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tv   Medical Technology for Veterans  CSPAN  May 25, 2018 6:42am-8:40am EDT

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veterans advocacy group, and project hero.
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ended chief scientist with the energy department, national nuclear security administration. technology will come to order. -- to declare recess of the committee at any time, good morning. and welcome to today's hearing entitled empowering u.s. veterans through technology. i now recognize myself for five minutes for an opening statement. >> the impetus for today's hearing goes back a year or so ago to may 17 when i first met one of -- for veterans in my district in manassas virginia. i heard first hand from john about the hero track system, and the wearable health monitoring device, the software designed to help veterans suffering from posttraumatic stress disorder. i was fascinated by this technology and the research
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going on with it and its potential to help our veterans. in my district as so many others, are home to so many research and technology companies on the forefront of technological innovation. so i am particularly pleased, also with a large veterans population, to chair this hearing today to profile technologies to help our dedicated veterans who have served our nation. by shining a spotlight on cutting-edge technology, designed to help combat injured veterans, the science community can help spread the word about the wonderful efforts in which our witnesses are engaged, and their impact on the lives of -- lives of our brave men and women who sacrifice and deserve our care and attention. i also look forward to hearing more about the department of energy, the department of veterans affairs collaboration, that will leverage -- high performance computing and machine learning capabilities to analyze health records of more than 20 million veterans, maintained by the va. the goal of this partnership is to arm the va with data it can use, to potentially improve healthcare offered to veterans by developing new treatments
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and provide better strategies. this win-win enterprise has revolutionized quality healthcare for veterans while providing the department of energy with unique insight and information to develop next- generation technology. we also have representing soldiers don, mr. meek, who will describe the soldiers --. in the effort to purchase it donate -- exoskeleton device, comprised of a number of devices. amazingly, it can help provide paralyzed veterans, the ability to once again stand, walk, and hug a loved one, i to i. appoint eloquently -- a point eloquently emphasized in ms. mcallen's testimony. -- being more familiar being on the other side. -- one of our witnesses today. we really appreciate her being here at her work for veterans. i mentioned john worden who founded project hero 10 years
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ago, to help veterans and first responders affected by injuries, including traumatic brain injury and ptsd to the program, such as john to recovery. while the success of the program and the therapeutic benefits of cycling, which is one of the main activities that he is engaged in with a high degree of recovery, obviously, has benefited thousands of veterans. i also appreciate the opportunity to highlight today how the hero tracks monitoring system can benefit veterans with ptsd, including how it can help generate more data on best practices to improve the lives of veterans. and since we did get to get together with mr. worden with the veterans roundtable in my district yesterday, i can just tell you that i know this will apply to all of the others testifying today. how excited the veteran services organizations were to hear about these new technologies, and how we can partner with the for example, we have a lot of equine therapy
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groups and service veterans -- that service veterans in my district that they understand how when we get more data here, we can demonstrate how impactful the equine therapy is for our veterans. they know that instinctively, but now we have a way of demonstrating that to data. i also welcome dr. major, who describes his very important research on motor control related to veterans. servicemember prosthetics. and orthotics and the underlying -- underlying --. and added benefit of today's hearing is that technology, research, and federal programs will hear about have promising implications for the population at large. i think all the witnesses for joining us today and for your service and efforts to help improve the lives of our nation's veterans. i now recognize the ranking member of research and technologies subcommittee, the gentleman from illinois, mr. lipinski for his opening statement. >> thank you. thank you for holding today's hearing. i was just looking -- on my
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ipad here. we are only six days away from memorial day. it is the busiest day of the year for me. for public events in my district, because of the importance my constituents and i place on honoring the men and women who serve in our armed forces. i am sure my colleagues on both side of the aisle -- present here this morning agree that supporting technologies to improve the lives of these men and women should be a high priority. unfortunately, any face an uphill battle to overcome a physical and mental toll of war, once they return home. that is why this hearing is so important. i want to thank our witnesses for being here this year with us. their efforts to provide veterans with the latest technologies, to improve the quality of life for our veterans. almost 20 million u.s. veterans are living today.
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just under half are enrolled in the department of veterans affairs healthcare system. the health records generated from decades of care provided trove of information. that may lead to more accurate diagnosis and treatment of certain conditions and diseases. high-performance computing can help analyze this massive amount of data, making it useful for delivering better healthcare outcomes, not only for veterans, but also for the general population. the federal government has made strategic investments over the years to advanced data analytics and data science research and development. i look forward to hearing from dr. -- about the progress of the big data science initiative being conducted by the va and the department of energy. some of which is taking place in my district at argonne national laboratories leadership computing facility.
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i would also like to hear about the privacy and security measures the agencies are taking to protect our veterans personal information. in addition to these -- chronic conditions that the va, doe collaboration will address, veterans who survive combat may have to adapt to civilian life with minute -- limited mobility due to physical injuries sustained in war. a number of federal efforts to support research in related areas, including advanced robotics, prosthetics, and full- body exoskeleton suits. for example, the national science foundation funds work examining the interface with the -- prosthetics. and the national institute of standards and technology has established an international committee to bring together public and private sector stakeholders for defining standards for wearable robotics. while the physical wounds of war can be seen, the mental scars are below the surface.
