Mass General Brigham Researchers Awarded ARPA-H Funding to Enhance Health Outcomes in Rural America

Mass General Brigham has been awarded three Advanced Research Projects Agency for Health (ARPA-H) contracts to deliver hospital-level care to Americans in rural communities across the United States. These awards will provide funding over five years to support the development of a scalable, multi-purpose, Care Delivery Platform (CDP)— an electric vehicle that integrates various medical devices and technologies to deliver hospital-level care where no hospital exists.

The initiative, known as the Platform Accelerating Rural Access to Distributed & Integrated Medical care (PARADIGM) program, will create CDPs to benefit the many Americans who face significant barriers to accessing advanced hospital-level care. Some 60 million Americans live in rural areas, representing a patient population that experiences 20% higher mortality rates from the five leading causes of death — heart disease, cancer, trauma, lung disease, and stroke — compared to Americans living in urban areas. These geographic disparities are expected to worsen as over 100 rural hospitals have closed in the past decade and 30% of remaining rural hospitals are at risk of closing. This trend threatens to further limit access to advanced imaging, procedures, and specialty medical services.

ARPA-H sought solutions within five technical areas to create a mobile platform capable of delivering a variety of advanced services across rural America. Projects have been awarded to three Mass General Brigham physician/investigators to address different technical areas:

• David Levine, MD, MPH, MA, Clinical Director of Research & Development at Mass General Brigham Healthcare at Home and Director of Ariadne Labs’ Home Hospital Program, and his team will help develop the next-generation clinical delivery platform designed to provide hospital-level care in rural areas without relying on the physical location of rural home hospital programs. The DEMOCRATIZE program will deliver cost-effective clinical care in rural America and measure health outcomes.

“The U.S. healthcare system typically centers its most advanced capabilities around hospitals and associated facilities, yet many patients are unable to access this care,” said Dr. Levine. “Our goal is to democratize access to hospital-level care, blending our experience in human-centered design, home-based technology, implementation, and rural Home Hospital to touch patients at common critical moments in their lives. We want to create a cost-effective, scalable solution for all of rural U.S.A.”

• Julian M. Goldman, MD, Anesthesiologist in the Department of Anesthesia, Critical Care, and Pain Medicine, Director of the Medical Device Interoperability & Cybersecurity Program at Massachusetts General Hospital, and Medical Director of Mass General Brigham Biomedical Engineering, and his team, will develop an advanced, scalable Medical IoT standards-based platform called PARADIGM-ICE. This Integrated Clinical Environment platform will integrate data from various medical devices and EHR systems to create a secure, standardized ecosystem, ensuring devices work together seamlessly to enhance patient safety and care efficiency.

“Our team is developing a transformative Medical Internet-of-Things (MIoT) platform designed to seamlessly capture and harmonize data from medical devices and patient care activities. This innovation will enhance safety, reduce caregiver workload, and enable remote medical experts to support advanced patient care in rural areas,” said Dr. Goldman. The MIoT platform will enable the smart and secure integration of clinical measurements such as blood pressure, oxygen saturation, electrocardiograms, and blood tests, along with critical interventions like intravenous chemotherapy administration. This project serves as a foundation for building and delivering Smart and Autonomous Medical Systems (SaAMS) for rural America.

• Rajiv (Raj) Gupta, MD, PhD, Vice Chair of Clinical Operations in the Department of Radiology, an Associate Radiologist in the Divisions of Neuroradiology and Cardiovascular Imaging, and the Director of the Advanced X-ray Imaging Sciences (AXIS) Center at Massachusetts General Hospital, and his team will develop an ultra-compact, lightweight, ruggedized, self-shielded CT scanner for use in resource-constrained environments. They will do this by reimagining both the hardware and software design elements of the device technology to simplify advanced imaging for use in a mobile unit. CT – which is the preferred imaging modality to diagnose various emergent and non-emergent conditions – is the standard of care in any urban emergency room and outpatient imaging clinic in the United States as it is required for the assessment of trauma, stroke, chest and abdominal pathologies, atherosclerotic disease, including coronary artery disease, lung cancer screening, and a variety of other emergent and non-emergent conditions.

“Despite the tremendous growth in Computed Tomography (CT) imaging within the United States over the past two decades, these systems are largely confined to urban settings due to their size and cost, providing little to no benefit to those in peri-urban and rural settings. The overarching goal of this project is to address this gap by enabling advanced imaging on a Care Delivery Platform operating in rural environments,” said Dr. Gupta.

If successful, the mobile platform will offer many advanced services, including multi-cancer screenings, hemodialysis, and perinatal care. By removing the need for fixed locations, this platform can bring medical care to even the most remote areas, allowing rural patients to access the care they need in their own communities.