mission model, mission model canvas, customer development, Hacking for Defense, lean startup, stanford, startup, steve blank, Pete Newell, Joe Felter, minimum viable product
Oppenheimer Film Discussion for Philosophy and Film
Surgency Hacking for Defense 2017
1. Team Surgency
Supporting time-critical combat care during mass casualty response
Week 0:
Problem: Developing the capability
for forward deployment of robotic
telesurgery in order to reduce the
‘Golden Hour’ critical time window
with early surgical intervention
Solution: Solve signal latency for
robotic telesurgery
Week 10:
Problem: Addressing triage and
treatment bottlenecks during mass
casualty situations at a Role 1
Battalion Aid Station
Solution: improve situational
awareness and intra-BAS
communication
90+
Interviews
2. Chris Sebastian
Software Engineering &
Product
Andrew DeClerck
Machine Learning &
Software Engineering
Negin Behzadian
Analog Circuit Design &
Signals
Abbey Cutchin
Tissue Engineering &
Orthopedic Surgery
Mentors and Sponsors
Rafi Holtzman
Dr. Steve Hong
Amanda Love, USAMMA
The Team
4. 0 1 2 3 4 5 6 7 8 9
EmotionalState
10
Robotic
Telesurgery
?
What is the
Problem?
It’s a
Management
Problem!
Who is this
for?
Beneficiary Buy-In
Development
Next Steps
Our Journey
5. Develop capability for robotic
telesurgery that would allow
physicians to provide time-critical
treatments for injured patients from
remote geographic distances.
The Original Challenge
6. “People are scared to move a
daVinci down a hallway, let alone
use it on the battlefield”
- Anonymous Stanford Hospital Trauma Surgeon
7. 0 1 2 3 4 5 6 7 8 9
EmotionalState
10
Robotic
Telesurgery
?
What is the
Problem?
It’s a
Management
Problem!
Who is this
for?
Beneficiary Buy-In
Development
Next Steps
Our Journey
8. Where can we add value?
Evacuation
Forward CarePOINT OF INJURY
Role 2
Role 3
12. Where can we add value?
Evacuation
Forward CarePOINT OF INJURY
Role 2
Role 3
13. “[Mass casualty triage] is not a
patient care problem, it’s a
management problem.”
- 129th Rescue Wing Pararescuer
14. 0 1 2 3 4 5 6 7 8 9
EmotionalState
10
Robotic
Telesurgery
?
What is the
Problem?
It’s a
Management
Problem!
Who is this
for?
Beneficiary Buy-In
Development
Next Steps
Our Journey
19. “The first time extensive triage
takes place is at the Battalion Aid
Station.”
- LtCol Hasseltine, former Commanding Officer, 2d
Battalion, 7th Marines,1st Marine Divison
20. 0 1 2 3 4 5 6 7 8 9
EmotionalState
10
Robotic
Telesurgery
?
What is the
Problem?
It’s a
Management
Problem!
Who is this
for?
Beneficiary Buy-In
Development
Next Steps
Our Journey
23. “There is a continuous stream of
communication at a BAS supporting triage,
treatment, and EVAC of casualties across
medical and tactical personnel. This chain
could easily break down in the chaos of a
mass cal.”
- MAJ Michael Holloway, former BAS Physician Assistant
24. 0 1 2 3 4 5 6 7 8 9
EmotionalState
10
Robotic
Telesurgery
?
What is the
Problem?
It’s a
Management
Problem!
Who is this
for?
Beneficiary Buy-In
Development
Next Steps
Our Journey
27. Final MVP: Evaluating Product-Mission Fit at the BAS
TRIAGE TREATMENT
CAS. INFO
INPUT:
Secondary Triage
Officer
OUTPUT:
Physician
Assistant
EXPECTANT
STAGING AREA
BLACK
SENSOR
INPUT:
Field Medics
MEDEVAC:
Medical Officer
28. Surgency: Mission Model Canvas
- UI/UX Design MVP
- Software Engineering
- Interface/integrate w/
Zephyr sensors
- Purchase/support
Zephyr supply
- Gain buy-in from JTS
and incorporate in
standard practice
- Continued sponsorship
by military beneficiary
- Industry (wearable
sensors, H2Care, Zephyr
Technologies)
- Course faculty and staff,
military liaisons, DIUx,
SOFWERX, In-Q-Tel
- Problem Sponsors:
USAMMA
- DoD organization with
interest in medical device
research (USAMRMC,
TATRC, DARPA)
- Joint Trauma Registry
-Primary: Physician
Assistants at Role 1 BAS
- Secondary: other BAS
medical officers (i.e., triage
medics), and potentially
tactical officers
- Tertiary:
Care providers at higher
echelons of care
- Increase situational
awareness: Constant vital
monitoring provides PA with
greater awareness of patient
status.
