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tv   Medical Technology for Veterans  CSPAN  May 23, 2018 3:18am-5:16am EDT

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book, a grand strategy. on strategic inking and leadership for contemporary global challenges. that he not a great eastern on cspan 3's -- cspan's q&a. >> next. to house science space and technology panels look at the new and emerging medical technologies, designed to help veterans. members are from the founders of the veterans kids -- veterans advocacy group, and project hero. 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
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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 going on with it and its potential to help our rawho sac 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 and provide better strategies.
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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 ago, to help veterans and first
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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 groups and service veterans --
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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. just under half are enrolled in
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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. combat and other traumatizing
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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 can meet the world's
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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 alike. and, i carry those lessons
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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 in the veterans populations
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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 has been the initiative of our
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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 donations of socks and other supplies from communities and businesses. mr. meek holds a bachelors of arts in economic and political science from syracuse university. a masters of business administration and financial management from pace university in new york city. our third witness today is miss martha maccallum. -- board member of soldier strong. she is here in that capacity today. of course, we also know her as a fox news anchor, where she is highlighted numerous military achievements on her show. the story with martha maccallum. ms. mcallen's coverage has included the accomplishments and personal stories of the green berets, navy seals, and metal winners for extreme bravery and afghanistan.
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she earned her bachelor's degree in political science from st. lawrence university. she also studied at the circle and a square theater school. mr. john worden, our fourth witness, is president and founder a project hero. his work to improve suicide prevention and health veterans and first responders has earned him national recognition. he began his career as a professional cyclist, participating in three u.s. olympic trials, and earning a bronze medal in the 1989 u.s. national championships. mr. worden was also president and founder of the fitness challenge foundation, which was the genesis of right to recovery in 2008. mr. worden holds a bachelors of science in finance from california state university at northridge. i did want to mention someone told me that the vice president tweeted about the hearing this morning. i know when we first met, we had started the right to
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recover after -- i guess he is watching to catch up on this, too. thank you again for joining us today. our final net -- witnesses dr. matthew mager. -- assistant -- at northwestern university. dr. majors research focuses on improving mobility a function -- musculoskeletal pathology through rehabilitation technology and therapeutic intervention. he holds bachelor of science and masters of science degrees in mechanical engineering from the university of illinois -- as well as a phd in biomedical engineering from the university of -- manchester in the united kingdom. so, i now recognize dr. -- for his five minutes to present his testimony. >> thank you. chairman smith, ranking member
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johnson, chairwoman comstock, chairman weaver, ranking member lipinski. and, ranking member vesey and distinguished members of the subcommittee on research and technology, and the subcommittee on energy. i thank you for taking up this important issue, and for the opportunity to address the members, and share with the department of energy, and collaboration with the department of veterans affairs -- is trying to do at intersection of next-generation artificial intelligence, supercomputing, u.s. innovation, and veterans health. that the department of energy, driven by where our missions are headed, work at the forefront of technologies. today, we are embracing artificial intelligence peer this coincides with diminishing returns from -- we are squeezing the most out of our supercomputing paradigm, this remains important. this post morris lot erin necessitates novel, artificial intelligence, or ai inspired architectures to navigate an increasingly data-
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driven world. i believe that a cornerstone for progress will be how rapidly we embrace the next generation of ai enabled, predictive supercomputing tools. precision medicine data can accelerate this technology change, by driving the development with likely the world's most complex data. this brings with it, subject matter experts and unique opportunities to rethink any of our traditional approaches, from post--- hybrid architectures to uncertain quantification, to computer code. our work with the va is underpinned by several opportunities for innovation that were captured in the 21st- century chair zach, the cancer moonshot in 2016, and the national strategic computing initiative in 2015. more recently, secretory theories -- as well as his administration's commitment to veterans issues, has allowed the rethinking of traditional
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paradigms, and facilitated novel approaches on how to solve complex problems. the va has a unique data set of medical records. hold genomes, and imaging to -- data that is most comprehensive in time, scale, and breath. in many aspects, this data set is considered to be the largest and most comprehensive in the world. both the va and the department of energy are alert for the unique privacy and security sensitivities of the veterans health data. today, our artificial driven intelligence big data initiative includes mvp champion, and a complementary effort called active. last year, in april, va and doe scientists, physicians, and leadership came to his mother -- came together to -- and artificial intelligence while developing solutions to priority issues, and caring for our veterans pick va priorities
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that were identified that could deliver early impact's work, patient specific analysis for suicide prevention, helping doctors make decisions around prostate cancer, and enhanced prediction and diagnosis of cardiovascular disease. since then, additional areas of interest from polypharmacy to traumatic rain injury has -- have surfaced. the fy 19 va budget request includes $27 million to support these initiatives. we recognize the critical role of the private sector in this effort. recently, the va and doe held a meeting with technology startups focused on precision medicine to understand the direction of the technology in the commercial sector. as with the human genome project, or the xo scale initiative today, partnership with labs, academia, and the private sector are important. a concerted effort here will lead to innovation tied to design and development of doe's next-generation supercomputing, that will merge big data, artificial intelligence and
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high-performance computing. the better healthcare, our strategy for precision medicine, through supercomputing and artificial intelligence -- when and how to treat our veterans to improve outcomes and control cost. for better science, via a cadre of researchers and clinicians, who specialize in healthcare with boe experts and big data ai and high-performance computing. it to better government via interagency collaborations, ringing to bear the full capabilities and expertise within public and private partnerships. thank you. i look forward to answering your questions. >> thank you. we now recognize mr. meek for his testimony. >> chairman comstock, lipinski -- technology. chairman weber and ranking member johnson of subcommittee of energy. members about subcommittees. thank you for having me here today. on september 11, 2001, i was running -- operations for
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goldman sachs at ground zero in new york city. as i watch the first responders running into -- a day. i wanted to do something to give back to those who serve. i am still -- services technician -- now s&p global. my passion project has become soldier strong. soldier strong is a 501(c)(3) organization, committed to improving the lives of our service men, women, and veterans. the organization accomplish most of its work from a cell phone in new york. this work started with a request from a forward operating base in afghanistan, to send basic supplies like tube socks and baby wexler our former troops. over the years, they sent over 75,000 pounds of supplies to 73 units in iraq and afghanistan. as the war has run data, we contemplated closing down, until one of our board members asked, if the troops had everything they needed when they came home and started life
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in u.s. veterans. in retrospect. one day in particular would bring this question into focus for me. april 27, 2011 was my daughter's 5th are typically celebrated like many families, with cake and ice cream, without a care in the world. 6800 miles away, army sergeant dan rose was being medevac from the metal -- battlefield from kandahar. he had an id.'s injuries deprived him of the ability to walk again. -- that day, was a personal reminder of what we owe our veterans. and the sacrifices that all of us take for granted the lies we are blessed to live here. two years after his injury, daniel became the first recipient of our soldier suit, empowering him to walk once again. today's soldier strong finds the most advanced mobility devices and prosthetics on the market and makes them available to injured veterans who otherwise would not have access to them. the type of devices we currently fund comprise the soldier suit, which covers full body, upper body, and lower body mobility devices.
