Tapping into astronauts' health data

Moffett Federal Airfield, Calif. The blanket of fog cutting visibility around San Francisco International Airport as seen from an air traffic control tower looked real.

NASA flight surgeons soon will have immediate access to astronauts' medical histories through a new electronic medical records system.

NASA's Comprehensive Medical Information System (CMIS) will integrate astronauts' medical information, which NASA collects when astronauts first enter the manned space program, with other clinical databases and laboratory information.

Eventually, the records will be available to surgeons at consoles in the mission-control center at the Johnson Space Center in Houston, where the system is being designed, so they can monitor the data when astronauts are on the space shuttle or the international space station.

NASA officials insist that the data will be secure. Only NASA flight surgeons will have access to the medical information system, and the system will not be used for research.

The system will be accessible through a virtual private network, and communications on the network will be encrypted. Users must have a public key that will enable them to move beyond the network's firewalls.

NASA decided it needed to integrate medical data about its astronauts into a central database about four years ago, said Patrick McGinnis, a NASA flight surgeon. Each shuttle mission maintained a separate record for each crew.

"Through an electronic format, we could consolidate medical records," he said.

Creating the electronic medical record system is the cornerstone of CMIS, McGinnis said. The system will help the surgeons identify trends in the medical histories of NASA's 150 astronauts, he said.

"We envision we will be able to re-engineer the way we monitor astronauts, whether they are at Johnson, in Russia or on a shuttle or a space-station mission," McGinnis said. "For shuttle missions, we were using pen and paper to keep track of the astronauts. For the station era, it will be a larger amount of data coming down."

Mission: Integration

Wyle Laboratories Inc., El Segundo, Calif., is managing the integration of the space agency's private medical databases, which started about three years ago.

Data from NASA's 150 astronauts' annual physical exams, pre- and post-shuttle mission exams, lab analyses, radiation monitoring, bone density, hearing and vision tests are being transferred into electronic medical record software from Medical Logic, said Phyllis McCulley, clinical lead on CMIS for Wyle.

Medical Logic's Microsoft Corp. Windows-based Logician software enables doctors to enter information about their patients into discreet categories and display the information graphically, she said.

Wyle also is using HIE Inc.'s Cloverleaf integration engine to route electronic medical records among the private databases. Cloverleaf software typically is used in the health care industry as a message broker to move inpatient and outpatient data between clinical and administrative systems, said Steven Fraser, vice president of solutions consulting at HIE in Marietta, Ga.

Cloverleaf is designed to export files in a large batch, such as the transfer of an older database into the new electronic medical records system at NASA, he said.

The CMIS became available in August with a major portion of the electronic medical record system, said Martha Thomas, project coordinator for Wyle.

The company plans to start using the interfaces with HIE's Cloverleaf software in February 2000 to integrate the Longitudinal Study of Astronaut Health database — used to access long-term effects of space flight — with the Flight Medicine Clinic, which provides medical care for astronauts and their dependents.

Once the data from the Longitudinal Study of Astronaut Health, which contains data collected since the 1950s, and the Flight Medicine Clinic databases are integrated, Wyle plans to make the system available to flight surgeons on their consoles in the mission-control center.

The consoles are used during space shuttle and international space station missions. That work, which will incorporate graphical images, pictures of dermatological conditions and possibly sounds, will begin by the end of 2000.

Other departments routing information to the electronic medical records system include the Occupational Medicine Clinic, which offers general health care for more than 29,500 space center employees; the Cardiopulmonary Laboratory, which is used for electrocardiogram and stress-function testing; and the Antrim Laboratory Information System, which holds blood analysis results.

In the future, Wyle hopes to interface with other NASA databases, such as those used by telemedicine, toxicology, and the bone and mineral laboratories.

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