U.S. GOVERNMENT PUBLISHING OFFICE

30–324PDF WASHINGTON : 2018

EMPOWERING U.S. VETERANS 

THROUGH TECHNOLOGY 

JOINT HEARING 

BEFORE THE

SUBCOMMITTEE ON RESEARCH AND TECHNOLOGY 

& 

SUBCOMMITTEE ON ENERGY 

COMMITTEE ON SCIENCE, SPACE, AND 

TECHNOLOGY 

HOUSE OF REPRESENTATIVES 

ONE HUNDRED FIFTEENTH CONGRESS 

SECOND SESSION 

MAY 22, 2018 

Serial No. 115–61 

Printed for the use of the Committee on Science, Space, and Technology 

( 

Available via the World Wide Web: http://science.house.gov 
(II) 

COMMITTEE ON SCIENCE, SPACE, AND TECHNOLOGY 

HON. LAMAR S. SMITH, Texas, Chair 

FRANK D. LUCAS, Oklahoma 

DANA ROHRABACHER, California 

MO BROOKS, Alabama 

RANDY HULTGREN, Illinois 

BILL POSEY, Florida 

THOMAS MASSIE, Kentucky 

RANDY K. WEBER, Texas 

STEPHEN KNIGHT, California 

BRIAN BABIN, Texas 

BARBARA COMSTOCK, Virginia 

BARRY LOUDERMILK, Georgia 

RALPH LEE ABRAHAM, Louisiana 

GARY PALMER, Alabama 

DANIEL WEBSTER, Florida 

ANDY BIGGS, Arizona 

ROGER W. MARSHALL, Kansas 

NEAL P. DUNN, Florida 

CLAY HIGGINS, Louisiana 

RALPH NORMAN, South Carolina 

DEBBIE LESKO, Arizona 

EDDIE BERNICE JOHNSON, Texas 

ZOE LOFGREN, California 

DANIEL LIPINSKI, Illinois 

SUZANNE BONAMICI, Oregon 

AMI BERA, California 

ELIZABETH H. ESTY, Connecticut 

MARC A. VEASEY, Texas 

DONALD S. BEYER, JR., Virginia 

JACKY ROSEN, Nevada 

CONOR LAMB, Pennsylvania 

JERRY MCNERNEY, California 

ED PERLMUTTER, Colorado 

PAUL TONKO, New York 

BILL FOSTER, Illinois 

MARK TAKANO, California 

COLLEEN HANABUSA, Hawaii 

CHARLIE CRIST, Florida 

SUBCOMMITTEE ON RESEARCH AND TECHNOLOGY

HON. BARBARA COMSTOCK, Virginia, Chair 

FRANK D. LUCAS, Oklahoma 

RANDY HULTGREN, Illinois 

STEPHEN KNIGHT, California 

BARRY LOUDERMILK, Georgia 

DANIEL WEBSTER, Florida 

ROGER W. MARSHALL, Kansas 

DEBBIE LESKO, Arizona 

LAMAR S. SMITH, Texas 

DANIEL LIPINSKI, Illinois 

ELIZABETH H. ESTY, Connecticut 

JACKY ROSEN, Nevada 

SUZANNE BONAMICI, Oregon 

AMI BERA, California 

DONALD S. BEYER, JR., Virginia 

EDDIE BERNICE JOHNSON, Texas 

SUBCOMMITTEE ON ENERGY

HON. RANDY K. WEBER, Texas, Chair 

DANA ROHRABACHER, California 

FRANK D. LUCAS, Oklahoma 

MO BROOKS, Alabama 

RANDY HULTGREN, Illinois 

THOMAS MASSIE, Kentucky 

STEPHEN KNIGHT, California 

GARY PALMER, Alabama 

DANIEL WEBSTER, Florida 

NEAL P. DUNN, Florida 

RALPH NORMAN, South Carolina 

LAMAR S. SMITH, Texas 

MARC A. VEASEY, Texas, Ranking Member 

ZOE LOFGREN, California 

DANIEL LIPINSKI, Illinois 

JACKY ROSEN, Nevada 

JERRY MCNERNEY, California 

PAUL TONKO, New York 

BILL FOSTER, Illinois 

MARK TAKANO, California 

EDDIE BERNICE JOHNSON, Texas 
(III) 