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combat and other traumatizing experience results in long-term damage for veterans. a look homelessness in suicide are manifestations of these wounds. 11% of veterans from the most recent combat operations suffer from posttraumatic stress disorder, or ptsd. these figures are similar for gulf war veterans, and unfortunately, even greater, 30% for vietnam veterans. i look forward to witnesses testimony about their efforts to provide physical and mental rehabilitation technologies to our deserving veterans who have sacrificed so much for our nation. i also look forward to hearing the witnesses ideas about -- agencies can be doing to accelerate the development of such technologies. thank you, madam chair. i look forward to hearing the testimony. i yield back. >> thank you. i now recognize the chair of
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the committee. mr. nichols. >> thank you chairwoman comstock, for holding such an interesting and important hearing today. today's hearing will highlight some fascinating technologies and efforts that will empower veterans. the -- supercomputer at oak ridge national laboratory can process a quadrillion calculations per second. that is a number followed by 15 zeros. thanks to collaboration between the department of energy and the department of veterans affairs, this computer will be used to analyze health records of 24 million veterans, to provide improved care. the partnership between the va and doe to transform the delivery of healthcare to our veterans, as we use complex computer models to learn more about the causes and warning signs of various diseases. the va has identified three priority areas of focus for early delivery impact is. suicide prevention, prostate cancer, and cardiovascular
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disease. by providing doe with access to a large-scale database, the va will help the energy department develop next-generation algorithms and modeling capabilities, will ultimately providing the va with data it can use to provide veterans quality of life. one of the witnesses today, mr. john worden is collaborating with the texas a&m university professor on a wearable device to help veterans suffering from posttraumatic stress disorder. and, we welcome dr. -- assistant professor of the department of industrial and systems engineering at a&m. thank you and your team in texas for your hard work and efforts to support our veterans. >> i would also like to thank mr. chris meek and miss martha maccallum for their respective efforts on behalf of soldiers strong. in january, soldier strong donated a robotic exoskeleton to the road l murphy memorial
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va hospital in san antonio, which i represent. destination will help the facility provide state-of-the- art rehabilitative care to veterans. one of the benefits of hearing from the experts today, is that the fruits of their labor are not limited to helping veterans. although, they do that so well. they can be applied to people all over the country, and the world, who suffer from similar ailments and injuries. in addition to this hearing, the science committee passed legislation last november to help veterans overcome obstacles as they reenter the workforce. -- 4323, the root -- supporting veterans and stem career act. the bill promotes veterans involvement in stem education, computer science, and scientific research and employment. that pass the house in december and awaits action in the senate. the subject at the hearing, shows yet again, how technology
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can meet the world's challenges. we look forward to our witnesses testimony today in finding out more about how that technology can help, not just veterans. but as i said, people around the world. thank you madam chair. i yield back. >> and, i now recognize the ranking member, ms. johnson? >> thank you very much, chairwoman comstock. ranking member lapinski, for holding this hearing to learn more about the technologies that are being developed to help improve the quality of life to -- to injured veterans. this is a topic close to my own heart. before i ran for political office, i served as the chief psychiatric nurse at the va hospital in dallas, where i -- that service. as for up close, the toll that serving in a combat zone can take on our men and women in uniform. i developed a deep appreciation for human frailty and strength
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alike. and, i carry those lessons forwarded to my political career. i regularly meet with veterans in my district in dallas to learn about the challenges they face, reentering civilian life, and discuss with the veterans what the federal government can be doing better to help ease their transition. today, there are about 20 million veterans in the u.s.. advances in medical response and technology on the battlefield have meant that more veterans are surviving. and, returning home with traumatic injuries, that meant certain death in earlier generations. we project protect -- protracted conflicts -- multiple deployments and combat zones. even if they survive these deployments without any visible injuries, some almost certainly suffer in other ways. veterans experience, mental disorders, substance abuse
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trauma -- -- and traumatic brain injuries at disproportionate rate, as opposed to their civilian counterpart. 18-22 veterans commit suicide daily. younger veterans are at the highest risk, while an exact count is hard to come by, approximately 40,000 veterans today are homeless. these are the statistics that should alarm us all. technology will not solve all of these challenges, however, technology can go a long way to aid veterans suffering from both physical, physical injuries and mental health disorders. continued advancements in prosthetics and exoskeletons will help improve the quality of life for veterans who have lost limbs. more accurate and wearable predictors are ptsd. -- keep veterans and their loved one safe. in better understanding of the range of conditions that occur
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in the veterans populations will help medical professionals and policymakers alike develop more effective interventions. i look forward to hearing more about the technologies that today's witnesses are working on. and, i look forward to a discussion of the role that our five agencies, such as a national science foundation our national institute of standards and technology can play in advancing these and other technologies to aid our u.s. veterans. our veterans deserve nothing less than -- from our nation and our government and our full dedication to helping them repair the wounds of war, that they suffered on our behalf. i think you and yield back. >> iq. and, i am now going to introduce our witnesses. -- want to recognize -- jordan of the northern virginia technology council, who has worked with the veterans on employment initiatives, which
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has been the initiative of our technology company in northern virginia, which has done wonderful work with our veterans, and i really appreciate having you here to hear about these great technologies in science. both public and private investment, which i know -- has always been great with public, private partnerships. thank you. >> our first witness today is dr. dimitri -- chief scientist at the national nuclear security administration of the u.s. department of energy. prior to the nsa, he served as director of the office of research and development for national security, science, and technology. dr. -- earned a bachelor of arts in physics in pure mathematics from the university of california at berkeley. he also holds a masters of science in physics, a phd in theoretical, nuclear physics, both from princeton university. our second witness today is mr. christopher meek. founder and chairman of soldier
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strong. soldier strong helps american service men, women, and veterans take their next steps forward by identifying and filling gaps in the traditional system supporting veterans and members of the military. originally called soldier soft, soldier strong stems from mr. makes first project, organizing makes first project, organizing he holds up bachelor of arts from syracuse university. our third witness today is ms. martha mckellen. she earned her bachelor's
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degree in political science. worked to improve suicide prevention. participating in three u.s. olympic trials. a bachelors of science in finance from california state university. you have started your right to recovery in the final
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witness. muscular skeletal pathology. masters of science degrees from the university of illinois. i now recognize the dr. to present his testimony.
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in collaboration with the apartment of veterans affairs. the department of energy. squeezing the most out of her 70 year paradigm. necessitates novel artificial intelligence to navigate an
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increasingly data driven world. i believe a cornerstone for progress will be how rapidly we embrace the next generation predictive supercomputing tools.be they can accelerate this technology change by driving the development with likely the world's most complex data. to rethink many of our traditional approaches the cancer moon shot in 2016. more recently secondary. as well as this administration's commitment to the veteran issues has allowed the rethinking of traditional paradigms.
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the va has a unique data set. this data set is considered to be the largest and most comprehensive in the world. in a complementary effort called active. the technical roadmaps for driving high-performance computing and artificial intelligence while developing solutions for priority issues.
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additional areas of interest have surface. the fi 19v8 budget request includes $27 million to support these initiatives. we recognize the critical role of the private sector in this effort. they held a meeting with technology startups to understand the direction of the technology. as with the human genome project. partnershipse with labs, academia and the private sector are important. a concerted effort here well lead to innovation tied to design and development of the next generation supercomputing. two better health care in our
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strategy for medicine. it could inform when and how to treat our veterans. they specialize in healthcare with dlg experts. and a better government within public and private partnerships. thank you and i look forward to answering your questions. we now recognize mister meek for his testimony. and members of both subcommittees think you for having me here today. on september 112001 i waspt running operations for goldman sachs.
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as i watch the first responders running into the courage of that day. i'm still a financial services executive.to shoulder strong as a charitable organization committed to improving the lives of our servicemen, and veterans. it started with a quest from an forward operating base. for the deployed troops. we assembled and sent over 75,000 supplies. as the words went down we contemplated shutting down. in retrospect one to in
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particular would bring this question to focus for me. april 27, 2011 was my daughter's fifth birthday. without a care in the world. 6,800 miles away army sergeant the site. his injuries would rob him the ability to walk again. dan's experience that date a date was the first reminder of how much we are veterans and how they allow all of us to take for granted the lives we were blessed to live here. empowering him to walk once again. they find the most advanced devices. the collection of devices we currently fund is with this shoulder suit. allows paralyzed veterans to
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stand and walk again. the physical and psychological impacts and been able to get up out of a wheelchair and see it at a level with the world againsi are profound. we had access to this technology.
