U.S. Army Telemedicine & Advanced Technology Research Center (TATRC) Leverages Deloitte and AWS to Deliver Critical Care in Austere Environments

Deloitte collaborated with the U.S. Army Telemedicine & Advanced Technology Research Center (TATRC) to create an application that supports the National Emergency Tele-Critical Care Network (NETCCN). NETCCN delivers remote clinical expertise to the point of need during disasters and on the Multi-Domain Operations battlefield. NETCCN incorporates AWS Wickr, an encrypted communications platform, and can be deployed with AWS Private 5G to create highly secure network capabilities to operate in disrupted, disconnected, intermittent and low-bandwidth (DDIL) environments.

The U.S. Army Telemedicine & Advanced Technology Research Center (TATRC) is focused on delivering solutions that help military health system leaders make better and faster decisions to support the nation’s soldiers. “Our mission is to create solutions that fuse humans, data, and machines to optimize warfighter performance and combat casualty care,” says Matt Quinn, science director at TATRC. “We do this by building medical intelligence systems that optimize human-machine teaming to keep soldiers healthy in the fight and make sure they’re taken care of faster if they’re injured.”

To support its mission, TATRC sought to use technology to assist wounded warfighters on the Multi-Domain Operations (MDO) battlefield where the “Golden Hour” for evacuation might not be possible. Quinn says, “During prolonged casualty care, when transport to the next level of care isn’t possible, in areas where connectivity is poor, the difference between life and death for a wounded warfighter can be providing access to critical care expertise.” Specifically, TATRC wanted to use telehealth technology as a way to bring medical assets to medics and combat lifesavers on the front lines. “With NETCCN, we realized we could match remote critical care clinicians with those struggling at the point of need,” says Quinn.

After announcing a request for proposal (RFP) for technology help, TATRC selected Deloitte, a consulting organization and Amazon Web Services (AWS) Partner, to help build a digital health solution based on AWS services. “We use AWS because of the services and the deep defense industry experience,” says Dan Adams, health technologist at Deloitte Consulting LLP. “We also appreciate the support. AWS is willing to try new things, and its focus on mission need matches our interests.”

Deloitte created its application for the National Emergency Tele-Critical Care Network (NETCCN), a solution to help hospitals struggling to manage COVID-19 surges. The NETCCN application combines agile infrastructure as a service (IaaS) and platform as a service (PaaS) cloud computing with automation to provide secure, virtual health workflows connecting remote experts to local providers. Managed by TATRC, NETCCN runs on AWS services including Amazon Elastic Compute Cloud (Amazon EC2) instances, Amazon Elastic Kubernetes Service (Amazon EKS) managed container service, and AWS Lambda serverless computing. NETCCN also relies on AWS natural language processing and automatic speech recognition data services such as Amazon Comprehend Medical and Amazon Transcribe to enrich the data flowing across the platform.

The Deloitte NETCCN application was initially fielded in support of a military mission to Guam Memorial Hospital in 2020. Clinicians and nurses at the hospital received consultative support through the application to better manage an increasing number of COVID-19 patients. “NETCCN helped expand the capability and capacity of clinicians in Guam to care for a surge of seriously ill patients,” Adams says. “Through the initial surges of COVID-19, we had 28 simultaneous missions in multiple states across different providers, helping manage care from the U.S. Army research lab,” says Adams.

After the initial success of NETCCN, TATRC asked Deloitte to enhance the application to accommodate care of wounded soldiers on the MDO battlefield. To meet these requirements, Deloitte integrated Wickr, a HIPAA-compliant cloud collaboration platform and an Authority to Operate (ATO) on military networks, recently acquired by AWS, and AWS Private 5G, a managed service for deploying and scaling private cellular networks. With Wickr and AWS Private 5G, NETCCN has highly secure, private cellular network capabilities and can facilitate conversational, AI-driven engagement between onsite care providers and remote medical teams delivering the real-time patient care experience.

TATRC and the Uniformed Services University Health System (USUHS) used the new version of Deloitte’s NETCCN application during Operation Gunpowder, an annual USUHS training exercise that prepares military medical students for in-field challenges they might encounter. During the exercise, military clinicians practiced tactical combat casualty care. They used NETCCN and the AWS Private 5G network to communicate, manage patients, access remote trauma support, and call for evacuation. “During Operation Gunpowder, we used Wickr and AWS Private 5G to provide reliable connectivity on the ground for NETCCN,” says Quinn. “This provided remote critical care and emergency expertise to help personnel effectively care for trauma patients.”

With these capabilities, NETCCN makes it possible for medics and other caregivers to conduct lifesaving remote telehealth sessions during combat. “Using the Deloitte and AWS solution, we can enable soldiers in remote and poorly-connected areas to securely communicate with medical professionals and care for the wounded in real time,” says Quinn. “This helps soldiers who might not have medical training to augment their skills without having to send personnel and heavy infrastructure into the theater. Ultimately, the solution can improve the survivability of patients.”

Deloitte and TATRC also plan to use NETCCN to help government agencies better manage natural disasters by reaching civilians in locations that are difficult to reach or have poor mobile network service. In particular, Deloitte and TATRC are working with the Administration for Strategic Preparedness and Response (ASPR) to integrate NETCCN into a new disaster management program. “Disasters, whether they’re a result of a hurricane or a pandemic, stress resources and often responders don’t have the tools they need,” says Quinn. “With NETCCN, we now have a tool to overcome these challenges and get people immediate medical attention, no matter the location.”

Deloitte will continue updating NETCCN to bring healthcare and military teams technologies that make it easier to serve patients. “Our healthcare workers and combat medics are overworked and stressed and dealing with very difficult situations,” says Adams. “Using this application on AWS, we can give them the support they need while improving national security and protecting and extending the lives of citizens.”