mountains which requires maintaining an incredibly high level of physical fitness.
Mission success depends on force readiness, and a major component of readiness is health. Early detection of illness and injury often yields a better prognosis. For example, if left undetected, infectious diseases can spread quickly through a population, endangering Warfighters and their missions, as well as the general population. Earlier diagnoses of injury (e.g., traumatic brain injury) can prevent inappropriate return-to-duty of Warfighters who may put themselves and others at risk.
Currently, understanding and assessing the readiness of the warfighter involves medical intervention with the help of advanced equipment, such as electrocardiographs (EKGs) and other specialized medical devices, that are too expensive and cumbersome to employ continuously or without supervision in non-controlled environments. On the other hand, currently 92 percent of adults in the United States own a cell phone, which could be used as the basis for continuous, passive health, and readiness assessment.
Embedded sensors in mobile devices (e.g., personal smartphones and smartwatches), such as accelerometer, GPS sensor, and Bluetooth sensor, have been applied to monitor human behaviors and track daily activities. The resulted data from these embedded sensors can be used to infer human health status, monitor mental health states, and deliver medical interventions.
Mobile technologies like wearables can be used for biometric monitoring, such as measuring soldiers’ health through nutrition, exercise and sleep, and improved battlefield readiness. Mobile technologies are being employed for improved healthcare of the warfighters right from when injury occurs in the field where medics perform online consultation with the field hospitals, to in hospital care where clinicians receive lab and radiology results as soon as they are available or even after discharge through home monitoring systems that transmit blood pressure and vital signs to a local physician for review.
Underpinned by advances in high-speed and high-bandwidth 5G networks, mobile will continue to enable incredible real-time analytics and data collection and new capabilities that will ensure soldiers can achieve peak health and performance on the battlefield, writes Chris Balcik is vice president for federal sales, Samsung.
US DOD thrust on Mobile technologies
Gen. West has emphasized the importance of using mobile solutions to harness real-time analytics on warfighter health data. “One benefit is being able to monitor the health and performance of deployed soldiers with real-time data streams. This is real data that can be used to provide real decision-making power to a commander on who he or she selects to go on the next missions,” she said. In fact, mobile technologies are central to transforming the way defense agencies aid warfighters in achieving mission-critical mission outcomes by collecting and providing information—all accessible in the palm of a hand or worn as part of a uniform.
Measuring real-time human health and performance is essential to keeping warfighters safe. Lt. Gen. Nadja Y. West, the 44th Army surgeon general and U.S. Army Medical Command commanding general, has focused on such efforts and recently called for new tools and capabilities that can help the Army better track soldier fitness on the battlefield.
For example, the Army recently doubled down on efforts to ensure warfighters are optimizing the performance triad (P3) of sleep, physical activity and nutrition, which optimizes physical fitness, cognitive dominance and emotional resilience. In conjunction with such efforts, the Army Research Institute of Environmental Medicine strapped wearable sensors on soldiers from the 75th Ranger Regiment, as they completed the first and second Ranger Assessment and Selection Program, at Fort Benning, Georgia. The purpose of the study was to predict heat illness in soldiers and use real-time physiological status monitors, keeping track of soldiers’ core and skin temperatures as well as heart rates. This will ultimately help researchers create a performance baseline and determine how the body responds when healthy and when experiencing heat illness or higher levels of stress so that they can better prepare future warfighters for taxing battlefield environments.
It’s imperative that soldiers get the treatment they need in what is known as the golden hour—the precious 60 minutes following a battlefield wound when proper medical treatment can be crucial to a soldier’s survival. Mobile technologies can deliver faster, life-saving data, especially in a chaotic battlefield environment to ensure correct and necessary critical care information is available to sustain injured warfighters.
A group of U.S. Air Force researchers recently developed a new electronic patient monitoring tool for the battlefield called the Battlefield Assisted Trauma Distributed Observation Kit (BATDOK). BATDOK is software that runs on smartphones or other mobile devices and draws patient information from a wide variety of commercially available, U.S. Food and Drug Administration-approved sensors. This can let medics monitor multiple patients in the field, seeing vital information and managing multiple patients in a complex, tactical environment.
“BATDOK is a multipatient, point of injury, casualty tool that assists our human operators and improves care,” said Dr. Gregory Burnett of the Airman Systems Directorate in the Warfighter Interface Division of the 711th Human Performance Wing. “It can be a real-time health status monitoring for multiple patients, a documentation tool, a user-definable medical library, a portal to integrate patient data into their electronic health records, and finally, it is interoperable with battlefield digital situation awareness maps, which helps identify the exact location of casualties.”