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we work closely with those around the country. they have received one or more of our devices. they care very deeply about her veterans. think's to thanks to shoulder shrug nearly 25,000 entrants had access to these devices. they have earned the right to the best technology they can provide. yet one of the pet tragedies of the care is that toet me veterans mustie rely on terrible organizations like ours. it sounds like science fiction it really hits you that these capabilities are quite real when you see them roll into a room and wheelchair and actually walk back out of that same room. i have a short video of how this technology works. this was made during one of
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our device donations. thank you. [indiscernible] [indiscernible]
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thank you. i will now recognize ms. mcallen. thank you so much for having me here today. as well as many other great men and women who serve or have served our country. i spoke with vice president penn's was very interested in the subject matter of our discussion here today and in particular the work of mister
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worden and the work of the soldier strong. this soldier strong. and the u.s. technology that can grow and a better benefit our veterans.ot like most of us as a citizen i am and mourn an enormously grateful for them. i could never live up to the measure of their bravery and heroism. like most of us i want to show our gratitude to those who put their lives on the line. those who make the sacrifices and face a the danger to go to the front line to protect us in the freedom that we cherish as americans. it was born out of 911. out of the desire to prove it to our patriots that we are forever thankful. it is to make sure that we are willing to make the move forward. and they will not now be able to move forward in life.
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whenever they lost on the battlefield or in injuries after they served we can help them overcome to the greatest of our ability.jute 911 was a date day that changed just for ever. as a lifelong resident i watched as the towers came down and with them the lives of people that i knew. the families of those who were lost 13 fathers and one mother from my hometown. i vowed that day to tell the story of the war on terror and the battles that continue. the people who knock these buildings down will hear from all of us soon. they made that message here heard loud and clear. some paid the ultimate price curing that message to our enemies.ar so when chris came to see me about the organization he have started with the simple mission of sending basic supplies to our troops.
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i've been dedicated to using my voice and the platform that have through my work to raise awareness and support into spread the word about cutting edge technologies emerging in this field and the life-changing impact that they can have to those whom i owe sofe much. i will nevernt forget the day that they came to our studio to demonstrate how the soldier suit allowed him to get up from his wheelchair and take the steps he never dreamed to be able to take. the look on his face said it all. will, possible -- possibility
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and promise. we must make sure that we get back. but give back in a way that is uniquely americanban that relis on this cutting edge technology and never take no for an answer. as jfk once that about the u.s. space mission. not because it's easy but because it's hard. a moment when technology can rebuild arms with that. companies like xl biotics. not because it is easy but because it's hard. it's a winner for the united states in the military. and for those who will benefit for the growth of these injuries . and make sense on every level. thank you to the work of a very lean and dedicated team
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they put nine to 12% near operating costs. the va facilities across country so far.th a has donated more than $2.5 million in high-technology medical devices that help our injured armed forces. i encourage you to think about how the funding that supports the fighting forces in the field can be extended to support the extraordinary research is being done with taxpayer funding that will ensure that the injured veterans had access to the scientific advances that come from it. i think you very much foror your time today and look forward to your questions. we now hear from mister worden. with the energy research and technology committee.
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i would like to introduce our dr.. it is an organization that brings our naturesr nations veterans together through sports helping them overcome challenges with their visible and invisible row ones. being a catalyst for the sports movement and continues to be the industry leader dedicated research including a georgetown university study confirms that the work being carried out since its inception is changing and improving the lives of tens of thousands of veterans. remember, the veterans volunteer the families are drafted. our mission is to stabilize by restoring hope recovery and
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resilience to the finest. we've have a tremendous impact. 62 percent of our program participants reduce or eliminate. the drug use. the stress attacks as measured by the hero track are reduced by 82 percent. the annual participant saves the va more thanoj $9,000 including prescription drugs and healthcare costs in italy. a soon-to-be released report reviewedhe they recommend steps to improve care. it provides they did it show why they commit suicide each day. what are the risk factors.e in the family components that are at the root cause of suicide. the diagnosis most common are depression, ptsd anxiety and alcohol use disorder with the average suicide having multiple diagnoses. the top risk factors are pain access to firearms worsening
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of health status. relationship problems, hopelessness and decline in physical ability. most of the suicides were not identified as high risk and their medical records.no of the 20 suicides per day only three were receiving mental health services at the time of their death. the reasons, inconvenience, long wait times, paperwork, transportation and stigma. the top recommendation of this report is to come up with an enhanced suicide risk assessment and safety planning capability that addresses the complex care needs of our veterans utilizing technologyty training and extending more and the community. there is a need for a more systematic assessment tool that can document risk.g the hero track initiatives saw this vital need with a solution for suicide prevention. can currently note tool exists
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with remote capabilities to complement ongoing treatment. it will be a device that will allow continuous monitoring and tech knowledge technology using the physiological sensors and can measure frequency, of a ptsd episode within two to four seconds. it is a wearable, monitor. and tested exclusively at events to learn the users physiological click cues. our goal will be a to prevent and eliminate suicide and military veteran population provide the active-duty component with a long-term focus on improving the overall readiness of the force by providing better health and healthcare analytics and provide support for some fibers of sexual trauma.
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the result will be better therapeutic outcomes and less cost.te using a combination of heart rate and heart rate variability monitoring. it will arm triggers the tool creates a personalized profile that monitors patterns and irritability to infer an episode if an episode is detected alarm vibration goes off with the visual prompt that the user will set up for options of support. the self resiliency tools they can connect to a peer to peer support network. which can include family, friends or clinicians. it can call the hotline or 911. it pairs with a smart phone and get can interface with the website to offer more features included direct connect to peers or clinicians by phone or video as desired.
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they can share with her peers and their social network which they wish to create for their own personal support system. when a person first joins the active-duty military. and they collect data on the mental and physical health record stress events. the advantage is to maintain objectives rather than subjective data and feedback in the grate of this information into the medical records. they can then provide a medical clinician with a complete mental and physical health picture whenever the participant visits their healthcare provider. or whether the care path that they been put on by their active-duty clinician is actually working. the overall advantage is a more comprehensive objective measurement of their disability metrics that will lead to increased disabilities. for the patient is a creative way for them and their family
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to understand the environment in surroundings that cause stress episodes in their life. they can understand what was the trigger.ve up on the screen we have screenshots of the app that the device pairs with c can see your data. on here you can see your heart rate, your physical activity the number of stress events and also your tools. accurate information on the mental and physical state of mind it will be a patient set or divide that provides the 24 sevenths support network with and peer-to-peer support. it's gps enabled. if you become disoriented or
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pass out. the person who has been alerted to your episode will know exactly where you are.pa a peer-to-peer support can provide motivation and feedback in the support of knowing that you are not alone. for that clinicians it provides a complete mental and physical health care action of their patients. a more comprehensive measurement which leads to increased abilities. up on the screen we have an actual data that was driven from one of our testing or you can see how it episode would look to a clinician. it starts out during sleep. and then you can see the spike in their heart rate that causes the alarm to go off. it also knows the difference between physical activity and an actual episode. for the dod it creates a baseline that consistently and constantly collects data on their mental and physical health so they can note the readiness of their troop. it maintains objective data and feedback on the overall
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readiness of the force and the information can be integrated into the electronic medical records. the most important need we had right now as a nation is to prevent more suicides and improve the mental health of those who serve our countryim although the conflicts may be winding down there is a lifelong commitment that we owe to these men and womener the track is vital to that commitment to ensure that they can see their children grow up in a supportive community. we all understand the need to reduce suicide. for veterans that live and work in each of our districts. there are veterans in your district right now they can be saved by utilizing the hero track. incorporation you very much for your time.e.ri >> i like to think the chairman and the ranking member.
