AI Will Tell Future Medics Who Lives and Dies on the Battlefield

SAN ANTONIO—In the warzones of the future, medics touching down amid heavy battlefield casualties will know who to treat first, how to approach every injury, and even who is most likely to live or die — all before looking at a single wounded soldier. 

That’s the vision of Col. (and Dr.) Jerome Buller, who leads the U.S. Army Institute of Surgical Research. 

Buller says biometric data gleaned from soldier-borne sensors, combined with in-depth medical and training data and augmented reality lenses, will help medics in combat evaluate the battlefield and everyone in it from a safe distance. They will make their most important decisions before even seeing their patients.

“Imagine that [the hypothetical future] medic is able to scan the battlefield and instead of seeing rubble, he’s seeing red or green dots, or amber dots, and he knows where to apply resources or not,” Buller said during the Defense One and NextGov Genius Machines event here on Wednesday. 

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“Let’s say you and your fellow soldier have the same injury. Looks the same, pools of blood are the same. You may compensate [as in, survive injury] far better than she can, or vice versa. And if I only have two packets of blood, who do I give it to? So this technology will help us to far better use these really scarce resources,” he said. 

That’s a big change from the way battlefield field medicine is performed now, relying heavily on medics’ intuition. “You have to literally determine which ones are going to live and die, so having some type of automated capability from a cognitive perspective to say, ‘Yep, you know they are red, I’m going to go to the next one,’ from a psychological perspective — I think it would have a huge impact on a positive note than just the medic making that call.”

There are three components Buller sees as essential to making that vision a reality. The first is using the vast amount of data that the military collects on soldier injuries, data that currently goes to the DOD trauma registry, and using it in a way that paints a predictive picture of future battlefield events via machine learning.

“We have a very rich DOD trauma registry,” he said. “In some cases, where they [the patient] didn’t make it, we have imagery and autopsy data. What’s happening now is it’s being looked at on an individual basis… let’s say you can mine this data. Now you have very specific combat injuries in very specific locations against specific enemies that we can potentially use machine learning applications on,” he said.

Still, he noted, the data would have to be cleaned and structured to be useful in training machines.

The second piece is getting better data from soldiers, both before they’re on the battlefield and during, by shrinking the size of soldier-worn sensors and enabling those sensors to collect more data.

“Right now, we have technology, it’s in the form of pulse oximeter-type interface,” he said, referring to a finger-worn sensor that checks oxygen levels in the blood. “It lets a medic know how well this person is compensating and whether not they are likely to go into shock.”

For the past year, his institute has been working with the Mayo Clinic on an improved version of the same technology: a wristwatch-like comprehensive medical sensor dubbed a Compensatory Reserve Measure, or CRM.

The last piece is augmented reality, via new heads-down displays like the IVAS system that the Army is looking to push out to the field in the mid-2020s. The display’s cameras and other lenses will let medics take “notes” on the injuries they see without writing them down — hardly an attractive prospect in the middle of a gunfight. The IVAS would record and transmit what the medic was seeing to the medical record to inform decisions then and later. “I think that’s an area we can really exploit,” he said.

He described the vision as “a concept being explored for future development,” not yet a program. But it in future wars, especially against more technologically-capable adversaries, it will be essential.

“The changing nature of war and what we are projecting our next conflict to be, which is far more lethal and far more complex than [current combat engagements are today] when we’re facing a near or near-peer competitor, when we are challenged in every single domain, land, air and sea, cyber, space, and across the electromagnetic spectrum, that’s going to require us to have our medics, not only our medics, but our warfighters more capable. There’s only such much training we can do, so leveraging technology is absolutely critical.”