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one example is the xo suit, which allows paralyzed veterans to stand and walk again with robotic assistance. the physical and psychological impacts of being able to get up out of a wheelchair and stand at eye level with the world again are profound. in fact, we are partnering with the denver va to conduct a full study on the mental health impact of access to this technology. another example is the luke arm. that is the first and only prosthetic arm which replaces the full range of motion, from the shoulder, to the elbow, to the fingers and the hand. it is the first one that works just like the original equipment. that is -- many advanced technologies, these devices tend to be extremely expensive, expensive, with -- two or more capable devices cost $200,000 or more each. we have learned over the years that most of these devices were first developed for frontline service men and women. america's commitment to putting cutting-edge technology on our war fighters is exceptional. it is the point of national
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pride, it should extend, but currently does not, do what veterans who bear the physical consequences of service to our country. we work closely with more than a dozen va centers across the country, which -- oversees one or more of our devices. the va cares very deeply about our veterans. they are sometimes held back by arcane regulations that have not kept place with modern technological advancement. thank soldier strong, nearly 25,000 veterans have access to one of these devices. we believe every injured veteran has earned the right to the best technology american ingenuity can provide forget, one of the tragedies of the post 9/11 veteran care, is that too many veterans must rely on charitable organizations like ours to get access to the medical help they need. what sounds like science fiction -- these capabilities are quite real. when you see a veteran roll into a room in a wheelchair, and stand for the first time in years and actually what out of that same room. i made a short video of how how technology works. is dismayed by one of the
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contributions to the richmond va. this video concludes my remarks today. i look forward to answering questions from the subcommittee pick up >> -- soldiers taking the next step forward. [ inaudible ]. today, we are here to --. [ inaudible ].
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>> thank you. i now recognize ms. mcallen. >> chairman comstock, sharon smith. ranking member lipinski, and ranking member johnson. members of the committee. thank you so much for having me here today. in my work, i am fortunate to speak with generals, military leaders, and pentagon officials, made -- navy seals and green berets. as well as many other great men and women who serve or have served our country. in fact yesterday, i spoke with vice president hence, who is very interested in the subject matter of our discussion here today.
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in particular, the work of mr. worden, and also the work of soldier strong. and the u.s. technology that can grow and benefit our veterans and other members of society. it -- like most of us, as a citizen, i am enormously grateful to them. for the service, and humbled by the sacrifice but knowing, that is much as i love my country, i could never live up to the measure of the bravery and heroism. like most of us, i want to show my gratitude to those who put their lives on the line. those who make the sacrifices, who face the danger, who go to the front lines to protect us, and the freedom that we cherish as americans. soldier strong was born out of 9/11. out of -- desire to prove to us patriots to prove that we are forever thankful. is what we do as citizens it is a country -- to make sure that we are willing to move forward in combat, and that they will now be able to move forward in life. what ever they lost on the
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battlefield, or it injuries after they serve, we can help them overcome to the greatest of our abilities. 9/11 was a day that changed us forever. as a lifelong new york, new jersey 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 bowed that day to tell the story of the war on terror, and the battles that continue. and, to support those who heard the call of president bush when he said, the people who knocked these buildings down will hear from all of us soon. the men and women of our armed forces made that message heard loud and clear. sum paid the ultimate price. carrying that message to our enemies. so, when chris meek came to see me about the organization that he had started, with a simple message -- mission of sending basic supplies to the troops to
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show them how we can, and how that omission -- mission evolved, i was in. i joined the advisory board in 2014, and have been dedicated to using my voice, and the platform that i have to my work -- through my work to raise awareness and support, and to spread the word about cutting- edge technologies emerging in these field, and the life- changing impact they have to those whom i owe so much for the response has been incredible. i believe our viewers and americans across this country want better for our veterans. better than a system that leads -- leaves gaps and does not allow them -- i will never forget the day that sergeant dan rose came to our studio to demonstrate how his soldier suit allowed him to get up from his wheelchair and take the steps that he never dreamed he would be able to take again. the look on his face said it all. will, possibility, and --. as americans, we must make sure that we give back.
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but, give back in a way that is uniquely american. that relies on this cutting- edge technology, and never take no for an answer. as jfk once said about u.s. space missions, we choose to go to the moon, not because it is easy, but because it is hard. >> we live in a time where ironman is not just a movie. it is a moment when technology made in america can rebuild arms with full mobility, and allow bodies with severed spinal cords to stand up and walk. companies like xo bionics, bionics, mobius bionics are leading the way. but there is still a long way to go pick and we will do it. not because it is easy, but because it is hard. and because it is the right thing to do. embracing the technology is a winner for the united states, for the military, and from those who will benefit from the growth of these industries, and the jobs that it creates here at home as well. it make sense on every level. thanks to the work of a very lean and dedicated team, soldier strong operates on a
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budget that puts us 9-12 to what operating costs pick for that 80% goes directly to bringing the technology to more than 25,000 veterans at rehab centers and va facilities across the country so far. soldiers -- soldier strong has donated more than $2.5 million in high-tech medical devices that affect -- and $5000 toward scholarships whose way forward is to work education that opens doors in the next up for the lives. i encourage you to think of the findings that supports our fighting horses in the field can be extended to support the extraordinary research that is being done with taxpayer funding that will ensure that injured veterans have access to this scientific advances that come from it. i thank you very much for your time today, and look forward to your questions. >> thank you. and, we now hear from mr. worden. >> good morning chairman comstock, chairman weber, and ranking members lipinski and --
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and distinguished numbers of energy research and technology committee. i would like to introduce dr. farzad --. industrial systems engineer at texas a&m. we also have some veterans from the project here at walter lee -- walter reed hub program today. -- is an organization that brings our nation's veterans and first responders to get into sports, activities, and community. helping them overcome challenges associated with their visible and invisible wounds. being a catalyst for the adaptive sports movement, project hope continues to be the industry leader. dedicated research, including a georgetown research study of -- methods confirms that the work being carried out since its inception is changing and improving the lives of tens of thousands of veterans, first responders, and the families. remember, the veterans volunteer. the families are drafted. >> our mission is to save lives by restoring hope -- hope, government, and resilience to
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america's finest. 62% program -- decreased prescription drug use. ptsd related stress attacks, as measured by the hero tracker reduced by 83%. the annual project hope or disappoint saves the va more than $9000, including prescription drugs, and healthcare costs annually. a soon to be released report reviewed 3000 suicides to evaluate the cause and effect, and recommends steps to improve care to our veterans, and provide the data to show why 20 veterans commit suicide each day. what are the risk factors, diagnoses, and from the components at the root cause of suicide? the review found that diagnoses most common in all suicides are depression, ptsd, anxiety, and alcohol use disorder, with the average suicide having multiple diagnoses. the top risk factors are pain,
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access to firearms, worsening of health status, relationship problems, hopelessness, and decline in physical ability. most of the suicides were not identified as high risk in their medical records. of the 20 suicides per day, only 3 were receiving va mental health services at the time of their death. the reasons, inconvenience. long wait times. paperwork. transportation. and, stigma. the top recommendation of the street for is to come up with an enhanced suicide risk assessment, and safety planning capability that addresses the complex care needs of our veterans, utilizing technology, -- training, and extending more into the community. there is a need for a more systematic assessment tool that can document risks. the hero track initiative
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solves this vital need for a technology-based objective, solution for suicide prevention and mental healthcare. currently, no ptsd tool exist with remote capabilities to complement ongoing treatment. the hero track will be an fda approved device that will allow continuous monitoring and detection of ptsd triggers, using physiological sensors and machine learning algorithms, and to measure frequency, severity, and duration of the ptsd episode within 2 to 4 seconds. the hero track is a wearable -- development texas a&m, and tested exclusively at project -- and to learn a users physiological cues. our goal will be to prevent, eliminate suicides in military veterans and first responder populations, provide 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 survivors of sexual trauma and other mental health diagnoses with the care they need for the result will be better served outcomes at less cost.