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for the invitation to testify. i also want to testify and think them. the large and growing number of veterans. they rely on the a rehabilitative care. when medically indicated. a team on how to use these devices effectively and ensure long-term rehabilitation's. on the factors that had balance and we do not yet fully understand why nearly 50% of community persons for at least one time per year. it has considerable implications and the va health care costs. they are useful for screening and modifiable through balance targeted intervention. uniquely the these studies utilize technology for assessing how they have the
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walkie disturbances. these platforms can deliver therapies that train users on how to manage disturbances and avoid false. i will provide two examples. we use a robot that has a control poll for the pelvis. we are interested in the lessons that can be large learned from the unique strategies here.e. in the second example we see use of an interactive system. as a means to the liberal walk disturbances. it requires controlled movements. and is combined with behavior therapy. the remaining projects focus on developments. we are addressing the unique meet needs and developing prostheses. we are alsoof developing a new method. based on an individual's body
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structure. and finally, we are designing technology to suspend prostheses from the amputated limb. the most critical aspect are the veterans using these devices. the research and development is granted as the ability to empower veterans understand how veterans interact with this technology is crucial. therefore, we should support parallel research efforts on its chemical application. the success of the rehabilitation process is dependent on clinicians used of practice. generated from quality clinical research. furthermore, the veteran rehabilitation does not end once they are fitted with the device. real-world use of this technology provides every a window. advances in wearable sensors has improved our ability to come liked data.
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it is needed to explore ways. and monitor user status with minimal interruption to daily activity. with the rehabilitation strategies and independent functions. the veteran rehabilitation research must continue to be interdisciplinary to celebrate the progress. i argue that we still lack a thorough understanding of the elements. more research is needed to better understand how the body responds to different designs b which therapies are most effective and see what the long-term outcome. and their quality of life. filling these gaps will improve personalized rehabilitation preventions.ps
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ultimately i believe technology is driving us towards a future where we can fine-tune rehabilitation tensions. the devices and therapies will be personalized based on individual patient characteristics. they will collect diagnostic data through onboard sensors. they will use these to monitor the progress in the design interventions. they will automatically adjust in real-time. combined with advances.ss they will be administered remotely. thereby improving access to care real-time monitoring and remote intervention delivery will promote rehabilitationov and encourage community engagement. they want to restore the greatest level of independence and quality-of-life to veterans. i think the research and technology subcommittee and the opportunity testify and i'm looking forward to discussion.
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>> think you all so much. what inspiring work you are all doing an innovation is really exciting. i can to pick up when we have our veterans roundtable yesterday. one of the things was how we can integrateveab these service. first of all what three things can we do and gives some action items to get what you're working on advanced and out to more of our veterans. the first thing is easy. that's funding. the technology groups have think in all of the speeches talk about funding and the need for more funding for technology because it will have such a large impact. we talked in the form about how people are trying to justify or understand how valuable equine therapy is.
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he would be able to tell immediately the overall mental and physical impact that that therapy was having on that particular person. then you can make better informed decisions technology will continue to evolve. with the reliability of the algorithm and it approves. more efficient and even more valuable. the third thing is just been able to work within the va system which i think is the biggest source of frustration for veteransur in the study that
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was quoted when it talks about inconvenience and long wait times. it has its challenges but also the way they treat nonprofits outside of groups and how wets can interact with them is very completed. to be an authorized prevention program. we still have a hard time working at the va medical centers. how can we fix and another fix is the right word. how can we make it so while it's a lot more eager for it's still the federal government.
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what has been your experience at the va. and getting more funding. the va request for 2019. $727million of the request is for medical prostatic research. is clearly one of the big news. and this goes to what mr. worden was sane. we have devices in 12 of them. it is clearly one of the big goals here. in terms of what i do.
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what are the veterans going through. that is something. and that's an effort i would make. i look at one of the quotes from one of the veterans that we had spoken to that alone is such a hampering factor. we want to find a way to help veterans feel when they are using these devices. that they are part of society. it's something that will go a long way to that. i think i agree with mister worden.g
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several great organizations. you are all fighting for the same private-sector dollar. getting help from people like yourself will really help have that. i can actually do that long-term savings here. as well as improved quality of life and the right thing to do. there is a win, win. result from this. a lot of them are originally funded. there is no funding for veterans. we recognize mr. lapinski.
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a lot of interesting things. i want to start with dr. major. you mentioned the potential of the smart thesis. to improve the rehabilitation progress. and what federal resources are needed. thank you for the question. in terms of the challenges that we face is difficult to find ways to integrate these y,nsors. the actually helped with
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this. again i thinkov what we are lacking is what they are actually concluded. has been derived from real world use and what essentially means and how we can direct that. how they can help the user. a lot of this is essentially basic research. once the data is available how do you ask use it. the research is being directed in a way that we can answer some of those questions. the sensor technology has improved dramatically. at this point is much improved. i don't necessarily think that is one of the bigger challenges. as that is a challenge of
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course because they do require ongoingg battery power. they obviously will help in this case. research does need to be doing that. and also protecting the privacy of the patient. one thing is to make sure that the patient privacy is being considered in that case. >> are we adequately train the next generation of scientists to do this work. do you think were doing an adequate job of that. or do we need to do more there. in my experience i think we are.
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is interdisciplinary. we need to make sure that continues to be so. we need to make sure that we are still promoted that type of disciplinary research to make sure we were staying competitive. i think we are doing an excellent job of course we can always do better. as long as we continue on this track this particular research will remain competitive. moving on it's great to see mister worden in the work that you're doing here. the veteran suicide still
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trying to understand this. what does the hero track really provide. in order to do this. the report that's about to come out.ep when you get into depression and anxiety. and helplessness. those are all factors. and what we had found in our research so far in our testing of the hero track. is that they feel like they have a support system with them 247 right on the wrist. i can connect to a loved one.
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the feedback that we had been getting from our focus groups have been really remarkable in the acceptance of being able to wear a technology monitoring device. and so, that power my wife or my girlfriend or my father. that ability really creates that sliver of hope that's the difference between suicide and not suicide. a lot of things to talk about here.
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i now recognize mister weber. to the ability of short and long-term. they felt the stigma and feeling that he was in the way i think you've you listed all of these things. was stigma one of those causes. that's one of the reasons why they don't receive vayo medical services.us
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how does the department and that. with the va and how do we put this problem together. they allow him to attack the artificial intelligence and technology challenge so that meaning and intersection happens at that placece where we look at that place.