- Improve efficiency of
communication among BAS
roles: Augmenting PA access
to communication flow from
medical officer -> PA ->
Platoon Sgt for quicker, more
informed decisions
- Improve efficiency of
MEDEVACs from BAS: More
accurate prioritization during
MEDEVAC requests prevents
unnecessary allocation of
MEDEVACs and crew
-Medical force multiplier: With
more efficient allocation of
MEDEVACs, allow for increased
access to shared resources
between different teams.
- Improved medic-supported triage of combat injuries at POI in
mass casualty situations
- Widespread adoption & trust from DoD medical team and DoD
command
- Lives saved / Improved Quality of Care / Time to MEDEVAC /
MEDEVACS sent vs patients transported
- Test case in mass
casualty situation with
advanced medical first
responders (18D trained)
- Test case in mass
casualty situation with
standard combat medics
Fixed:
- Software design & engineering
- Robotics/Surgery Suite Costs
Variable:
- Customer acquisition/sales
- USAMMA procurement
/sustainment resources
- Medical Advisors
- Testing facilities
- AI/ML advisors
- Need demand signal
from BAS medical officers
responsible for triage,
treatment, and EVAC
decisions
- Need execution and
active use by medics and
first responders at BAS
-Need implementation
direction from DoD
leadership
Beneficiaries
Mission AchievementMission Budget/Costs
Buy-In/Support
Deployment
Value PropositionKey Activities
Key Resources
Key Partners
29. Value Propositions and Beneficiaries
Automated Continuous
Monitoring
Improved Intra-BAS
Communication
Increased Situational
Awareness @BAS
Medical personnel at
a BAS
Care providers at higher
echelons of care
Increased Situational
Awareness/Preparation at
higher Roles of Care
Tactical personnel at
a BAS
30. “I have dozens of anecdotes of
patients that have died or had poor
outcomes, because the number of
casualties overwhelmed capability
to monitor or treat...”
- LtCol DeLellis, Deputy Surgeon at the United States Army
Special Operations Command
31. “...active monitoring would likely
have changed the outcome, for
the better, for many of those
patients.”
- LtCol DeLellis, Deputy Surgeon at the United States Army
Special Operations Command
33. 0 1 2 3 4 5 6 7 8 9
EmotionalState
10
Robotic
Telesurgery
?
What is the
Problem?
It’s a
Management
Problem!
Who is this
for?
Beneficiary Buy-In
Development
Next Steps
Our Journey
38. “[The MVP] would effectively eliminate
the standard 15 minute interval
between vital re-measurements by
enabling continuous vitals monitoring.”
- 23rd Marine Regiment Corpsman
39. 0 1 2 3 4 5 6 7 8 9
EmotionalState
10
Robotic
Telesurgery
?
What is the
Problem?
It’s a
Management
Problem!
Who is this
for?
Beneficiary Buy-In
Development
Next Steps
Our Journey
42. Where do we go from here?
- Secure funding sources for further development i.e. the
AAMTI Award
- Interface with Zephyr biopatch sensors
- Work with USAMMA to develop formal requirement upon
MVP screening
- Explore field testing with a unit in a frequent deployment
cycle i.e. the 101st Airborne
43. Acknowledgements:
- USAMMA: Amanda Love, Jay Wang, Nita Grimsley
- TATRC: Daniel Kral, James Beach, Nathan Fisher
- Mentors: Steven Hong, David Zinn, George Hasseltine, Seth
Krummrich, Rafi Holtzman, Tammer Barkouki
- MVP Feedback: Stephen DeLellis, Jeffrey Oliver, Michael Holloway,
Erwin Villeros