C O N T E N T S 

May 22, 2018 

Page 

Witness List ............................................................................................................. 2 

Hearing Charter ...................................................................................................... 3 

Opening Statements 

Statement by Representative Barbara Comstock, Chairwoman, Subcommittee 

on Research and Technology, Committee on Science, Space, and Technology, 

U.S. House of Representatives ............................................................................ 4 

Written Statement ............................................................................................ 6 

Statement by Representative Daniel Lipinski, Ranking Member, Subcommittee on Research and Technology, Committee on Science, Space, and 

Technology, U.S. House of Representatives ....................................................... 8 

Written Statement ............................................................................................ 10 

Statement by Representative Lamar Smith, Chairman, Committee on Science, 

Space, and Technology, U.S. House of Representatives .................................... 12 

Written Statement ............................................................................................ 13 

Statement by Representative Eddie Bernice Johnson, Ranking Member, Committee on Science, Space, and Technology, U.S. House of Representatives .... 15 

Written Statement ............................................................................................ 16 

Witnesses: 

Dr. Dimitri Kusnezov, Chief Scientist, National Nuclear Security Administration, U.S. Department of Energy 

Oral Statement ................................................................................................. 18 

Written Statement ............................................................................................ 20 

Mr. Christopher Meek, Founder and Chairman, SoldierStrong 

Oral Statement ................................................................................................. 30 

Written Statement ............................................................................................ 32 

Ms. Martha MacCallum, Advisory Board Member, SoldierStrong 

Oral Statement ................................................................................................. 37 

Written Statement ............................................................................................ 39 

Mr. John Wordin, President and Founder, Project Hero 

Oral Statement ................................................................................................. 42 

Written Statement ............................................................................................ 45 

Dr. Matthew J. Major, Research Health Scientist and Assistant Professor 

of Physical Medicine and Rehabilitation, Northwestern University 

Oral Statement ................................................................................................. 64 

Written Statement ............................................................................................ 66 

Discussion ................................................................................................................. 77 

Appendix I: Answers to Post-Hearing Questions 

Dr. Dimitri Kusnezov, Chief Scientist, National Nuclear Security Administration, U.S. Department of Energy ........................................................................ 98 
Page

IV 

Appendix II: Additional Material for the Record 

Statement submitted by Representative Randy K. Weber, Chairman, Subcommittee on Energy, Committee on Science, Space, and Technology, U.S. 

House of Representatives .................................................................................... 102 

Statement submitted by Representative Marc A. Veasey, Ranking Member, 

Subcommittee on Energy, Committee on Science, Space, and Technology, 

U.S. House of Representatives ............................................................................ 104 
(1) 

EMPOWERING U.S. VETERANS 

THROUGH TECHNOLOGY 

TUESDAY, MAY 22, 2018 

HOUSE OF REPRESENTATIVES, 

SUBCOMMITTEE ON RESEARCH AND TECHNOLOGY AND

SUBCOMMITTEE ON ENERGY, 

COMMITTEE ON SCIENCE, SPACE, AND TECHNOLOGY, 

Washington, D.C. 

The Subcommittees met, pursuant to call, at 10:00 a.m., in Room 

2318 of the Rayburn House Office Building, Hon. Barbara Comstock [Chairwoman of the Subcommittee on Research and Technology] presiding. 
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Chairwoman COMSTOCK. The Committee on Science, Space, and 

Technology will come to order. 

Without objection, the Chair is authorized to declare recesses of 

the Committee at any time. 

Good morning, and welcome to today’s hearing titled, ‘‘Empowering U.S. Veterans through Technology.’’ I now recognize myself 

for five minutes for an opening statement. 

The impetus for today’s hearing goes back a year or so to May 

2017, when I first met one of our witnesses, John Wordin, at a Ride 

2 Recovery event for veterans in my district in Manassas, Virginia. 

I heard firsthand from John about the HEROTrak system and the 

wearable health-monitoring device with software designed to help 

veterans suffering from post-traumatic stress disorder. I was fascinated by this technology and the research going on with it and 

its potential to help our veterans. 