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we bring together the technology specialist and ask how to answer those questions. the nexus as the two agencies coming together. we draw from the bread. we engage the private sector. we bring in as many people as we can because we recognize it's going to be on all of the above type of activity to answer these priority areas that the veterans administration can find. and thereby do outweigh with that stigma. and to make this as seamless as possible. i'm so going to come back to for one more. these partnerships have that
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in the bio i think the answer is yes in terms of replication. because of the unique complexities.th with data streams. it talks to a situation in unique ways. with predictive technologies. in the computing. when we start to get our have around what those hardware and
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software technologies areg. user once we were to apply to other it draws and some the other partners who want to come and participate. it's a force multiplier for our activities. do you see any problems with them working together. i'm beginning of april.. they did sign a new mi my way it has identified more data than we already had resident. we have a very nice path irward. what process would you use to report back to congress. to say this is working we are making huge steps in the right direction. how do we get that from you. i think at your discretionte coming to you with the va
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side-by-side would be an effective means to do that. i will render and yelled back at this time. i wanted to ask a couple of questions on data privacy for the big data science initiative is obviously very sensitive information almost 600,000 veterans voluntarily given a dna and other samples that can be used. what i want to know is how is the va working together to implement the federal requirements. i will add to the list. secretary perry also joined
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pursley in may of 2017 donating his dna. insecurity of coursee is certain. the personal health information enclave in the initial one that we launched at oak ridge national laboratory is what is considered a moderate with enhanced controls underer the 199 standard that meets it. in the requirements. so had set up an enclave consistent with the protection standards but in addition to our cia zero office. in the privacy specialist. we do external reviews of the enclave we also have engaged the va counterparts and information security offices for their assessment of how we protect the data. in addition we were very sensitive to appropriate use. who gains access is done
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through training programs. we identify laboratory people who will be engaged. we run through the va.en attacking the key problems that had surfaced. the members of the teams that are allowed to access the data is controlled by the va. once we go through the training requirements. so just housing the data doesn't give anyone access to the data. we had set up certainly in enterprise sensitive to the use and protection of the data for the very reason you are marked. with you putting in all those parameters to protect the information are there any challenges to accessing the complete medical records.
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a veterans when need be. in situations where it needs to be. there are two parts to your question. technically it is easy to access now. in terms of the tools, the infrastructure we had set up. hardware and software. the learning environment.. and what is still a bit of a challenge is the irb process what we've been doing here is new every step we take is new for everybody in terms of how we access the data and data and i think as we try and create the structure for accessing veterans data we are sensitive to the fact that machine learning and artificial intelligence will invert the world that people are used to. normally when you have a researcher looking at data. they will pull the specific
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data they want to put text a particular problem. if you're trying to learn more than 22 millionyi health records. and apply it machine learning the way you access. the patterns of use are quite different than how anybody else has ever looked at this data. in setting up the right part of stock calls is a process that we are still working through. we have done some. you can technically access the data. we've accesses with accesses in controls in place but we are still working through how we get everyone to think about where the future is in terms of learning from data. we now recognize and thank you to our witnesses today let me just say. this is not directly on
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technology some other things that you are describing have motivated you to focus on trying to find technological solutions like depression, a sense of hopelessness et cetera. a lot of it can be traced to theho use of opiates by the va. and some of us believe that it has taken the easy way out simply by subscribing -- prescribing. you'll end up with someone with serious problems. should the va be permitted to use cannabis should they have that as an option rather than just opiates and have some
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other questions that go directly to technology. can i have your opinions on that.ct yes no or yes no. i will jump in. should cannabis be an option for va in terms of treatment. i understand your question. i've been doing this for ten years. i will tell you unequivocally they use it as an alternative to opioids. it seems to be working. they are also a lie. anybody else have an opinion on that. i won't force you on coming publicly on that. i would suggest that it is sinful that we do not permit our veterans the veterans and
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the doctors know a number of veterans who the doctors had had to pull aside. they can then recommend it and marijuana. that we do put doctors in a situation like that. you mentioned that it's difficult for medical devices to get approval and we find that strange with commercial items as well. like the fda. as well as other regulatory things could you give us a little bit more detail about
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that. i will reference the primary device that we fund. there is certainly if you go through many phases of the quote clinical trials then you have to go through different phases for approval. and it takes years. given example of some devices that are left behind. he's able to walk his daughter down the done aisle at the wedding. it does work. i have serious troubles with my arms. a lot of veterans get this as well. all of the cartledge was gone. i know how painful that was
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and what have really helped is that i had had as shoulder replacement that was developed to help our veterans and now they have helped all of us. do you have that situation. i think the question is are they actually getting the technology through the va or private facilities. they will get it much more quickly and assessable. then going through the va process. whether to get the funding or not. it does not come from the va it's up to them to deemm appropriate or necessary for their veterans care. that's where we step in. new technologies and medicines are elongated in the process.
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and when you mention batteries about how they will probably help. in many of the challenges that we face for helping the disabled let me just know that there are new batteries on the way.y. they had have a major breakthrough should have an incredible impact. other people were talking about. .. .. utilizing new technologies for our veterans. thank you very much. >> thank you and in recognize myself for five minutes. >> thank you, madam chairwoman. i want to thank the chairwoman and ranking member lipinski for
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joining us are today. as member of both the science basin technology committee and fetters can do what you think all of you for your important work here today and give a shout out to mr. meek and soldier strong based in connecticut. where grateful for the work you have done. all of us in connecticut know people who died in the twin towers. i that is a a searing memory ande committed to that, my nieces when those who enter that call and served in afghanistan and is know how important work all of youto are doing. i think it was you, mr. meek, no darpa for the va. dr. major, youio talked about te vadr does not have aging facilities to do research. a a couple questions some goingo ask all of you to say whether you think there ought to be a darpa for the va or rather rather we should be using darpa
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as it exists that has been with va on the specific goals. that's that's what's happening around -- the early work was to darpo. they have dropped it. it's been for va to pursue. quick if people could opine on that, please. >> i'll begin. essentially in terms of funding mechanisms we are all for additional funding. the typical way the mechanisms run in the va, there are certain priorities that research is directed towards. for instance, prosthetic limbs for women has come of that man because of theat growing population of women veterans but essentially those type of priorities are fit into existing mechanismsof and i look for to something whether is maybe more targeted mechanisms targeted funding mechanisms speaking specifically toward certain priorities. darpa may be a way to do that or some formation similar to that which could be implemented.
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that would be quite effective. maybe not darpa in and of itself but something that could work effectively in the va that would allow individual to target certain priorities. that would help with the technology development, the advancement and implementation in the va specifically which is something that is essentially badly needed. so thank you. >> mr. wordin, , i know actually under dr. shulkin, his only critical priority was on suicide prevention. you've talked a lot about feedback information. a question for you is you are collecting huge amount of important information and much of the tracks with what we know anecdotally as well as researching deeding to be done about feedback. do we have an ability to share or how would we go back to sharing that important information that basically you are developing with the privacy concerns as proprietary to you? here's part of the challenge.