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using a combination of heart rate and heart rate miller -- variability monitoring, the ptsd alarm will identify trigger spectacle creates a personalized profile that monitors patterns and variability to infer at ptsd episode. if an episode is detected, a lot of vibrations go off, with a visual prompt that the user will set up for options of support. self resiliency tools, they can connect to a no vet alone, peer- to-peer support network that they program into the watch themselves. that can include family, friends, or clinicians. you can automatically call the va crisis hotline or 911. the device pairs with a smart phone, and can interface with the website offer more features, including direct connect to peers, military command, or clinicians, either by phone or video as desired. the user will be able to share information with peers in the
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social network, that they wish to create for their own personal support system. the device can best be utilized when a person first choice active-duty military to create a baseline, and then constantly and consistently collect data on the mental and physical health, report stress events during the service. -- integrate this information into one electronic medical record. this biometric, collective data can then provide a medical clinician with the complete mental and physical health picture whenever the participant visits their healthcare provider. there by understanding whether the prescription drugs they have been using are actually working. or, whether the care path that they have been put on by their active-duty clinician is actually working. the overall advantage is a more comprehensive, objective measurement of the disability metrics that will lead to increased abilities and a better care continuum. for the patient, it is a
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creative way for them, for them and their family, to understand the environment and surroundings that cause stress episodes in their lives. they can look back at the minutes, the five minutes, the 30 minutes prior to a ptsd episode and understand, what was the trigger? also on the screen, we have screenshots of the app that the device pairs with, so you can see the data. on here, you can see your heart rate, your resting heart rate, your physical activity, the number of stress events, and also, your tools. it will convey active information on the -- accurate information on the state of my pick it will be a patient center that provides a 24/7 support network, with medical resiliency, and peer-to-peer support, if you have a ptsd episode. is gps enabled. if you become disoriented or pass out, the person who has
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been alerted to your ptsd episode will be able to know exactly where you are. a peer-to-peer support can provide motivation feedback, and the support of knowing that you are not alone. for the clinicians, it provides a complete mental and physical healthcare picture of the patient's. a more comprehensive measurement with disability metrics, which include -- provides a more informed care continuum. on the screen, we have an actual data that was driven from one of our testing, you can see how a pt st episode look to a clinician. it starts out during sleep. and then, you can see -- a spike in their heart rate that causes the alarm to go off. and also knows the difference between physical activity and an actual episode. so, the dod, it creates a baseline that consistently and constantly collects data on the mental and physical health, so that they can know the readiness of their troops before going on deployment.
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it maintains objective data and feedback on the overall readiness of the force, and that information can be integrated into the electronic ethical records. the most important need we have right now as a nation, is to prevent more suicide and improve the mental health of those who serve our country. although the conflicts may be winding down, there is a lifelong commitment we owe to these men and women. the hero track is vital to that commitment, to assure that they can see their children grow up in a supported community. we all understand the need to reduce suicide and improve mental health for veterans that live and work in each of our district's. there are veterans in your district right now that can be saved by utilizing the hero track. thank you very much for your time. >> we will now hear from dr. major. >> thank you. first, i would like to thank chairman barbara comstock, ranking member pinsky -- for
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the information to testify. i also want to rub her eyes --. there exists a large and growing number of veterans with neurological or muscular -- pathology to rely on --. where medically indicated, an interdisciplinary medical team delivers custom prostheses, and introduces therapies to train veterans how to use these devices in and ensure long-term success. currently, studies on -- persons in upper and lower limb what. we do not yet fully understand why nearly 50% of community living persons with limb loss fall at least once per year for many from experience -- have experienced upon related injury. this has implications to the veterans quality of life and healthcare cost. the study aims to identify factors that are useful for fall rescreening, and -- balance target interventions. the studies -- helper thesis
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uses -- users respond to --. >> this first example, we use a robot that -- a full blow to the pelvis. with the assistance of motors and cables. we are interested in the lessons that can be learned from the unique strategies of the individuals you see here. the second example, with the use of an interactive system, which provides both virtual and augmented reality. as a means to deliver walking disturbances. the system is used to deliver physical training, that requires controlled movement, and is combined with cognitive behavioral therapy as part of a holistic treatment. the remaining projects focus on development and evaluation of prosthetic devices. we are addressing the unique prosthetics needs of women with limb loss, and can accommodate changes in footwear. we are also developing a new method to deliver personalized aesthetics to the knees, based on the individuals body structure and individual --
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activity level. -- to assist -- to improve mobility and limb health. while prosthetic -- is advancing rapidly due to advances. the most critical aspect to -- are the veterans using these devices. research and development has granted us the ability to empower veterans of functional impairments, but understanding how veterans interact with this technology is crucial. therefore, we should support parallel research efforts on development of technology and its clinical applications. the success of the rehabilitation process is depended on clinicians use of evidence-based practice. that is generated from quality clinical research that considers the holistic needs of patients. furthermore, veteran rehabilitation does not and once they are fitted with the device and appointed to the community. real-world use of the technology provides a window into rehabilitation progress and quality of life. advances in wearable -- have sensors have improved our ability to create -- collect
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data. research is needed to explore ways we can best integrate sensors into devices to monitor user status with minimal interactive -- addresses the daily activities. we also need to -- guide rehabilitation strategies to better support independent functions. overall, veteran rehabilitation research must continue to be interdisciplinary to accelerate its progress. integrating science and engineering and medicine. to argue that we still lack a thorough understanding of the interaction between the human elements and rehabilitation technology. the more research is needed to better understand -- how the body responds to different designs, and b, which therapies are more effective. and c, and how the long-term outcomes are to the veterans life. filling these gaps will include personalized rehabilitation interventions that help close the loop between technology and
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clinical practice. ultimately, i believe the technology is driving us toward the future, where we can find two rehabilitation interventions with extreme precision, accuracy, and speed. devices and therapies will be personalized, based on individual patient characteristics. and, smart trustee fees will collect diagnostic data through onboard sensors. clinicians will use these data to monitor patient progress, and design intervention. while the devices themselves will automatically adjust in real-time to meet the demands of daily activity. combined with advances in -- therapy will be administering remotely, without traveling to a clinic, thereby improving access to care. real-time monitoring at remote intervention delivery will promote rehabilitation of veterans, while permitting in -- community engagement. rn golf -- a greater level of independence, a quality of life to veterans, which will reflect the main --. once again, i think -- for the opportunity to testify. and i'm looking forward to discussion. >> thank you all so much.
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but inspiring work you are all doing and innovation. it is all very exciting. i am kind of picking up, when we had our veterans roundtable yesterday, one of the things, how we can integrate the services. first of all, mr. worden, and that i want to kind of ask everyone this question. what three things can we do, you give us some action items for each of you to get what you are working on advanced, and out to more of our veterans. >> well, the first thing is easy. it is funding. the technology groups, in all the speeches, talks about funding, and the need for more funding for technology, because it has such a large impact. we talked yesterday in the forum , about how, for example,
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people are trying to justify or understand how valuable equine therapy is. if every participant was wearing a hero track device, he would be able to tell immediately, the overall mental and physical impact that therapy was having on that particular person. and so, you can make better informed decisions, as both the patient, as a clinician, at the congress, and where to appropriate and prioritize that funding. technology will continue to evolve. i would say that that is the second issue. as technology evolves, particularly our device, will become even more powerful. as phones become more powerful, as the wearable technology becomes more powerful. battery life improves. the reliability of the algorithm improves. the device will become even more efficient, and even more valuable. and then, the third thing is being able to work within the va system, which, i think is the biggest source of frustration for veterans.
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and that study that was quoted, where they talked about inconvenience, long wait times, paperwork, transportation, and stigma. the va has these challenges. but also, the way the va treats nonprofits, outside groups, and how we can interact with them is very, very conjugated. we are lucky. we are one of the few, we were one of the first with secretary shelton to be an authorized mental health and suicide prevention program at the va. but even with that, official designation, we still have a hard time working with individual va medical centers. and so, how can we fix, i don't even know ethics is the right word, but how can we make it so that, while it is a lot easier to to work with active dod component with dod. it is still the federal government if they are still supposed to be one rule book.