My district as so many others are home to so many research and 

technology companies on the forefront of technological innovation, 

so I am particularly pleased, also with a large veterans’ population, 

to chair this hearing today to profile technologies to help our dedicated veterans who have served our nation. By shining a spotlight 

on cutting-edge technologies designed to help combat-injured veterans, the Science Committee can help spread the word about the 

wonderful efforts in which our witnesses are engaged, and their impact on the lives of our brave men and women whose sacrifices deserve our care and attention. 

I also look forward to hearing more about the joint Department 

of Energy and Department of Veterans Affairs collaboration that 

will leverage DOE’s high-performance computing and machine 

learning capabilities to analyze health records of more than 20 million veterans maintained by the VA. The goal of this partnership 

is to arm the VA with data it can use to potentially improve health 

care offered to veterans by developing new treatments and preventive strategies. This win-win enterprise could revolutionize quality 

of health care for veterans, while simultaneously providing Department of Energy with unique insight and information to support development of next-generation technologies. 

We also have representing SoldierStrong Mr. Meek, who will describe the SoldierSuit and his efforts to purchase and donate this 

transformational robotic exoskeleton device comprised of a number 

of devices. Amazingly, it can help provide paralyzed veterans the 

ability to once again stand, walk, and hug a loved one eye-to-eye, 

a point eloquently emphasized in Ms. MacCallum’s testimony. And 

Ms. MacCallum is probably more familiar being on the other side, 

being an interviewer of us, is one of our witnesses today, and we 

really appreciate her being here and her work for veterans. 

Now, I mentioned John Wordin, who founded Project Hero ten 

years ago to help veterans and first responders affected by injuries 

including traumatic brain injury and PTSD through the programs 

such as Ride 2 Recovery. While the success of the program and the 

therapeutic benefits of cycling, which is one of the main activities 

that he’s engaged in with the Ride 2 Recovery have benefited thousands of veterans, but I also appreciate the opportunity to highlight 

today how the HEROTrak monitoring system can benefit veterans 
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with PTSD, including how it can help generate more data on best 

practices to improve the lives of veterans. 

And since we did get together with Mr. Wordin with a veterans 

roundtable in my district yesterday, I can just tell you, and I know 

this will apply to all of the others testifying today, how excited our 

veterans’ services organizations were to hear about these new technologies and how we can partner with them. For example, we have 

a lot of equine therapy groups that service veterans in my district, 

and they understood how when we can get more data here, they 

can now demonstrate how impactful the equine therapy is for our 

veterans. They know that instinctively but now we have a way of 

demonstrating that through data. 

And I also welcome Dr. Major, who will describe his very important research on motor control related to veterans and service 

members’ prosthetics and orthotics and the underlying factors of 

falls. 

An added important benefit of today’s hearing is that the technologies, research and federal programs we will hear about have 

promising implications for the population at large. 

I thank all our witnesses for joining us today, and for your service and efforts to help improve the lives of our nation’s veterans. 

[The prepared statement of Chairwoman Comstock follows:] 
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Chairwoman COMSTOCK. I now recognize the Ranking Member of 

Research and Technology Subcommittee, the gentleman from Illinois, Mr. Lipinski, for his opening statement. 

Mr. LIPINSKI. Thank you, Chairwoman Comstock. Thank you for 

holding today’s hearing. I was just looking up Honor Ride on my 

iPad here seeing when one in Chicago is, so it’s good to have you, 

Mr. Wordin. 

We’re only six days away from Memorial Day, and it’s the busiest 

day of the year for me for public events in my district because of 

the importance my constituents and I place on honoring the men 

and women who serve in our armed forces. 

I’m sure my colleagues on both sides of the aisle in the subcommittees present here this morning agree that supporting technologies that improve the lives of these men and women should be 

a high priority. 

Unfortunately, many face an uphill battle to overcome the physical and mental toll of war once they return home. That’s why this 

hearing is so important. 

I want to thank our witnesses for being here to share with us 

their efforts to provide veterans with the latest technologies to improve their quality of life for our veterans. 