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we have innovative work being done on the private sector in it to all of the eight and then we have questions about who has access to the data, how do we safeguard and share the information you are developing. it would help us develop that are programs forwe veterans. >> i'll tackle that in pieces. first off, under secretary president trump suicide prevention of mental health is the number one priority. yet there is no visible funding for technology that addresses those issues. not a single dime. so that's one area of concern we have. with the testing were doing now we're not collecting and were clicking individual information but not a divine the individuals. it's a blind study so there's no privacy concerns with the. with the program in general we partner with the va and we track mental health status andnd suice ideation every participant in our program and we've done that
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on a basis for some time. that information is contained or house in the va medical records. welo are able to do with the privacy in that regard. as long as the va medical records are private and insecurity, then information we're gaining will have the same security. >> i want to follow up with t afterwards because we had interesting testimony in the senate on gun violence issues and work thatfo l.a. is doing to do with students who are suicidal ideation and other issues. the maybe alternatives that we can look at that have been developed elsewhere thate could help married the technologies you are developing to connect to the va hotline. how can we have an ability to connect to them is one of the issues, how do we have people even know about the va hotline, make sure you let the staff. i don't know if you've looked at that. >> when we do our focus groups and as the devices have been developed it has four options we
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have ptsdd episode, whether it's self resiliency or contacting a family member or a pure or contacting the va hotline or 911. what we find is most veterans i would say over 80% of veterans would rather connect with a peer or family member rather than a stranger on the va crisis hotline. >> that tracks with all the other research we have that ho y would rather have -- i'm over time but it what you think all of you for your important work on these initiatives and urge you to continue to bring your ideas forward salute into a better job to serve those who have served this country. thanks very much. >> thank you. i recognize mr. hultgren for five minutes. >> thank thank you, chairwoman. thank you all so much. this is really important. there's nothing more important that we could be doing than caring for our veterans, letting them at every opportunity for full lives that are fulfilling and containing to be amazingly
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productive, to thank you for your work. dr. kusnezov, if i could first address a couple questions to you. unique feature of the ridgership is the oak national that facility will be able to host protected the health of data, the old institution outside the va to do so. what steps is d.o.e. taken to protect the personal information of our veterans? also follow-up call should d.o.e. be allowed to host secure data from other sources such as private industry? >> thank you very much forto tht question. the data security piece isr vey important for us.th certainly compliance with kindle and -- hit the and high tech on port. we a process to put in place to secure the data in the enclave. it includes an annual external review from a third party that reports back to the feds and then we provide the authority to operate the enclave.
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we engage our cybersecurity and privacy experts and counterparts from the date you oversee this. we are very careful about data use and protections for this enclave. >> do think there's opportunity to host other secure data from other sources? >> these are things we already do a cost d.o.e. for many different reasons come from other agencies. for many different reasons. so yes, the simple answer. >> d.o.e. houses four of the top ten fastest cedric richmond world. how will providing do you read with access to the va data health benefit healthcare research specifically for veterans? >> i think what we've started to find in applying the basic existing tools and artificial intelligence is they break rather easily at the scales of
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veterans of the complexes, , the size, the medical information containedta already exceed the standard toolsets are allowed can accommodate. d.o.e. is very interested in pushing of technology a supercomputer on a it and these canisters of her interesting to us interned with the next generation of more cognitive tools will come from. so we're going to be pushing this data. the data itself is the mechanism in which we set up this next frontier of ai inspired assimilation. >> great. dr. major, thank you for being here. grateful for your work. so proud of northwestern. getting older brings with it many challenges including the danger of falls.
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did your research by any quantitative data and how much more of a danger this is to veterans in need of prosthesis as compared to veterans who don't require such devices? >> thanks for the question. i'm not too good with any research that is targeted specifically veterans of that nature or the distinction between those again who used for setting device and knows when a pickup terms of falls and fall risk, thaty the research is needed. anything inosai terms of lookina specifically different types of veterans, the era in which they come from, the combat they serve. i think that research would be helpful in trying to target certain rehabilitation technology in order to target a specific to individual cohorts. it's something that can be done. speaking to some issues are brought up today, the veteran
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statistic on the type of data we have because it is such an integrated healthcare system, it's right for the type of research. it cannot be conducted on a wider scale. i think the resources we have available to us through the vha, a perfect opportunity to do that type of work. it is curly some of it is being done but i think we could take that opportunity. >> quickly, , doctor come if i could follow up. our goal is to continue to improve the quality of life of veterans but for all people. i wonder what your research and work into prosthetics, how is it making its way to companies that develop such devices that could benefit from your findings and in turn provide better technologies to veterans and to all people? >> one of the benefits we have is oftentimes the partnerships that we develop to a lot of these research efforts. just use an example my research in particular, even though it is
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directed to the fund in close partnership withic academia, northwestern university in addition to that even industry partners as well. much of the technology that is developed in the patterns thatte are developed through those efforts are jointly owned. it would be owned by vba as well as industry partners or academia as well. that is a way as a method which of the technology that is developed by funding supported to the va that can be brought it and benefit civilians. we do a lotpe of that and i thik it's a great mechanism. i will say that in terms of technology transfer, i think it's a certain mechanisms could be felt within the va to help advance the process, would certainly be beneficial because there's great technology that is developed in the va and his effort and funding to support that. trying to get that out to civilian population will be of great benefit. >> would love to see that. my time is expired. yield about. >> thank you. i now recognize mr. mcinerney for five minutes. >> i think the chair. i thank the committee frenemy
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this committee. i got got excited listening to testimony. dr. kusnezov, the federal government scientist who worked for the gsibs 1983 made more than $400 million when he sold the company for $11 billion to this bar pharmaceutical giant deleted 2012. discovered, the drug was discovered with better resources and treated veterans of hepatitis c. unfortunately, once the drug was sold to private company that was out of reach for veterans and for the va both. so the va and the d.o.e. work together with the private sector. how do we also ensure that the data and technology resulting from taxpayer resources is not exploited by startups in the private sector entities solely for the commercial gain for a feww individuals? >> thank you.
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that is a great question. there are some fundamental tenets we have. one is open source for the tools we create for the very reason you mentioned. we do have someth partnerships withth pharma, for example, with glaxo smith kline right now, an effort called adam which is also related to all of this activity. what we do in the space with pharma, the technology companies is pretty competitive. it's by definition open to other entities to join an openly available and accessible for that reason it. we are sensitive to the question you're asking, and we have to manage the middle ground in a suitable way so that it does draw in the right kind of risk mitigation from the private sector which add value to this
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but does not do this at the expense of others. we are keeping an eye on it, again open-source and pre-competitive are foundationa foundational. >> we've seen this in other cases. it's a difficult situation when veterans can have access to medicines that were developed withsi federal money. mr. wordin, i was pretty excited about your ptsd alarm and you're using data and the graphs you show saw ath spike in the heart rate, and then additional sort of physical indicators after that. were you able to identify in those cases that physical event or the emotional event that triggered those reactions? >> we are not able to do that but we asked the participant in
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our study to keep a journal, and they were able to document what the environment was. we try to look at both immediately before a few minutes before and maybe half hour before.mi it's great empowerment to an individual pattern to understand what causes of ptsd episode for them because it's different for each veteran. >> absolutely.y. >> if you could understand what's triggering it then that leads leaves all kinds of and medication of those trigger. >> absolutely. the great thing about the device is it will measure that and see if you are doing to mitigate is actually working on whether you see whether the prescription drug therapy options healthcare provider is given to you. you can objectively understand how it is working, , what is working, if it's working.
