Ron Poropatich is Implementing Revolutionary Change in Patient Safety

A retired U.S. Army colonel, director of the University of Pittsburgh's Center for Military Medical Research, and Professor of Medicine in Pitt's Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Ron Poropatich has played a pivotal role in the advancement of both telemedicine and revolutionizing the use of artificial intelligence and machine learning to care for patients in the battlefield and beyond.

Born in Lawrenceville and growing up in Shaler, Dr. Poropatich went onto the University of Pittsburgh receiving his Bachelor of Science in biochemistry, master's degree in science focusing on bacteriology at Wagner College, and received his MD at Drexel University.

"I wanted to go on to medical school. I graduated in 1977 from Pitt. I did okay, but not good enough for med school, so I decided that as a fallback to gain some maturity and experience I would join the ROTC (Reserve Officers' Training Corps) during my last two years at Pitt. I used that ROTC to help get a master's degree in microbiology.I came into the Army then as a first lieutenant, and I was assigned to Walter Reed Army Medical Center in DC, where I served as an army officer in the microbiology laboratory," Dr. Poropatich recounted.

By 23 years old, Dr. Poropatich was named the director of that laboratory and became "more serious in purpose," applying to medical school and attending Hahnemann Medical College (now Drexel University) for his medical degree.

He served 30 years in active duty, retiring in 2012 with the rank of Colonel, with extended assignments at Walter Reed National Military Medical Center starting in 1985.

During his time in active-duty service, he led the U.S. Army effort from 1993-2012 in the development and deployment of telemedicine capability across 22 time zones for remote consultation for stateside Army locations, as well as overseas locations, including Afghanistan, Iraq, Somalia, Kuwait, Haiti, and Croatia. Since 1996, he has served as an associate editor of the "Telemedicine and e-Health Journal," is the former Chair of the NATO Telemedicine Team (2000-2012), and former President and board member of the American Telemedicine Association, where he served from 1995-2004.

"I was doing telemedicine and standing telemedicine up around the world," Dr. Poropatich said. "When I left the Army in 2012 (a mandatory retirement) after 30 years, we were doing about 5,000 telemedicine consults a month across 22 time zones, which at this time was significant. But COVID really exposed the vulnerabilities of face to face clinical care and as a result jumpstarted telemedicine."

He continues to work on telemedicine with an upcoming Department of Defense (DoD) sponsored trip to Warsaw to help stand up a telemedicine training program for Ukrainian doctors and nurses in battlefield telemedicine. Working in telemedicine for some time, he said it was rewarding to see it finally embraced during the COVID-19 pandemic.

"I read and write the literature on telemedicine – but I think the future is AI/ML," Dr. Poropatich said.

Following his military service, in 2012, he became the leader of the University of Pittsburgh's Center for Military Medicine Research (CMMR), and a tenured Professor of Medicine. At CMMR, Dr. Poropatich works in collaboration with other Pitt researchers addressing the needs of the armed services, particularly those working closely with clinical providers at military hospitals. Their research is an effort to understand the military's current needs and developing solutions to meet future needs. The work of CMMR involves strategic partnerships with industry, academia and government that results in developing medical products that meet both military and civilian health care needs.

"In 2017, I became interested in the use of artificial intelligence and machine learning (AI/ML) in health care because it became very clear to me that with large, clinical data sets you can come up with predictive algorithms to treat someone in pre-hospital settings where there is limited or no communication," Dr. Poropatich said.

Developing a clinical decision support tool which applies technology noninvasively to a patient to generate meaningful data and autonomously provides computer information to predict and guide treatments are the future frontiers of medicine.

In the research, a multidisciplinary team of Pitt researchers and clinicians from emergency medicine, surgery, critical care, and pulmonary fields will provide real-world trauma data and medical algorithms that CMU roboticists and computer scientists will assist to incorporate into a platform to render medical care.