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>> ms. mcallen and mr. make to mark what has been your experience in working with the va, and how can we help advance, and obviously, i think we all agree, getting more funding directed to this? i can we integrate better? >> just get the va request for 2019 $198 million. $727 million of that request is for medical prosthetic research. so, funding is clearly one of the big issues. what i think about soldier strong, there is 170 va medical centers in the country. discussed what mr. worden was saying. we have devices in 12 of them. so far. so, the issue of scale, and scaling up, so that these devices are more available to veterans across the country, it is clearly one of the big goals here. in terms of what i do, i think communication, and helping people to understand across the
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country, whatever veterans go through when they get home. i think that is the message we need to continue to spread, and that is something that i would like to see more news organizations spend more time on. and, that is an effort that i would make. a look at one of the quotes from one of the veterans that we have spoken to. he said, you feel like a burden. and, you avoid social situations. that alone is such a hampering factor, to moving forward. so, we want to find a way to help veterans feel, especially when they are using these devices, that they are not in the way pick that they are normal. that they are part of society. i think raising awareness to greater communication is something that will go a long way to that. >> thank you. >> i think to agree with mr. worden, i think the two things that you can do, our first, to pass legislation, making this technology available to all veterans but more importantly,
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appropriations. it's wanting to pass a bill, but if you can't pay for it, it is not going to do anybody any good. there are several great organizations appear all doing some great things. at the end of the day, we are all fighting for the same sector, private donor dollar. there is only so much of that out there. took on getting help for people like yourself and this committee will help transform the lives of those veterans who need to pick >> i think one of those things that you have all demonstrated in testimony, with these devices and these things are made available, it is lowering ptsd. we actually do have long-term savings here. as well as, obviously, improve quality of life and the right thing to do. so, there is a win-win result from this. >> as you mentioned before, a lot of these devices were originally funded through --. what we are finding now, is that there is no dogma for veterans when they come back home. that is one thing that organizations like ours are trying to do here is step up and fill up that void. >> thank you very much. i think my time is up.
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mr. lipinski? >> thank you. i think all the witnesses for their testimony. a lot of interesting work, in different areas, to help our veterans with technology. i wanted to start with dr. major. you mentioned the potential of smart prostheses that can incorporate onboard sensors and real-world data to improve -- and designer intervention. what are the current challenges that the field faces in achieving the goals of smart prostheses? and what federal resources are needed, or could be leveraged to reach this target? >> thank you for the question. i think, in terms of the challenges that we face, necessarily, it is difficult to find ways to essentially integrate the sensors.
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i know a lot of sensors are available -- actually help provide the ability to be able to include them in devices like these. again, i think, what we are lacking is, what percentage are actually included trying to view that mapping between the data vats is being derived from real-world use. what that essentially means and how to direct that to how these directives -- devices either interact -- help the user, learn from the user, improve mobility. i think there are still gaps missing in terms of research. this is basic research, in the sense that again, once the data is available, how do you effectively use it? we need to make certain that research is being directed in a way that we can answer some of those questions to answer those gap. the sensor technology has improved and is rapidly advancing. they are getting smaller and smaller, and our ability to include devices such as prostheses, at this point is much improved.
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i don't necessarily think that is one of the bigger challenges. empowering those devices, powering the sensors, that is a challenge because they do require onboard battery power as well. obviously advances in battery power and -- technology will obviously help in this case. again, researchers need to be directed in terms of how we answer those questions. and we can collect the -- collect the data and how clinicians can use the data. also at the same time, protecting the privacy of the patient. once the data is streaming in, many to make sure that patient privacy --. >> are we training they, as we train the next generation of scientists to do this work -- a lot of different areas. do you think we are doing an adequate job of that? do we need to do more? or do we need to do more than? >> i would be hesitant to speak will probably. in my experience, i think we are. i think we want to be --
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benefits of this type of research, that it is interdisciplinary. we need to make sure that it continues to be so. again, it is this combination of engineering and medicine, we need to start integrating other disciplines as well. a look to science, robotics, whatever it might be. we need to be sure we are still promoting that type of integrative, interdisciplinary research to make sure we are staying competitive and advancing this particular science. i think we are doing an excellent job. we can always do better. as long as we continue on this track, i think this particular research will remain competitive, and we will be able to take the steps that we need to elevate this type of technology. >> moving on. it is great to see mr. ward and the work that you are doing here with hero track. -- veteran suicide, data is inconclusive.
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still trying to understand, what does hero track really provide in that direction? what else more do you think can be done to leverage commercial technologies, in order to do this? >> this report that is about to come out is pretty clear on what the root causes and diagnoses of suicide are. when you get into depression, anxiety, hopelessness, those are all factors. what we have found in our research so far, in our testing of the hero track, is that veterans feel like they have a support system with them 24/7, right on the wrist. because, it can connect to a loved one, a clinician, a family member, or a peer. so that it they have an episode, they are able to get
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out immediately. and, it is something that they direct pixel, they are in control. the feedback we have been getting from our focus groups has been really remarkable in the acceptance of being able to wear, basically, a technology monitoring device it understands what is going on with you, mentally and physically. and so, that power helps alleviate that hopelessness. so, if you are feeling depressed, you know, if i have an episode, it automatically will text message my buddy from iraq. or, my wife, or my girlfriend, or my father, or whatever you program in. and, that ability really creates that sliver of hope that is the difference between suicide and not suicide. >> thank you very much but my time is up. a lot of things to talk about here. to thank all of you for the work that you are doing.
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>> i now recognize mr. weber. >> thank you chairwoman. dr. -- in your prepared testimony, you talked about how the doe national labs have a history of research collaboration, and the ability to confront short and long-term complex science challenges. hold that thought in mind for just one second. ms. mcallen, you said you talk to a vet who felt the stigma when trying to interact with >> going out and socializing and being in a wheelchair and trying to get around people and feeling that he was in the way. >> mr. worden, you listed all of these causes of suicide. to you have that list available for us where we can get that letter? anxiety, depression, was stigma one of those causes? >> no. but stigma is one of the reasons why they don't receive va medical services. >> thank you. dr. -- back to you. we have --'s -- a history of
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working with some of those other agencies you said earlier. mr. worden, you said that the va has trouble working with outside groups. i would offer up the point that the department of energy does night. does not. -- does not. >> how does the department -- benefit from performing data analytics and computational research on behalf of the va? how do we meld this problem together? we will come back to you later. go ahead. >> thank you. that is the right question to ask. for us, the data, with its unique complexity that comes with subject matter experts, that is curated by experts, brings with it a team of specialists that allows us to attack the artificial intelligence and technology challenge with our experts. so, the meeting, the intersection happens at that place where we look at the
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priority questions of the veterans administration have service. we bring together the technology specialists. hardware, the software, the engineers, and ask, how do we answer those questions? >> does are outside industry and groups. keep going. >> yes. so, the nexus is the two agencies coming together. we draw from the breath of the laboratories. we engage the private sector and academia as needed. we bring in as many people as we can, because we recognize it is going to be and all of the above type of activity to answer these priority areas at the veterans administration's, as defined. >> actually, that is a perfect marriage, if you will. -- been able to do that, and thereby do away with stigma. --. do away with the -- to work with outside groups and make this a seamless as possible.
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i am going to come back to you with one more. these research partnerships have the potential to accelerate scientific breakers and healthcare systems and bio sciences. should the department replicate this model in other fields of research? and, what steps can we as congress take to facilitate that? >> i think the answer is yes, in terms of replication. our focal point right now has been on the veterans health data, and on the precision medicine data set, because of its unique complexities. because it comes with annotations with handwritten notes, with data streams, and imagery, and the collections of multimodal data that talks to the situation in unique ways, that is going to test how we develop predictive technologies, artificially intelligent based computing. when we start to get our head
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around what those hardware and software technologies are, these are ones we want to apply to other areas. but, we find that the highest leverage opportunities for us is around this data set. it draws in so many other partners who want to come. you want to participate. it is a force multiplier for our activities. >> that brings me to another question. do you see any problems the doa and the va working together? >> no. not at all. the beginning of april, secretary perry, and acting secretary loki design a new mo way to work together, that we have started to implement now. it identifies more data than we already have resident, that we plan to aggregate, so we have a very nice path forward. >> what process would you use to report back to congress? in other words, to say this is working, we are taking -- making huge steps in this direction? can we get that from you?