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that's the great thing about the device is it is completely objective. it is what it is. >> do you see similar sort of characteristics, dated characteristics from different individuals with regard to ptsd triggers? >> yeah. when you look at the spike and if that's what you're referring to, yes. that's a common theme if some 70 ptsd episode, that's how the device detects that ptsd episode is that spike in heart rate or the heart rate variation. >> we saw a spike in the result low bit of a quite time it was additional. >> the graph you referring to come that should physical activity because i wanted to differentiate because one of the questions i get is how does know whether it's physical activity or whether it's a ptsd episode? the device is able to detect because the steepness of the current would have a ptsd when you are riding her bike. there's a difference in how your heart rate elevates. and a basket elevates it. >> thank you. i just y back.
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>> thank you. i now recognize, let's see, mr. webster. >> thank you, madam chair. thank you all for appearing. great work you are doing and we really appreciate it. mr. meek, you talked about, i don't know your exact words, but you talked about the fact that technology was ahead of the fda's practice, in a sense, and that you got these technological advances that are not a part of the normal va treatment. i would assume, i don't know if this is true but i make the assumption that advances in technology usually cost more and that if ites does what it probay cost more. my question would be how do we balance and mold together availability and advancement so
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that, i mean, you could have this scenario where you make and advancement, and if you spend all your money making advancements, then you could come up with something that helps a veteran ten times better than current practice. however, you could only afford one out of ten, where under the old technology you could afford ten out of ten. ten. is there a balance? do you see what we might be able to do to sort and want to make advancements but we also want to pay for it. >> to go back to the earlier question about whether darpa should be a model to transfer to the va, i think it should be. with with the most advanced technology we can on our war fighters but once it is done beating darpa specs for the battlefieldgy that's it. funding sops. there's nothing to commercialize that to the privacye tobacco. you look at these devices, , the
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average cost is 100,000 with a couple of them almost 200,000. think about the original cell phone, the size of a small suitcase and cost $1000. today it's at the size of a calculator and fits in your pocket and it's a supercomputer. having the continued research and development on a specific device for advancement, where that funding comes from, there are certain separate poolsco we couldd look at my job to keep that fundingth going because ovr time it will bring costs down. a lot of these devices are so advanced that yes, they cost a lot right now but ten, 20 us know, some of the work dr. major is doing, they are hardwiring committees device in individual springs. icing virtual-reality waswo a lt an arm in vietnam and through virtual-reality held itself turning our doorknob and he cried because of the first time he touched something in 25 years. in time that it will reduce the cost of those devices it will reduce costs of medical in va care for thosese patients.
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>> i saw a live presentation of the technology showed in your video. i was just totally astounded soy we could go from a sitting position and rise with no help at all, not even necessarily using their arms. they could just get up. i would want everybody toco have that here it's just the idea of making it available is an expensive, and sometimes it would come at the expense of any more technology. i had another question. mr. wordin, you mention, this doesn't have to do with that particular issue. it has to do with self-directed mental health care, which i have come you said something about, i don't know exactly what you said but it struck a note that that is what you're talking about. in that the press would help in the direction of what to be choosing for their mental health care. i have seen that were in the private sector. do you think that ought to be
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more uniformly applied in the va? >> i don't know if i'd use the word uniformly but i think it needs to be available. because of a veteran of the suffers from ptsd is different. the view seen one that it with ptsd, using one veteran with ptsd. i think what defined as their support system individual is the most important path. and the great thing about the hero track device is it gets in feedback individually so then they can makee the decisions for themselves based on how the quality of life is that they that they have right now.t they have right and so you go to the va and use your mental health clinician and he goes, well, how are you sleeping? not so good. we're going to give you some ambien. how do you know whether that you? with the device are able to monitor and look at sleep patterns can look at ptsd episodes during sleep and be able to decide whetherth or not
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that's something, it is every prescription drug that you take as a side effect or some kind of addictive quality. and that affects effexor qualie his will life as well. weto have veterans in our progrm that literally have suitcases full of prescription drugs at the va sends them on a regular basis, and then when they get into our program, they get all of those prescription drugs and yet they va continues to send them the prescription drugs. when you talk about costs for technology, technology is way cheaper than prescription drugs. >> yes, that's not shocking. and that's awesome. thank you all for appearing, anyone of you. it's been very encouraging, each of you and your work. yield back. >> thank you, and i would like to take a little prerogative. on that particular point, if you can send us some of those examples, with whatever way that protects the patient privacy, that would be really helpful in
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as making this case. i think this is a great disruptive technology, this is going to save money, and the more we can highlight examples like that, i think as we move forward, so i never recognize mr. dunn for five minutes. >> thank you, madam chair. i love these joint committee meetings. we all gathered, sort underscores our interconnectedness. we're sitting here with the energy, research subcommittee, talking a quantum computing for our national labs. it is being applied to tension nation translationalal genomics. all this on the subject of yet another committee, veteransan health. dr. kusnezov, on the urologist. prostate cancer near and dear to my heart. i know your work out to determine biomarkers that determine the locality of prostate cancer can what needs to be treated and how aggressively. can you outline a a couple of those for us?
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>> i can talk more to the technology side than the side that you might be familiar. >> i want to know the biomarker, but i do appreciate what you're doing and i think that's key. mr. meek, you've partnered with va hospital, , also i suppose military hospitals like walter reed? >> completely separate. they don't need your help. you partner with the va hospitals. how to select which ones? >> so we work with the device manufacturer, depending on what the device is. if it's for an individual, sometimes they fall through the va cracks in the manufacture will find somebody that maybe the va will not find it or find the device but not the fitting. they will reach out to us to fill that void. in terms of the exoskeleton devices can we work with the manufacturer. our 20 for spinal cord injury medical facilities within the va center. we start with those for the largest population that they
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serve with a qualitative all those with one device to begin with andpu go back and circle bk again. so, for example, virginia, the largest with 5000 veterans. one device. they they could use 25. palo alto has three to 4000 veterans veterans of the circuit a could use a few devices. one doesn't cut it. it's a a rehabilitative devices the lakers in like going to the gym with a personal trainer and you set your time and two laps around the va. >> do you also, when you do provide one of the exoskeleton type suits to the veterans, do you also provide continued support, maintenance, upgrades? >> that also comes with a four you want to ask what is training for the entire staff at the va. >> you mentioned the regulatory burdens so want youni to know we less than the president to streamline the regulatory burdens. if your regulations you think are bad, duplicative, get and we can bring them to us. we'd love to get rid of
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regulations, especially bad ones. ms. mccollum, youmo are a people specialty you do with a lot of people. have you in your opinion have you seen that the a, and the veterans themselves, are they receptive to some of these new technologies? >> absolutely. i think about the fact that demonstrate with sergeant those on our set, we were able to raise enough money to buy an xo suit for aou veterans hospital n one day. i just think the awareness that people need to have and also the partnership with public andth private entities is so important. i think about the new the ape of us make way through congress and whether gaps exist and the va can't provide that assistance come they are not allowed to turn to a private entity in order to fill that gap. i think we need to look for more
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ways to do that. so private enterprise and the va officially and i think you'll see us getting up with this technology in private facilities and inveterate facilities and i think the will of people in terms of what we've seen is behind it also think when you look at the cost-benefit analysis in terms of taking care of veterans long-term and you deserve what mr. wordin said about the incredible expense of pharmaceuticals. this psychological benefits bed life benefit of these devices hopefully will make some of the pharmaceuticals and necessary. >> i share your optimism and i thank you for that gratuitous plug for the va bill we are caring across the finish lineit right now. it's near into to my heart. i sit on the kerry as well. looking at 20-second left on the clock and it's notte fair to brg up the question,k. mr. wordin, u
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brought up, cogently in your report from the statement that we attach to ptsd in tbi, not just a veterans but in our active-duty troops. and yet this is a major, major problem that we have just been pushing past the graveyard on. if we could treat perfectly we could still are not allowed to diagnose our active-duty troops, lest we wound the careers that would allow time for you to comment on that but i'm glad you brought it up. >> if i could i'd like to say one thing about speedy with the chair permission. >> one of the thingsto we foundn testing, one would think that was brought up biased, by the beat is veterans would not want to wear a hero track because it would cause a statement just within wearing a device. but because it's an apple watch and makes them cool. the statement has been removed and, therefore, they're getting help that they wouldn't ordinarily get.
