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Health Beyond's vision for Canadian flagship: Connected Care Medical Module (C²M²)

Canada's ranging climate and expansive geography have shaped our national culture and individual character. The resultant sparse distribution of our population over rugged terrain from coast to coast to coast drives Canada's unique approach to remote healthcare delivery. Paired with our specialized expertise in several relevant areas, our leadership in medical education and practitioner training, our expertise in advanced healthcare delivery, and our research and academic excellence, Canada has all the cards to not only contribute to, but lead the development of a deep space healthcare model.

The Canadian Space Agency's (CSA) Health Beyond Initiative aims to collaboratively identify and develop innovative and sustainable medical solutions as part of evolving the healthcare delivery model currently used in low-Earth orbit for deep space, in line with the recommendations of the Advisory Council on Deep Space Healthcare. This new "deep space healthcare model" would address the additional and heightened healthcare challenges to be faced by astronauts traveling to farther destinations.

A vision to redefine remote healthcare in space and on Earth

Health Beyond envisions a Canadian flagship contribution to the international space program that would also serve to improve healthcare on Earth, since a lot of the challenges faced by astronauts are similarly faced by some remote, northern, or indigenous communities across Canada. This contribution consists of a transformative approach to remote healthcare delivery that is predictive, proactive and increases on-site medical capacity and autonomy. The objective is to equip and empower crews to manage their health throughout long duration missions to distant destinations. With strategic national and international actors, the co-creation, co-operation, and co-iteration of such novel healthcare approach will primarily occur on Earth, to prepare for eventual implementation into deep space missions. This will dually serve to address today's inequalities in healthcare access across Canada, and demonstrate capabilities to international space partner nations.

Connected Care Medical Modules

Health Beyond's vision is to enable agile, rapid prototyping and iterative operation of Connected Care Medical Modules (C²M²) on Earth, with the ultimate objective of operation in space. A C²M² is a scalable integrated system of state-of-the-art medical technologies and methodologies contained in a deployable unit. A shipping container will first be used for research and development purposes and for easy deployment across Canada via the existing intermodal freight transportation network. When preparing for space application and deployment in remote communities with collaborators, the Module, can be scaled down and adapted as needed.

One of the novel features of the C²M² is its core computer-based system that facilitates the incorporation, interconnection (i.e., flow of information), and usage of the latest medical technologies. This plug and play architecture will enable multiple configurations based on the end-users' needs. These technologies increase the user's capacity to independently detect, diagnose, treat, and/or monitor health conditions on site. This improves the timeliness, quality, and continuity of care; refines clinical decision-making; and reduces the occurrence of risky and expensive medical transportation of patients from remote regions to urban hospital facilities.

Flexible framework towards creating the future together

We aim to provide a "Flexible Framework" for the development of C²M²s to leverage and rally the expertise, experience and vision of health stakeholders. This Framework entails the provision of guiding elements, clear deliverables, and an overarching strategic vision while respecting and encouraging developers' creativity and independence of innovation. C²M²s represents an opportunity, among our various collaborative research and development activities, for innovators, industry, practitioners and researchers to collaborate to propose an integrated and agile concept. Continuous guidance, direction, and feedback from collaborators, developers, and users will inform future C²M² prototyping and allow national actors and industry to collaboratively redefine the future of healthcare in the most innovative way.

As C²M²s evolve and a terrestrial market is established, the Modules or their components (such as the Integration Platform) could be integrated into existing healthcare infrastructure whether in remote communities or large urban facilities. This offers numerous and continuous opportunities for Canadian innovators while also streamlining adoption of Canadian innovation, such as novel medical technologies.

Timeline - Present and upcoming actions

As an initial step, the CSA recently posted a Request for Proposals (Ariba) for which we will award up to five bidders with approximately $2 million each to provide their own first version of a C²M² by early . These contractors will serve as "Prime Developers" and may collaborate with sub-contractors to create the Module as a whole. We envision funding multiple Prime Developers on an annual basis to maintain competitiveness and maximize innovation throughout the rapid prototyping scheme.

Terrestrial application is of foremost focus for at least the first several years of C²M² development, with adaptation for space application potentially occurring within a decade of initial versions.

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