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>> i think, at your discretion, coming to you with the va, side- by-side, would be an effective means to do that. >> okay. thank you, madam chair. i'm going to yield back. >> thank you. i now recommend mr. -- for five minutes. >> thank you, madam chair. i wanted to ask a couple questions on data privacy and cyber security. dr. kus enough, the information collected for the big data science initiative, obviously very sensitive information. almost 600,000 veterans have voluntarily given dna, and other samples that can be used. what i want to know, is how is the va and the doa working together to implement federal requirements for cyber security? >> thank you very much. i would add to your list of veterans who have signed up, the secretary of energy, secretary perry also joined
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personally in may 2017, donating his dna and his medical records to the set, so security of course, is important. the personal health information enclave, the initial one we launched at oak ridge national laboratory, is what is considered a moderate, with advanced controls over the 199 standard, that meets both hipaa and high-tech act requirements. so, we have set up an enclave consistent with the protection standards, but in addition, through our cio office, to our cyber security specialists and privacy specialists, we do external reviews of the enclave. we also have engaged the va counterparts in the information security offices for their assessment of how we protect the data. in addition, we were very
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sensitive to appropriate use. housing the data is one thing. but, who gains access is done through training programs. we identify laboratory people who will be engaged, but we run that through the va. we have created teams, va and doe laboratory scientists who are backing the key problems the va has surfaced. the members of the teams that are allowed to access the data is controlled by the va. once we go to the training requirements. so, just housing the data does not give anyone access to the data. we worry about the control. we worry about the use of the data for the purpose, and we monitored that to irb processes as well. we set up, certainly, and enterprise sensitive to the use and protection of the data for the very reason you remarks. >> with you putting in all of those parameters to protect the information, are there any challenges to accessing the complete medical records of
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veterans, when need be? i just i want to know, is it easily accessible, quickly accessible, in situations where it needs to be? so, there are two parts to your question. technically, it is easy to access now. in terms of the tools, the infrastructure we have set up hardware and software. the learning environment. what is still a bit of a challenge is the irb process. what we have been doing here is new. every step we take is new for everybody, in terms of how we access data, and i think as we try and create the irb structure, for accessing veterans data, we are sensitive to the fact that machine learning and artificial intelligence will kind of 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 address a particular problem. if you are trying to learn from more than 22 million veterans health records that's been decades, from genomic data, to images, to someone, and apply machine learning, the way you asked us, the patterns of use are quite different than how anyone else has ever look at this data. and so, walking through the irb, and setting up the right protocols to allow access is a process that we are still working through. so, we have done something we can technically access the data. we have accesses and controls in place. but, the policy side, we are still working through how we get everyone to think about where the future is, in terms of learning from data. >> thank you. >> it in chair. i yield back. >> i now recognize mr. rohrbacher. >> thank you very much. and thanks to our witnesses
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today. >> this is not directly on technology. but, it is -- va issues. some other things that you are describing, have motivated you to focus on trying to find technological solutions, like depression, a sense of hopelessness, etc. a lot of that can be traced, some of us believe, to the use of opiates by the va. and, some of us believe that the va has taken the easy way out, simply by prescribing opiates to somebody with the problem, which when you supply that kind of drug, you are going to end up with probably someone with serious problems. now, this question. should the va be permitted to use cannabis? should they have that as an option, rather than just
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opiates? and, just, i guess another question to go directly to technology, but can i have your opinions on that, just know, yes, no, something like that? >> i will jump in. >> okay. >> should cannabis be an option for va, in terms of treatment of our folks, rather than just opiates? >> i understand your question. >> i have been doing this for 10 years. and, i have had over 30,000 veterans come through my program. and, i will tell you, unequivocally, that many of the veterans in our program use cannabis. and, they use it as an alternative to opioids. so, >> is it good? >> it seems to be working. they are all still alive. >> does anyone else have an opinion on that? >> okay. i won't force you into coming publicly on that. yes. they are controversial issues. i would suggest that it is sinful that we do not permit our veterans that option.
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the veterans, doctors, i know countless, not callous. i know a number of veterans or the doctors have had to pull aside and go to them in their, in an off-campus situation, where they could then recommend marijuana. and, it is ridiculous that we have to put doctors in a situation like that, where they can't even recommend what they think is the right treatment. mr. make -- esther make. you mentioned that it is difficult for medical devices to get approval. maybe you could give us -- we find that the same with commercial items as well, like the fda, and others. as well as other regulatory
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things. can you give us a little more detail on that? >> sure. you talked about the fda specifically. i will reference the ecstasy, which is the primary device that we fund. you certainly have to go through many phases of the clinical trials. and then you have to go through different phases for fda approval. that takes years. literally, years. >> people are suffering during those years. you have an example of a device that was left behind, or delayed so much that people were left to suffer? >> that's the case with the ecstasy. that has proven -- a veteran from iowa who was told he would never walk again and going to six months of rehab, was able to walk his daughter down the aisle at her wedding. it does work. >> i had serious trouble with my arms. i know a lot of veterans get this as well. actually, all the cartilage was gone. and they ended up -- all the
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cartilage away in my arms. i know how painful that was. and, what has really helped, as i have had the shoulder replacements that were, i believe, developed to help our veterans, and now, they have helped all of us. do we have a situation where veterans are having to wait? because, i know how painful that was. our veterans having to wait to use the technology that we have developed? >> i think the question is -- of the getting the technology to va or private facilities? private rehabilitation facilities will get it much more quickly, and it is much more accessible than going to the va process of them going to fda approvals, whether they get funding or not. it doesn't come from va here in washington. each individual va has its own budget. it's up to them what they deem appropriate or necessary for the veterans here. that's where we step into >> new technologies and new medicines are really elongated in the process for us to use
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them. and, when you mentioned batteries, about how new batteries will probably help many of these challenges that we face, for helping the disabled. let me just note, that there are new batteries on the way. and, dr. goodenough, the inventor of the lithium battery has had a major breakthrough that should have an incredible impact on the things we are talking about pick but then again, we have to make sure that the fda approves the use of these batteries. and, everybody else approves the innovation all the way down. so, i am very please -- pleased that you have alerted us to the bureaucratic problems that have to be overcome in utilizing new technologies for our veterans. thank you very much. >> thank you. i now recognize -- for five minutes. >> thank you, madame chairwoman. i want to thank the chairwoman
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and ranking member lipinski, and chairman weber and ranking member -- for joining us today. is member of the science, space and technology committee and the veterans committee, i want to thank all of you for your important work today. and give a real shout out to mr. meek. soldier strong based in connecticut. we are grateful for the work you have done. all of us in connecticut know people who died in the twin towers. and that is a scary memory. and, your commitment to that pick my niece was one of those who answered that call and served in afghanistan. and i know how them important to work all of you are doing is. i think it was you, mr. meek, mentioned, no darpa for the da. and dr. major, you have also talked about -- the va does not have aging facilities doing research. i have a couple of questions here. i am going to ask all of you to say whether you think there ought to be a darpa for the va, or rather, we should be using
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darpa, or task them with the va on va specific goals? that is what happening around exoskeletons. -- around exoskeletons through darpa. they kind of adopted. it has been left -- left for va to approve. if you could opine on that, please? >> i will begin. essentially, in terms of money mechanisms, obviously -- conditional funding. the typical way that the mechanisms run in the va. there are certain priorities that research is directed towards. for instance, prosthetic knees for women. that is something that has come about. because of the growing population of women veterans. essentially, those types of priorities that fit into existing mechanisms. i actually would look forward to something where there is maybe more targeted mechanisms, targeted funding mechanisms,
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speaking specifically toward certain priorities. doppler may be a way to do that, or some different formation similar to that, which could be implement it in the va. i think that would actually be quite effective. again, maybe not darpa in and of itself. but something that could work effectively in the va, that will allow individuals to target certain priorities. i think essentially, that would help of the technology, develop the advancement and the implementation in the va specifically. i think that is something that essentially is needed. >> mr. worden. i know that actually under dr. shelton, his only clinical priority was on suicide prevention. you have talked about a lot of feedback information. a question i have for you, is you are collecting a huge amount of important information. much of it tracks with what we know, anecdotally, as well as the research beginning to be done about feedback. do we have an ability to share, or how would we go about sharing that important information that basically, you are developing, with the privacy concerns and that is proprietary to you? you're as part of the
