This article is part of a series sponsored by HLTH highlighting topics that will be discussed at the HLTH conference November 13-16 in Las Vegas.
In order to realize the vision for advancing space exploration, we need to ensure the development of healthcare resources to make it tenable. 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 Hury highlighted some of the institute’s work, his background in pediatrics, and some of the problems for which it’s developing practical solutions from substantive food production to neurocognitive changes, radiation exposure, and more.
What is the Translational Research Institute for Space Health?
TRISH is funded by the NASA Human Research Program to provide federal, nondilutive funding to the best emerging health and human performance technologies and knowledge to support humans in space. We’re planning for commercial spaceflight, NASA’s Artemis missions, as well as future Mars missions. TRISH is a consortium that is headquartered at Baylor College of Medicine, and includes Caltech and MIT. TRISH is focused on solving health challenges, wherever humans explore.
What does your role entail?
As Deputy Director, I coordinate staff and solicitations to achieve TRISH’s strategic goals. This involves developing research solicitations and providing contract support for TRISH EXPAND commercial spaceflight program. As Chief Innovation Officer, I oversee the Industry Program which seeks to fund companies with space health applicable technologies and devices, and I have input on initiatives with the TRISH Science team.
How are you applying 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 startup 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, capabilities, and areas of resilience. Spaceflight data enhances our knowledge of physiology and medicine applications for people on Earth. Medical and scientific research on human health in space promotes the advancement of translational technologies in both directions – adapting known technology for space applications and using space-based insights to improve healthcare at home. As the only institute dedicated to promoting space health discoveries and technologies, TRISH is accelerating research that will benefit all people 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 how to do health within the Van Allen Belts very well. Humans have not traveled beyond LEO in since Apollo 17 in 1972. As NASA prepares astronauts for the upcoming Artemis missions, and eventually for extended stay on the Moon and the long journey to Mars, TRISH research is pivotal to ensuring critical space health solutions and technologies are available.
What are some of the projects/startups that you are particularly excited about working with in terms of innovative technologies or their goals?
We are focused on building a full-circle medical system that is vehicle agnostic to test on commercial missions in LEO. This system will involve middleware that will incorporate interoperability to allow for any input plug-ins, a decision support component for space health challenges, a closed-circuit approach to include recommended countermeasure management, and data transmission back to Earth to coordinate with ground-based medical support. This system would be a precursor for home-based health monitoring. After all, our spaceship to Mars will be very similar to home-based healthcare needs. Even if we have a physician on the Mars missions, the joke is that person is certain to get sick. Therefore, we need a “ship-based doctor” that can stay on mission, even if the crew becomes incapacitated.
What criteria do you use for vetting startups?
TRISH funds high-risk endeavors to provide the best potential tools to the US government. Most investors focus on the management or the so-called “jockey” when evaluating the potential of a company. TRISH focuses on the impact of the “horse”. We believe the underlying science will find a way to market in whatever vehicle gives it the best chance to succeed. 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 cranky patients that won’t articulate when they are suboptimal. Apparently, solving health challenges for astronauts is not very different. Both involve small markets right now with unique constraints. The space health market is just as infinite as space. However, more human activity is needed to justify solving difficult problems like surgery in space or childbirth. Only 600 people have ever left Earth, depending on your definition of where space starts. Most of those space travelers have been peak health individuals carefully prescreened for most health outliers. Commercial spaceflight has opened up 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 amazing opportunity to learn from outliers, which is what pediatric-focused innovators have been doing for decades. The art is in aligning market currents with underlying space health needs.
What are some of the challenges of developing health tech 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 substantive food production to double-stranded DNA damage, neurocognitive changes, radiation exposure, effective interventions, and other stressors within the very tight mass, power, and volume constraints. I argue that we need perfect health information in our pocket. This aligns with the needs of low-resource healthcare and even home-based healthcare. That perfect health information needs to be able to operate in the vacuum of space, under heavy radiation, and with a minimal power and data storage footprint. But, these challenges is how humanity learns and iterates. When we solve these problems, we solve aging, cancer, and mental health.
What does the near term future of health in terms of space exploration look like?
TRISH has built a program to test health technologies and knowledge in LEO with commercial spaceflight partners. The EXPAND program allows TRISH to place experiments across several flights and several crews to increase the “N,” or number, of subjects. The commercial crews are participating in research for the benefit of all mankind. The crews consent to IRB oversight and the research compliments that are advanced through spaceflight certification by TRISH. The research subjects consent to TRISH essential measures as well as unique experiments that will significantly advance human knowledge, in everything from Intracranial Pressure to cellular damage and repair. By partnering with commercial spaceflight providers, like SpaceX and Axiom Space, TRISH can rapidly mature technologies and do 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 to land the first woman and first person of color on the Moon.