Almost 20 million U.S. veterans are living today and just under 

half are enrolled in the Department of Veterans Affairs’ healthcare 

system. The health records generated from decades of care provide 

a trove of information that may lead to more accurate diagnosis 

and treatment of certain conditions and diseases. High-performance computing can help analyze this massive amount of data to 

make it useful for delivering better healthcare outcomes not only 

for veterans but also for the general population. 

The federal government has made strategic investments over the 

years to advance data analytics and data science research and development. I look forward to hearing from Dr. Kusnezov about the 

progress of the Big Data Science Initiative being conducted by the 

VA and Department of Energy, some of which is taking place in my 

district at Argonne National Laboratory’s Leadership Computing 

Facility. 

I’d also like to hear about the privacy and security measures the 

agencies are taking to protect our veterans’ personal information. 

In addition to the diseases and chronic conditions that the VA– 

DOE collaboration will address, veterans who survive combat may 

have to adapt to civilian life with limited mobility due to physical 

injuries sustained in war. A number of federal efforts support research in related areas, including advanced robotic prosthetics and 

full-body exoskeleton suits. For example, the National Science 

Foundation funds work examining the interface of brain and machine for mind control of robotic prosthetics, and the National Institute of Standards and Technology has established an international committee to bring together public and private sector 

stakeholders to define standards for wearable robotics. 

While the physical wounds of war can be seen, the mental scars 

are below the surface. Combat and other traumatizing experiences 

may result in long-term damage for veterans. Homelessness and 

suicide may be manifestations of these mental wounds. Eleven to 

20 percent of veterans from the most recent combat operations suf-
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fer from post-traumatic stress disorder, or PTSD. These figures are 

similar for Gulf War veterans, and, unfortunately, even greater, 30 

percent, for Vietnam veterans. 

I look forward to the witnesses’ testimony about their efforts to 

provide physical and mental rehabilitation technologies to our deserving veterans who have already sacrificed so much for our nation. I also look forward to hearing the witnesses’ ideas about what 

more the federal science agencies can be doing to accelerate the development of such technologies. 

Thank you, Madam Chair. I look forward to hearing the testimony, and I yield back. 

[The prepared statement of Mr. Lipinski follows:] 
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Chairwoman COMSTOCK. Thank you, and I now recognize the 

Chair of the Committee, Mr. Smith. 

Chairman SMITH. Thank you, Chairwoman Comstock, for holding 

such an interesting and important hearing today. 

Today’s hearing will highlight some fascinating technologies and 

efforts that will empower veterans. 

The Titan supercomputer at Oak Ridge National Laboratory can 

process a quadrillion calculations per second. That’s a number followed by 15 zeros. Thanks to collaboration between the Department of Energy and the Department of Veterans Affairs, this computer will be used to analyze the health records of 24 million veterans in order to provide improved care. The partnership between 

the VA and DOE could transform the delivery of healthcare to our 

veterans as we use complex computer models to learn more about 

the causes and warning signs of various diseases. 

The VA has identified three priority areas of focus for early delivery impacts: suicide prevention, prostate cancer, and cardiovascular 

disease. By providing DOE with access to a large-scale database, 

the VA will help the Energy Department develop next-generation 

algorithms and modeling capability while ultimately providing the 

VA with data it can use to improve veterans’ quality of life. 

One of the witnesses today, Mr. John Wordin, is collaborating 

with a Texas A&M University professor on a wearable device to 

help veterans suffering from post-traumatic stress disorder, and we 

also welcome Dr. Farzan Sasangohar, Assistant Professor in the 

Department of Industrial and Systems Engineering at A&M. 

Thank you and your team in Texas for your hard work and efforts 

to support our veterans. 

I would also like to thank Mr. Chris Meek and Ms. Martha 

MacCallum for their respective efforts on behalf of SoldierStrong. 

In January, SoldierStrong donated a robotic exoskeleton to the 

Audie Murphy Memorial VA Hospital in San Antonio, which I represent. This donation will help the facility provide state-of-the-art 

rehabilitative care to veterans. 

One of the benefits of hearing from the experts today is that the 

fruits of their labor are not limited to helping veterans, although 

they do that so well. They can be applied to people all over the 

country and the world who suffer from similar ailments or injuries. 