Mobile immersive technologies like virtual reality (VR), augmented reality and mixed reality are helping rehabilitate soldiers returning from the battlefield, including through treatment for posttraumatic stress disorder. These types of solutions can serve as a therapeutic tool for a variety of treatments including pain management. Albert Rizzo, research professor at the USC Davis School of Gerontology, reported, “Exposure therapy is an ideal match with VR…You can place people in provocative environments and systematically control the stimulus presentation.”
USAF, US Navy and industry discuss physiological sensors development
All Navy personnel gained official authorization to wear smartwatches and fitness trackers while in uniform. In a new attire- and grooming-centered policy update in August 2021, the military branch extended its permissions to allow for the technology-based, biometric-capturing wearables. While in uniform, sailors and all other officials can wear one fitness tracker and one wristwatch or smartwatch simultaneously—but each on a different wrist, according to the update. Bracelets can’t be worn on the same arms as those devices.
Smartwatches and fitness trackers are modern, wrist-worn accessories that perform multiple functions and can connect to the internet and GPS. Fitness trackers generally capture details around wearers’ activities and detect information regarding walking steps, running distance, heart rate, sleep patterns and swimming laps. Smartwatches can also record information such as heart rate and other vital signs, but are more like mini-computers with access to mobile applications.
The USAF and US Navy intend to develop sensors that are capable of gathering data from pilots before, during and after a flight. Both the airforce and navy established PEATs to address the spike in the rate of physiological episodes. The services have been working with each other to share data and research. USAF Physiological Episodes Action Team (PEAT) lead Brigadier General Gregor Leist said: “Efforts surrounding this issue are really driven by the nature of the challenge. It’s a safety-critical issue, and we need to throw everything we can at this and find the root, if there is a root, for the safety of our pilots.” The PEATs used different sensors to collect aircraft data. The effort was aimed at accurately characterising the breathing and pressurisation systems to understand the cause for physiologic episodes.
AFRL sensors development team lead Dr James Christensen said: “The Integrated Cockpit Sensing programme aims to identify best-of-breed sensors for near-term operational implementation while defining an architecture, which will allow the airforce to continually add or upgrade the best sensing capability to prevent and/or mitigate the effects of physiological events.”
US DoD chooses IncludeHealth for next-gen warfighter fitness protocols
Digital health and wellness company IncludeHealth has secured an AFWERX Phase I grant from the US Department of Defense (DoD) and the US Air Force for the delivery and standardisation of next-generation warfighter fitness protocols. In a two-month study involving 40 warfighters, the Air Force Research Laboratory (AFRL) will employ IncludeHealth’s equipment and cloud-based platform at its Signature Tracking for Optimized Nutrition and Training (STRONG) lab at the Wright Patterson Air Force Base in Ohio.
AFRL STRONG lab director Dr Adam Strang said: “We are interested in applying IncludeHealth’s technology to develop and validate next-generation, mission-specific fitness protocols resulting in objective, data-driven, and evidenced-based duty qualifying scores. “We also see powerful applications to remotely issue individualised training and rehab protocols across the Air Force network without the need for human proxy.” Phase I of the Small Business Innovation Research grant will adopt IncludeHealth’s medical-grade platform to produce tailored warfighter fitness protocols, using cloud-based data.
Initially, a fitness coach will be on hand to oversee the delivery of the protocols, but the developers said they hope to devise fully autonomous training using IncludeHealth’s cloud platform, which complies with the Health Insurance Portability and Accountability Act of 1996.
IncludeHealth founder and CEO Ryan Eder said: “By providing integrated digital and physical tools with deep objective data sets, our technology has the potential for meaningful impact and powerful applications in the DoD and Air Force. “We hope to leverage our commercialised platform to help further quantify and qualify the health of our warfighters while also ensuring best-in-class care post deployment, whether that is returning to duty or civilian life. It’s an honour to apply our technology towards this purpose.”
Phase II and III of the grant are expected to expand the project further by using IncludeHealth’s technology across the US Air Force network to incorporate more data and deliver the next-generation protocols to the DoD.
However, the wearables are designed to capture location data and connect to the web, which presents some cybersecurity risks. A couple years ago, for instance, a website and app used to collect athletic information with GPS data, compiled users’ data in a heatmap and inadvertently disclosed location of multiple overseas military bases. The Pentagon later banned all personnel from using geolocation services on their personal and government-issued devices in all “operational areas.” In the policy update, Navy officials noted “smartwatches and fitness trackers are subject to applicable security regulations.”
“We cannot comment on specific security procedures and protocols, but our policy ensures sailors know that security regulations take precedence over this uniform policy that allows [them] to wear this type of technology,” Callaghan said. “It is important to note that we have established the uniform policy to ensure a professional and uniform appearance, while maximizing a sailor’s opportunity to choose wearable technology as they see fit.”