Investigation and Analysis of Available Chatbot Technologies to Integrate in Multi-Domain Operational, Delayed/Disconnected, Intermittently Connected, Low-Bandwidth Conditions.

Introduction: Paper-based clinical protocols and treatments have been historically used by combat medics to treat injuries and optimize survival. There is a need to replace these historical methods with digital processes to modernize the battlespace. With advances in artificial intelligence/machine learning (AI/ML), Chatbot interactions hold the potential to provide critical capabilities for military providers in Multi-Domain Operations (MDO), performing when connectivity is diminished or denied. Chatbots are autonomous, can also refine point of injury treatment, protocols-based patient care procedures, medical history, and current data. The Telemedicine and Advanced Technology Research Center (TATRC) and Madigan Army Medical Center (MAMC) have partnered to explore the feasibility of prototype clinical decision support system (CDSS) Chatbot solutions that feature ML and AI to aid combat medics in clinical protocols and treatment.

Materials and methods: The current analysis has 3 phases: Phase 1: Available commercial off the shelf (COTS) options were evaluated to determine which COTS technologies were capable of functioning under Delayed/Disconnected, Intermittently Connected, Low-Bandwidth (DIL) MDO conditions. Phase 2: CDSS Chatbot algorithms were trained by the Algorithm Directed 2020 US Army MEDCOM Algorithm-Directed Troop Medical Care (ADTMC) protocols and validated against historical anonymized patient data from previous projects. Phase 3: Chatbot prototype will be integrated with hands-free headset technologies that will be interconnected with the hardware and software solutions acquired in Phase 1. The final prototype will be tested in DIL conditions.

Results: Based on the needs assessment conducted in Phase 1, the solutions that offered portable, rugged, and secure devices in DIL/MDO conditions were the Amazon Web Services (AWS) Development Kit (software), AWS Snowball (hardware), Amazon Echo 10 (hands free), and Microsoft HoloLens (hands free) technologies. At the time of this abstract, prototype hardware and software integration into the hands free input devices, Echo 10 and HoloLens, are ongoing.

Conclusions: This effort includes development, systematic assessment, and leveraging existing CDSS clinical algorithms into Chatbot enhanced CDSS prototypes that specifically focus on utilizing hands free inputs to provide appropriate medical guidance for casualty treatment.