Dr. Poropatich is the principal investigator along with a talented team from Pitt and CMU co-investigators on a four-year, $3.72 million DoD contract driving research that advances health care for service members and veterans. The project, called "Trauma Care in a Rucksack (TRACIR)" aims to develop autonomous, a pre-hospital robotic controlled cardio-pulmonary resuscitation platform that is widely deployed across the battlefield via unmanned air or ground vehicles.

He is also the co-investigator on a DoD funded project at CMU "Delivery of Trauma Care in the Field – RoboTRAC), which was started in 2019 and set to end this year.

"We are definitely focused on the military and the civilian need," Dr. Poropatich said. "What we've been able to do with TRACIR is important. It's an important development of what we're doing here in Pittsburgh – and in August 2023, we were awarded another DoD grant for $3.28 million to further advance the TRACIR platform. with prehospital trauma care."

Capturing patient data from the UPMC Stat Medevac system with Emergency Medicine co-investigators, Dr. Poropatich's work uses that data to inform and test the algorithms currently on animals with the goal of providing Continuous Precision Resuscitation, work that has the ability to impact and improve patient outcomes, remove stress from frontline workers, and revolutionize the delivery of health care.

Dr. Poropatich continues to participate in DoD-funded telemedicine research efforts in critical care medicine, while also advocating for broader utilization of AI and ML in health care.

"We've learned a lot about where mistakes are made and what we need to do to prevent mistakes in patient care. Medical Remote Autonomous Systems (MedRAS) is an exciting initiative that will utilize a lot of the AI, ML, and big data, to best determine how we can avoid medical errors, improve outcomes, decrease patient stays."

Beyond his research work, Dr. Poropatich said his role at the center is to grow University DoD medical research funding opportunities and to position faculty to compete for those dollars.

"I also serve as the principal investigator or the co-investigator across 10 different projects right now. I'm very active in managing research and finding money for research," Dr. Poropatich said.

Dr. Poropatich has mentored several research teams involved in the MedRAS initiative, providing the lessons he's learned from telemedicine and assisting in the creation of AI/ML systems of care to work in patient safety.His advice: "Start low with the rollout of patient safety technology, claim success early on and build on that success."

He explains, "Working in so many technology projects is an incremental process where you bring on more people who understand what you're trying to do; it's like a snowball rolling down a hill with more people involved and more successes that make a bigger snowball with more people joining the project and making patient safety a key priority."

Dr. Poropatich likens the patient safety movement to telemedicine, stressing that for some time no one knew what telemedicine was until the COVID-19 pandemic hit and it was essential to the delivery of care. Bringing patient safety to the forefront is going to involve heightening awareness over time by strategically underlining successes and bringing communities together, which JHF and Karen have excelled in.

"We spend so much money on health care in this country and yet we're not performing as well as you'd think based on some of our outcome-based metrics. How we identify medical errors and use big data and AI/ML to synthesize solutions to mitigate those errors are key goals Dr. Poropatich said. "It really plays into a lot of what I'm doing with patient safety by improving access to care, improving and utilizing technologies, and improving outcomes and hospital care."

A long-time friend of the Jewish Healthcare Foundation and of JHF's CEO Karen Wolk Feinstein, PhD, and serving as a Pittsburgh Regional Health Initiative Board member and a member of the RAPS Advisory, Dr. Poropatich draws a parallel of Feinstein's multi-layered approach to the skin of an onion.

"She has her own team, then she reaches out to the region, and then she goes outside of the region to other national and international leaders," Dr. Poropatich said. "Karen is just a dynamo. She has so much energy and she's able to convey these fuzzy ideas very succinctly and very clearly. And she brings wonderful, talented people committed to the mission of making a difference."

"She does a wonderful job of making everyone feel welcome and values their opinions. That kind of relationship garners trust where people are willing to share ideas and be involved in putting pencil to paper to write proposals, educate other people about what it is we're trying to do."