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challenges we have. -- that in the private sector, in order to push it to all of -- we have these questions about access. who has access to the data? how do we safeguard and how do we share the information you are developing, that would help us develop better -- for vegans. >> i will tackle that in pieces. first off, undersecretary shelton and president trump, suicide prevention and health is a number one priority. and yet, there is no visible funding for technology that addresses those issues. not a single dime. so, that is one area of concern that we have. with the testing we are doing right now, we are not collecting-we are collecting individual information, but we are not identifying the individuals. it is a blind study. there is no privacy concerns with that. with our program in general, we partner with the va, and we track, particularly mental health status and suicide -- of
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every participant in our program. and, we have done that on a longitudinal basis for some time. and, that information is contained, or housed in their va medical records. so, we are able to deal with the privacy in that regard. as long as the va medical records are private, and they have security, then the information that we are gaining will have that same security. >> i want to follow up with you afterwards. because you had some interesting testimony on gun violence issues, and work that la is doing to deal with students who have suicidal ideation and other issues. i think there may be alternatives that we can look at being developed elsewhere that could help mary the technologies that you are developing to connect to say, this va hotline. aachen we have an ability to connect to one of those issues? how do people even know about the va hotline? make sure we have got that staff. i want to make sure -- have you
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looked at that all? >> when we do our focus groups, as the device has been developed, it has four options when you have a ptsd option. -- episode. whether it is self resiliency, or it is contacting a family member or., or whether it is contacting the va hotline or 911. and what we find is that most veterans, i would say over 80% of veterans, would rather connect with a peer or a family member, rather than a stranger on the va crisis hotline. >> that tracks with all the other research we have, that they would rather have peers. overtime, but i really want to thank all of you for your important work on this initiative. energy to get to continue to bring your ideas forward and do a better job to protect those who served. >> thank you chairwoman. thank you all. this is really important picker is nothing more important that we can be doing in caring for our veterans. letting them have every opportunity for full lives,
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that are fulfilling, and continuing to be amazingly productive. so, thank you for your work. dr. --, if i could first address a couple of questions to you. the unique feature of the doe -- doe, va partnership, is it -- will be able to host protective va data. it's the only institution outside the va to do so. what steps is doe taking to protect the personal information of our veterans? and also, a follow-up, should doe also be allowed to host secured data from other sources, such as private industry? >> thank you very much for that question. the data security piece is really important to us. certainly, compliance with hipaa and high-tech are important. we have a process we have 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.
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and that, we provide the authority to operate the enclave. we engage our cyber security and privacy experts and counterparts from the va to oversee all of this. we are very careful about data use and protection for this enclave. >> do you think there is opportunity to host other secure data from other sources? >> these are things we already do across doe for many different reasons peer from other agencies. for many different reasons peer so, yes. the simple answer, i think >> doe houses four of the top 10 fastest supercomputers in the world. and it is a principle -- for leadership in computer facilities. i will providing doe with access to the va benefit healthcare -- benefit healthcare research is, specifically for veterans? >> i think what we have started to find in applying the basic existing tools in artificial intelligence, is they break rather easily. at the scales of the veterans
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data set. the complexity, the size, the amount of information contained, already exceed what the standard toolsets are allowed-can accommodate. doe is very interested in pushing the limits of technology and supercomputing in ai, and these kind of stresses are very interesting to us. in terms of whether next- generation of more cognitive tools will come from. so, we are going to be pushing this data, the data itself, is the mechanism in which we set up this next frontier, of ai inspired simulation. >> dr. major, thank you for being here. i am grateful for your work. -- northwestern. an incredible accomplishments that continue to come out of your -- and others at northwestern. so, thank you for being western. getting older brings with us --
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with it many challenges including the risk of falls. does your research provided quantitative data and -- other -- compared to veterans who don't require such devices? >> thank you for the question. i am not particularly aware of any research that is targeted specifically of veterans of that nature. or, the distinction between those, again, who do use prosthetic devices and those who may not. in terms of falls and forest. that it type of research is certainly needed. i think anything's of -- looking specifically at different types of veterans, the area they come from, the combat was they perhaps served, i think that particular research would be helpful in trying to target certain rehabilitation technology, whether it is prosthetic devices or other types of rehabilitation technology. in order to target specifically to individual cohorts. i think that is something that can be done. again, some of the issues that
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were brought up today. the veterans statistics, the type of data we have, because it is such an integrated health system is right for that type of research, essentially, that cannot be conducted necessarily on a wider scale. i think the resources we have available to us through the vha, this is the perfect opportunity to do that type of work. some of it is currently being done. but i think we can take better opportunity of that. >> very quickly dr. major. if i could follow up. clearly, our goal is to continue to improve the quality of life to veterans. but also, for all people. i wonder, with your research and work in prosthetics, how is it making its way to company that develop the 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 through a lot of these research efforts. so, just to use an example, my research in particular, even
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though it is directed to va funding, it also includes partnerships with academia -- northwestern university. and industry partners also. the technology that is developed in the patents that are then developed through those efforts are jointly owned. it would be owned by dva, as well as industry partners or academia as well. that is away as a method in which the technology that is developed by funding, supported by the va can be brought out, and benefits of billions. we do a lot of that, and i think it is, it is a great mechanism. i will say that in terms of technology transfer, i think so mechanisms could be developed within the va to help that, to help adapt that process, that would certainly be beneficial. there is a lot of great technology developed in the va. these efforts and funding to the va to support that. i think trying to get that out to civilian populations would certainly be of great benefit >> the time is expired. thank you so much for your work. >> thank you. i recognize mr. -- for five minutes. >> i think the chair.
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i think the committee for having this hearing. i have got to say, i got excited listening to your testimony. dr. -- a federal government scientist that worked for the va since 1983, maine more than $400 million when he sold the company for $11 billion to the giant gilead in 2012. the drug was then discovered, the drug was discovered with federal resources, and -- veterans with hepatitis c. but unfortunately, once the drug was sold to the private company, it was out of reach. for veterans and the va, both. so, is the va and the doe work together with the private sector, how do we also ensure that the data and technology resulting from taxpayer resources and labs is not exploited by startups in the private sector entities, solely for the commercial gain of a few individuals? >> thank you.
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that is a great question. in our partnerships, there are some fundamental tenets we have. one is open source. with the tools we create. for the very reason you mentioned. we do have some partnerships with 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 is, in the space with pharma and the technology companies, it is pretty competitive. so, it is by definition, open to other entities to join, and openly available and accessible for that reason. so, we are sensitive to the question you are 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 adds
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value to this. but, does not do this at the expense of others. oh, we are keeping an eye on it. again, open source and pre- competitive are foundational. >> i mean, we have seen this happen in other cases, too. it is a very difficult situation, when those have access to medicines that were developed with federal money. we need to work on the -- on strengthening those protections. mr. worden. i was pretty excited about your tps d alarm. it, you are using data, and the graphs you showed sauce mike in the heart rate. and then, additional sort of physical indicators after that. were you able to identify in those cases, the physical event, or the emotional event that triggered those reactions?
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>> we are not able to do that. but, we asked the participants in our study right now 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 a half hour before. and, it is great empowerment to an individual veteran do understand what causes a ptsd episode for them. because, it is different for each veteran. >> absolutely. if you could understand what is triggering the thing, that leaves all kinds of opportunities for treatment and mitigation of those triggers. >> the great thing about the device, is it will measure that, and see what you are doing to mitigate is actually working, whether you see what the prescription drug or the therapy options at the va or your healthcare provider has given to you. you can objectively understand how it is working, what is working? if it is working?