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we are very aware of statement in our organization and the vets we service, and just to find creative ways to get around it. >> thank you very much. i yield back. >> thank you. and it is gathering general information that is good for health and well-being along the way, too. excellent. i now recognize mr. palmer for five minutes. >> thank the chairwoman. i will be fairly brief. i have to preside over the house in a few minutes, but ms. maccallum, looking at your involvement in this, i i really appreciate how this started soldier strong providing things to the soldiers in the field. someme good friends of mine son lance corporal thomas rivers sister started the program, and seeing everything from sporting magazines to staples to essential things and they got to the point where her brother would get things and the other guys would say, could you share that? it turned into a program called support our soldiers.
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unfortunately, lance corporal rivers was killed in helmand province on april 28, 2010, an ied. but the program continues and has expanded and would having a banquet next thursday night. these programs are incredibly important for morale but also, a lot of these guys don't get letters from home so thank you protruding. mr. wordin, in your test when you mention the project years reduce participants use of prescription drugs and opioids and other at the present used significantly. ande ug mr. dunn brought this us well about i think the process of dealing with these soldiers begins before they get home. the whole thing about ptsd, all that begins before they get home. one of my concerns, we've got 22 veterans per day that commit suicide.
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i just have to wonder how much of that is related to reactions to drug use and what you trying to do to reduce the dependence on drugs. i think, mr. wordin, could you comment on that, how you think that might help us reduce what i think is ann unbelievable tragey that's occurring every day with a veterans? >> sure. when you look at the report that is going to come out, the risk factors did look at, worsening of health status and decline in physical ability, those can be directly related to prescription drug use, particularly when you have overprescribing of prescription drug use. it's not working and, therefore, you start losing hope, and then it starts depression and then you are on the downhill spiral and then eventually that's what leads to suicide. so that's why think the prescription drug use comes into play is because for doctors, the
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easiest solution is here's a pill that will make you all better. where as that's notre necessary what is in the best interest of that individual and i think that's one of thewh great and exciting things about the hero track is you can to get what's in the best interest of the individual and be able to prescribe for that person a healthcare path that will make a difference for him. >> thank you. i told this mr. yarmuth would yield to me i would hold up to three minutes. mr. norman,, madam chairman, i yield back. >> i now recognize mr. dunn. mr. norman, i'm sorry. >> thank each of you for taking time to testify. this is whatt dr. dunn said, as you move forward, apc regulations that are in pd what you do, let us know because we got the body that is strong and will take your case to get
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needless regulations out of the way.y. it's the coal of the president, the goal of the body and the suspect ms. maccallum, you have an interesting role as they describe in the people business as an anchor and on advisory board. what is your opinion and what is been your experience on thehe specific technology for veterans that is effective with raising money and raising the awareness? is the want but you that you can point to? >> you know, i think when people hear the stories of these veterans and the impact that has on their lives, here's one veteran who was a soldier strong exosuit beneficiary. he said you cannot put a price on walking. you can't put a price on someone's ability to be six feet tall again and stand up and kiss your wife or stand up and hugged her daughter oron your son. you can't put a price on that. we talk a lot about me because we have to. because it's part of bringing the technology to our veterans,
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but i think there is a will in america. i know there ise a will in the neck to provide for this and to think the people of a much work, you talk about regulations, of the ways that exists in the federal government in its goodin efforts to solve some of these problems anyone sitting is working towards efficiency, and approving the lives of our veterans. through technology and to awareness a lot of these ideas can help us to cut some of the waste in these programs and to produce more benefit. >> that's, you know, , we don'te know what we don't know. i'm glad you brought up waste because of the agency, particularly now, can give us a roadmap as to where there is waste and specifics on how we can address it. i hope you all will do as you move forward because every dollar saved through waste goes back, would go back into potential could use.
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mr. meek, how do we decide what strong, on the soldier strong, decide which the hospitals will receive the soldier suits? >> again we work with a device manufacturer and within the medical system there are 24 episode that have spinal cord injury unit. we work with those that have traumatic unit as well, and so spinal cord injury unit will be focused on spinal injury. we will take the recommendation from the manufacturer with the goal offa getting those that see the largest population of the vice first, then going from there. >> okay,tt perfect. thank y'all. i think we're at about 12:00. appreciate your testimony. i yield back. >> thank you so much. and i think the witnesses for the testimony today and the members for the questions. without objection chairman weber and ranking member veasey opening statements which there
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were not available to make when we started the drink are made a part of the record. i really appreciate the great testimony today. i think we are really saying disruptive, positive, innovative technology. and i think there's no question that we need to reallocate resources, get new resources, and make sure we are providing this choice. because a lot of things we're talking aboutch veterans, trying to improve more veterans choice program are offering is more positived more outcomes. i really do think it is a lot of win-win solutions that you have. to working with you on how we can redirect and reprioritize this actually end up with better outcomes that will ultimately most importantly save lives, but also save money. so this is a real exciting and a beginning of what i hope will be
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a continued discussion on this. we are already discussing some legislation at efforts that we can work on with our colleagues here on this committee who are also on the veterans committee. so thank you for your inspirational work. the record will remain open for two weeks for additional written comments and written questions from members, and this hearing is now adjourned. s [inaudible conversations] [inaudible conversations]
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>> coming up live a fight president trump will be the commits is because the u.s. naval academy in annapolis, maryland. our coverage begins at 10 a.m. eastern on c-span. once he spent you of events on venezuelans recent presidential elections. >> this weekend on afterward form a national intelligence director james clapper with his book fax and fears, hard truths from a life in intelligence. is interviewed by house intelligence committee member jim himes. >> what are the weaknesses that the i see has today? what are the changes like eyes like you and me need to think about for the next ten, 20 years of

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