This article is part of a series sponsored by HLTH highlighting topics that will be discussed at HLTH Conference November 13-16 in Las Vegas.
To realize the vision of progress in space exploration, we must ensure the development of health care resources to make it sustainable. The Baylor College of Medicine-based Translational Research Institute for Space Health (TRISH) is focused on these needs. In response to emailed questions, deputy director and chief innovation officer James Hurey highlighted some of the institute’s work, its expertise in pediatrics and some of the problems it is developing practical solutions for, from essential food production to neurocognitive changes, exposure of radiation and others.
What is the Translational Research Institute for Space Health?
TRISH is funded by NASA’s Human Research Program to provide undiluted federal funding for the best emerging technologies and knowledge about health and human performance to support humans in space. We are planning commercial space flights, NASA’s Artemis missions, as well as future missions to Mars. TRISH is a consortium headquartered at Baylor College of Medicine and includes Caltech and MIT. TRISH focuses on solving health challenges wherever people explore.
What does your role involve?
As Deputy Director, I coordinate staffing and invitations to achieve TRISH’s strategic goals. This includes developing research proposals and providing contractual support for the TRISH EXPAND commercial spaceflight program. As Chief Innovation Officer, I oversee the industry program that seeks to fund companies with space health-applicable technologies and devices, and contribute to initiatives with the TRISH Science team.
How do you apply healthcare insights from space to people on Earth?
TRISH brings together in one central location research proposals from academic and pharmaceutical research institutions, as well as biotech and start-up companies. We are building a thoughtful portfolio of scientific discoveries and technologies with the potential to address pressing health and safety challenges in space travel – from Low Earth Orbit (LEO) missions today to Mars missions in the next decade – with applications on Earth as well. The extreme environment of space challenges the human body and mind, revealing innate vulnerabilities, abilities and areas of resilience. Data from spaceflight improves our knowledge of the applications of physiology and medicine to humans on Earth. Medical and scientific research on human health in space is driving translational technology advances in both directions—adapting known technologies for space applications and using space insights to improve healthcare at home. As the only institute dedicated to advancing space discovery and technology for health, TRISH is accelerating research that will benefit all humans with a future in deep space as well as here on Earth.
What are some of the milestones we’ve reached when it comes to the intersection of space exploration and understanding human health and how to improve it?
The United States has had a continuous presence in low Earth orbit (LEO) since 2000 on the International Space Station (ISS). NASA knows very well how to take care of health in the Van Allen belts. Humans have not traveled beyond LEO since Apollo 17 in 1972. As NASA prepares astronauts for the upcoming Artemis missions and eventually for an extended stay on the Moon and a long journey to Mars, TRISH research is key to providing critical solutions and technologies for health in space are available.
What are some of the projects/startups you are particularly excited to work with in terms of innovative technologies or their goals?
We are focused on building a full circle medical system that is vehicle agnostic to be tested in commercial missions in LEO. This system will include middleware that will include interoperability to allow any input plug-ins, a decision support component for space health challenges, a closed-loop approach that includes recommended countermeasures management, and data transmission back to Ground to coordinate with ground medical support. This system will be the forerunner of home health monitoring. After all, our spacecraft to Mars will be very similar to home health care needs. Even if we have a doctor on Mars missions, the joke is that this person is bound to get sick. Therefore, we need a “ship doctor” who can stay on mission even if the crew becomes incapacitated.
What criteria do you use to screen startups?
TRISH funds high-risk efforts to bring the best potential tools to the US government. Most investors focus on management or the so-called “jockey” when evaluating a company’s potential. TRISH focuses on the impact of the “horse”. We believe that basic science will find a way to go to market in whatever vehicle gives it the best chance for success. This investment of taxpayer dollars keeps expertise at the forefront of human innovation as well as gives our astronauts the best chance to come home alive and well.
How did your experience at Texas Children’s Hospital prepare you for this role?
Pediatric innovation involves solving very difficult problems with very specific constraints for (understandably) very irritable patients who do not want to articulate when they are suboptimal. Apparently, solving health challenges for astronauts is not much different. Both involve small markets at the moment with unique constraints. The space health market is as endless as space. However, more human activity is needed to justify solving difficult problems such as space surgery or childbirth. Only 600 humans have ever left Earth, depending on your definition of where space begins. Most of these space travelers were individuals in peak health, carefully prescreened for most health abnormalities. Commercial spaceflight has accelerated the rate of space exploration and offers humanity the chance to learn from different, possibly less than optimal, human systems under extreme stress. This offers an incredible opportunity to learn from outliers, which pediatric-focused innovators have been doing for decades. The art is in aligning market currents with the basic health needs of space.
What are some of the challenges in developing health technologies for space?
Deep space exploration—beyond low Earth orbit, to the Moon, Mars, and beyond—presents unique mental, physical, and emotional challenges. To thrive in deep space, humans will need practical solutions to problems from essential food production to double-stranded DNA damage, neurocognitive changes, radiation exposure, effective interventions and other stressors within very tight constraints on mass, power and volume. I argue that we need perfect health information in our pocket. This meets the needs of low-resource healthcare and even home healthcare. This perfect health information must be able to operate in the vacuum of space, under intense radiation and with a minimal energy and data storage footprint. But these challenges are how humanity learns and iterates. When we solve these problems, we solve aging, cancer and mental health.
What does the near future of health look like in relation to space exploration?
TRISH built a program to test health technologies and knowledge in LEO with commercial spaceflight partners. The EXPAND program allows TRISH to conduct multi-flight, multi-crew experiments to increase the “N” or number of subjects. Commercial teams are involved in research for the benefit of all mankind. Crews agree to IRB oversight and research compliments that have advanced through spaceflight certification from TRISH. Study subjects agree on basic TRISH measures as well as unique experiments that will greatly advance human cognition in everything from intracranial pressure to cellular damage and repair. By partnering with commercial spaceflight providers such as SpaceX and Axiom Space, TRISH can rapidly develop technologies and conduct tests in conditions that mimic the early Artemis missions. TRISH is committed to supporting NASA’s Artemis missions, which aim to return humans to the moon for the first time since 1972 and land the first woman and the first person of color on the moon.