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if so, that is the great thing about the device. is completely objective. it is what it is. >> and, do you see similar sort of characteristics, data characteristics from different individuals with regard to ptsd triggers? >> yeah. when you look at the spite, if that is what you are referring too. yes. that's a common theme. if someone is having an episode, that's how the device detects that ptsd episode, is through that spike in heart rate, or the heart rate variation. >> we saw a spike. and then we saw a little bit of quiet period, and then we saw additional- >> the graph that you are referring too. that showed physical activity. i wanted to differentiate. one of the questions i always get, is how does it know if it's physical activity or a ptsd episode? and, the device is able to detect because of the steepness of the curve when you are having a ptsd episode as opposed to when you are riding your bike. there is a difference in how your heart rate elevates, and
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how fast it elevates. >> thank you. >> thank you. and, i now recognize-let's see. mr. webster. >> thank you manager thank you all for appearing. great work you are doing. we really appreciate it. mr. meek, you talk about, i know your exact words, but you talked about the a -- if technology was ahead of the va's practice, in a sense. and that, you get these technological advances that are not a part of the normal va treatment. i would assume, i don't know this is true. but i am making an assumption, that advances in technology usually cost more. and that it if it does more, it probably costs more. my question would be, how do we balance it? how do we mold together availability and advancement,
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so 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 helped a veteran 10 times better than current practice. however, you could only afford one out of 10, where under the old technology, you could afford 10 out of 10. is there a balance there? do you see what we might be able to do two-we certainly want to make advancements. but we also want to pay for. >> i think, go back to the other questions about if darpa should be a model to transform the va. i think it should be. we put the most advanced technology we can at war fighters. but once it's done meeting darpa specs for the battlefield. that it. the funding stops. there is nothing to commercialize that. for the private sector back at home. a lot of these devices, i
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mentioned that the average cost that we fund is 100,000, with some of them being almost 200,000 think about the original cell phone. if it inside a small suitcase. it cost $1000. today, it is the size of a calculator, and it fits in your pocket it it is a supercomputer. so, having that continued research development on a specific device, whatever it may be, for advancement, and where the funding comes from, there are certain -- we can look at. but, you have to keep that funding going. because over time, it will bring costs down. a lot of these devices also advance. but they cost a lot right now, and 10-20 years from now, if you look at some of the work that dr. majors is doing. their hardwiring some devices in the individuals great. -- brain. i have seen -- were somebody lost his arm in vietnam. he actually opened the door knob and cry because it was the first time he felt in 25 years. asked to be semi-. because in time, -- will reduce the cost of the devices. it will reduce the cost of
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medical and va care for those patients. >> -- presentation of the type of technology showed in your video. i was totally astounded that someone could actually go from a sitting position, and rise, with no help at all. not even, necessarily, using their arms. they could just get up. so, i would want everybody to have that. it's just, the idea of making it available is an expensive, and sometimes, that would come at the expense of any more tech the logical advances -- technological advances. i have another question. mr. worden, you mentioned, this doesn't have anything to do with that particular issue. it has to do a self-directed mental healthcare. which, he said something about -- i don't know exactly what you said, but it struck a no. that's what you are talking about. and that the person would help in the direction of what they would be choosing for their mental healthcare. i have seen that work in the
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private sector. do you think that ought to be more uniformly applied in the va? >> i don't know if i would use the word uniformly. but i think it needs to be available. because, every veteran that suffers from ptsd is different. if you have seen one veteran with ptsd, you have seen one veteran with ptsd. i think, what they find is a support system individually is the most important path. the great thing about the hero track device, is it gives them feedback, individually, so they can make decisions for themselves, based on how their quality of life is, that they want, or that they have right now. and so, if you go to the va, and you see your mental health clinician, and he goes, well, how are you sleeping? i'm not sleeping so good. we are going to give you some ambien. well, how do you know what that actually does any good for you? with the device, you are able to monitor and look at can --
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sleep patterns. look at ptsd episodes during sleep. and be able to decide whether or not that is something. because every prescription drug that you take as a side effect, or it has some kind of addictive quality. and, that affects your quality of life as well. we have veterans in our program that literally have suitcases full of prescription drugs that the va sends them on a regular basis. and that, when they get into our program, they get off of those prescription drugs. and yet, the va continues to send them the prescription drugs. when you talk about cost for technology, technology is way cheaper than prescription drugs. >> yes. that is not shocking. and that's awesome. thank you all for, every one of you pick it has been very encouraging. -- and your work. >> thank you. i would like to take a prerogative, too. on that particular point. if you can send us some of those examples, with whatever way that protects the patient's
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privacy, that would be really helpful. in us making this case. because i think this is great -- technology, that is going to save money. and, the more we can highlight examples like that, i think, as we move forward. i now recognize mr. done for five minutes. >> thank you madam chair. i love these steering committee meetings. it sort of underscores our interconnectedness. we are sitting here with the energy -- research subcommittee. we are talking about quantum computers from -- computing from national labs. -- translational -- and all of this on the subject of yet another committee, the veterans help. though it is interconnected. dr. alexis -- is near and dear to my heart. i know you are working on ways to determine biomarkers that determine -- relative -- of -- and how aggressively. can you recently -- can you --
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a couple of those for us? >> i can talk more to the technology side down the side that you might be more familiar with. >> -- but i do appreciate what you are doing. i think that that is key. esther meek, you partner with va hospitals. i suppose military hospitals like mr. -- watery. >> of course, they don't need your help. so, you partner with the va hospital. how do you select which ones? >> we work with the device manufacturer. depending on what the devices. so, if it is an individual, sometimes we fall to the va cracks. the manufacturer will find somebody that the va won't run, or the va will fund the device but not the it in. they will reach out to us to fill that void. in terms of the exoskeleton devices, we work with the manufacturer. there are 24 spinal cord individual -- within the va center. we start with those at the
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largest population that they serve. with the goal of hitting all of those with -- to begin with and circle back again. for example, -- virginia serves a larges with 5000 injured veterans. they have one device. they could use 25. -- a 3000 veterans acer. they could use a few devices as well. if one doesn't cut it, -- the device, were somebody goes in, like going into the gym with a personal trainer. they set your 45 minute time. you do laps around the va. >> when you do provide one of these exoskeleton, whatever type suits to the veterans, do you also provide continued support, maintenance, upgrade? >> when you purchase it, it comes with a four-year warranty, as well as training by the entire staff of the va. >> you mentioned that the regulatory verb -- burdens. we have been tasked by no less than the president to streamline the regulatory burdens, so if you have regulations that you think, bad regulations to get in the way, bring them to us.
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we went love to get rid of regulations. especially bad months. miss maccallum. you are sort of a people specialist. do you deal with a lot of people on a different strata. of you in your opinion, have you seen the va's -- and the veterans themselves, are they receptive to some of these new technologies? >> absolutely. when i think about the fact that just demonstrating with sergeant rose, on the set, and our set, we were able to raise enough money to buy an ecstasy for a veterans hospital in one day. i think that the awareness that people need to have. and also, i think the partnership between public and private entities, is so important. i think about the new va a look -- va bill. the va can't provide that assistance, they are now
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allowed to turn to a private entity to fill that gap. i think we need to look at -- for more ways to do that, so that private enterprise and the va can work most efficiently together. i think you will see a scaling up of the technology, and process facilities and it veterans facilities, and i think that the will of the people, in terms of what we have seen, is certainly behind it. i also think that when you look at the cost benefit analysis, in terms of taking care of veterans long-term, and uses her mr. worden said about the incredible expense of pharmaceuticals. this psychological benefit and life benefit of these devices, hopefully, will make some of those pharmaceuticals unnecessary. >> i share your optimism. it, i thank you for the gratuitous plug for the mission act of the va, the we are carrying across the finish line right now. it is near and dear to my heart. i said on that committee as well. i am looking at 20 seconds left on the clock. it's not fair to bring up the
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question, mr. worden, that you brought up. so, -- a new report of the stigma that we attach to ptsd and tpi, and not just our veterans, but in our active- duty troops. it, this is a major, major problem that we have been -- past the graveyard on. if we could treat, perfectly, we still aren't allowed to diagnosed active-duty troops, lest we ruin their careers. and we don't have time for you to comment on that. but i am glad you brought it up. >> if i could, i would like to say one thing about it. >> with the chairman's permission. >> one of the things that we found in testing. one of the things that was brought up by the va, is that that's what they want to wear a hero track, because it would cause a stigma, just for them wearing a device. but, because it is an apple watch, it makes them cool. >> the stigma has been removed.
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>> and ever, they are getting help that they would not ordinarily get. so, we are very aware of stigma in our organization, in the vets that we service. you have got to find creative ways to get around it. >> thank you very much. >> you bet. >> gathering general information that is good for health and well-being along the way, too. -- i've now recognized mr. palmer for five minutes. >> thank you chairwoman. i will be fairly brief. i have to provide -- preside over the house in a few minutes. but, miss maccallum, i am looking at your involvement in this. i really appreciate how this started, with soldier strong providing things to the soldiers in the field. some friends of mine -- lance corporal thomas rivers sister started that program, and sending everything from touring magazines to staples to central things. she got -- for her brother would get things in the other guys said, would you share
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that? it turned into a program called support our soldiers. unfortunately, lance corporal rivers was killed in the helmand province on april 28, 2010. and ied. but, the program continues. it has expanded, and we are having a banquet next thursday night. the annual banquet. these programs are incredibly important for morale. but also, for the families. a lot of these guys don't get letters from home but they don't get things. oh, thank you for what you are doing. mr. worden, in your testimony, you mentioned that project hero has reduced participants-the use of prescription drugs and opioids, and other -- significantly. and, mr. done brought this up as well about, i think the process of dealing with the soldiers begins before they get home. and, the whole thing about p std, -- before they get home. one of my concerns, we have got 22 veterans per day that commit
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suicide. and, i have to wonder, how much of that is related to reactions to drug use? and, what you are trying to do to reduce the dependence on drugs. i think, mr. worden, could you comment on that? you think that might help reduce, what i think is an unbelievable tragedy that is occurring every day with veterans? >> sure. when you look at the report that is going to come out, the risk factors that they looked at , worsening of health status, and decline in physical ability. those can be directly related to prescription drug use. particularly, when you have overprescribing a prescription drug use. and, it is not working. and therefore, you start losing hope. and then, it starts depression. and then, you are on the downhill spiral. and eventually, that leads to suicide. so, that is where i think the
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prescription drug use comes into play. because, for doctors, the easiest solution is, here is a pill. this will make you all better. whereas, it is not necessarily what is in the best interest of that individual. i think that is one of the great and exciting things about the hero track, is you will be able to figure out what is in the best interest of the individual, and be able to prescribe for that person, a healthcare path that will actually make a difference for him. >> thank you. -- would yield to me -- i think i came pretty close to that, ms. norman. madam chairman. i yield back >> i recognize mr. dunn. >> mr. norman. i am typing >> thank you so much bethink each of you for taking the time to testify. i have emphasized what dr. dunn said. as you move forward with, if you see regulations that are impeding what you do, let us know. we have got a body here that is strong, and will take your case
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to get needless regulations out of the way. this will go to the president. this will come at the body of the suspect miss maccallum, you have the interesting role, as i described, and the people business. as an anchor, and on the advisory board. what is your opinion on -- what has been your experience on this specific technology for veterans, that is effective with raising money, and raising the awareness? is there one or two that you could point to? >> you know, i just think when people hear the stories of these veterans, and the impact that it has on their lives, here is one veteran, jason geiger, who was with soldier strong axis it beneficiary. he said, you cannot put a price on walking. you cannot put a price on someone's ability to be six feet tall again, and stand up and kiss your wife. or stand up and hug your daughter or your son. you cannot put a price on that. and, we talk a lot about money,
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because we have to pay because, it is part of bringing the technology to our veterans. but, i think there is a will in america. i know there is a will in america to provide for this. i do think that people are very much aware, you talk about regulations, of the waste that exists in the federal government. and its good effort, in many ways to solve some of these problems, but i think everyone sitting here is working toward efficiency, in improving the lives of our veterans. i think that through technology, and through awareness, a lot of these ideas can help us to cut some of the waste in these programs, and to produce more benefits. >> and, you know, we don't know what we don't know. i am glad you brought up waste. because, every agency, particularly now, can give us a road map as to where there is waste, and specifics on how we can address it. and, i hope you all will do that as you move forward. because, every dollar saved through waste, would go back into potential good use.
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mr. -- mr. meek, how did we just died -- headed soldier strong decide which hospitals will receive the soldier suit you mark >> we work with the device manufacturer. and, -- medical system there 24 facilities, the spinal facility -- spinal cord facility --. we also work with those who have a traumatic unit as well. spinal cord injury will be focused more -- versus folks on stroke. we will take the recommendation from the device manufacturer. with the goal of getting those to certain large populations, a device first. and going from there. >> okay. perfect. thank you well. i think we are about a 12:00. i appreciate your testimony. i yield back. >> thank you so much. and, i think the witnesses for their testimony today, and the members for their questions. without -- with that instruction, chairman weber and ranking member -- opening
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statements, which they were not available to make when we started the hearing are made a part of the record. and, i really so appreciate the great testimony here today. i think we are seeing disruptive, positive, innovative technology. and, i think there is no question that we need to reallocate resources, get new resources, and make sure we are providing this choice. we are -- a lot of the things we are talking about with our veterans, what we are trying to prove is more veterans choice. what you are offering is more choice. and, more positive outcomes. i really do think it is a lot of win-win solutions that you have here. so, we look forward to working with you on how we can redirect and reprioritize this that we actually end up with better outcomes, that will ultimately, most importantly, save lives. but also, save money. so, this is really exciting. i think this is the beginning
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of what i hope will be a continued discussion, since we are already discussing this legislation and effort we can work with our colleagues here on this committee would -- who are also on the veterans committee. thank you for your inspirational --, and the record will remain open for two weeks for additional written comments and written questions from members. and, this hearing is now adjourned.
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>> i think the most important thing the leaders of our great countries can do is preserve our rights as citizens. not only and nevada, but for all of the country. and, in this day of censorship, i think they need to remember that we are the freest country in the world. and it needs to stay like that. >> the most important thing going on his education. i feel like, -- have more resources and more income coming to our teachers to help provide education for our students. for that, we may succeed in life >> i think the most important issue, anywhere, especially the state of nevada, and in our northern nevada region, is two things. one, affordable housing, whatever affordable housing may mean. and number two, is workforce. because, we are growing so rapidly, that we just don't have enough people to build,
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and to fill the jobs. >> -- going out our status poverty. we need to add more jobs so people can work and make a living for the family and have a good life >> the most important issue, i would say, is our environment -- keeping our environment clean and safe for all kind of organisms and species. >> voices from the state. part of cspan city capital's tour. and a stop in carson city, nevada. here is a rundown of the live events wednesday on this cspan networks. house meet at 10 am pick they continue work on the defense program spell. that lays out pentagon policy in the coming year. the senate works on several nominations, and on cspan 3 . secretary of state, my compay oh testifies for the first time as secretary at a house foreign affairs committee hearing. our coverage beginning at 9 am pick in the afternoon, house
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democrats hear from high school students about gun violence. thursday morning. we are in madison wisconsin, for the next stop on the -- 50 capital's tour, wisconsin lieutenant governor, rebecca clay fish will be our guest during washington girder -- washington journal. starting at 8:30 am eastern. next, u.s. customs and border protection officials talk about border facility

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