In addition to this hearing, the Science Committee approved legislation last November to help veterans overcome obstacles as they 

reenter the workforce. H.R. 4323, the Supporting Veterans in 

STEM Careers Act, was introduced by Representative Neal Dunn 

of Florida, a member of the Science Committee. The bill promotes 

veterans’ involvement in STEM education, computer science, and 

scientific research and employment. It passed the House in December and awaits action in the Senate. 

To me, the subject of the hearing shows yet again how technology 

can meet the world’s challenges, and we look forward to our witnesses’ testimony today and to finding out more about how that 

technology can help not just veterans but, as I said, people around 

the world. 

Thank you, Madam Chair, and yield back. 

[The prepared statement of Chairman Smith follows:] 
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Chairwoman COMSTOCK. And I now recognize the Ranking Member, Ms. Johnson. 

Ms. JOHNSON. Thank you very much, Chairwoman Comstock and 

Ranking Member Lipinski for holding this hearing to learn more 

about technologies that are being developed to help improve the 

quality of life for our injured veterans. 

This is a topic close to my own heart. Before I ran for political 

office, I served as the chief psychiatric nurse at the VA Hospital 

in Dallas where I actually helped to start that service. I saw up 

close the toll that serving in a combat zone can take on our men 

and women in uniform. I developed a deep appreciation for human 

frailty and strength alike, and I carried those lessons forward into 

my political career. 

I regularly meet with veterans in my district in Dallas to learn 

about the challenges they face reentering civilian life and to discuss what the veterans—what the federal government can be doing 

better to help ease their transition. 

Today there are about 20 million veterans in the United States. 

Advances in medical response and technology in the battlefield 

have meant that more veterans are surviving and returning home 

with traumatic injuries that meant certain death in earlier generations. 

The protracted conflicts in Iraq and Afghanistan resulted in 

many of our veterans serving multiple deployments in combat 

zones. Even if they survived these deployments without any visible 

injuries, some almost certainly suffer in other ways. Veterans experience mental health disorders, substance use disorders, post-traumatic stress, and traumatic brain injury at a disproportionate rate 

compared to their civilian counterparts. Eighteen to 22 American 

veterans commit suicide daily. Younger veterans are at the highest 

risk. While an exact count is hard to come by, approximately 

40,000 veterans today are homeless. These are statistics that 

should alarm us all. 

Technology will not solve all of these challenges. However, technology can go a long way to aid veterans suffering from both physical injuries and mental health disorders. Continued advancements 

in prosthetics and exoskeletons will help improve the quality of life 

for veterans who have lost limbs. More accurate and wearable predictors of PTSD attacks will help veterans keep themselves and 

their loved ones safe, and better understanding of the range of conditions that occur in the veteran population will help medical professionals and policymakers alike develop more effective interventions. 

I look forward to hearing more about the technologies that today’s witnesses are working on, and I look forward to a discussion 

of the role that our science agencies such as the National Science 

Foundation and the National Institute of Standards and Technology can play in advancing these and other technologies to aid 

our U.S. veterans. Our veterans deserve nothing less from our nation and our government than our full dedication to helping them 

repair the wounds of war that they suffered on our behalf. 

I thank you and yield back. 

[The prepared statement of Ms. Johnson follows:] 
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Chairwoman COMSTOCK. Thank you, and I’m now going to introduce our witnesses but before I do, I did want to recognize Steve 

Jordan of the Northern Virginia Technology Council, who has 

worked for the Veterans Employment Initiative, which has been an 

initiative of our technology companies in northern Virginia, which 

has just done wonderful work with our veterans, and I really appreciate having you here today, Steve, to hear about these great 

technologies, and both private and public investment, which I know 

NVTC has already been great with public-private partnerships. So 

thank you. 

Okay. Now, first our first witness today is Dr. Dimitri Kusnezov, 

Chief Scientist at the National Nuclear Security Administration at 

the U.S. Department of Energy. Prior to NNSA, he served as Director of the Office of Research and Development for National Security 

Science and Technology. Dr. Kusnezov earned a bachelor of arts in 

both physics and pure mathematics from the University of California at Berkeley. He also holds a Master of Science in physics as 

well as a Ph.D. in theoretical nuclear physics, both from Princeton 

University. 

Our second witness today is Mr. Christopher Meek, Founder and 

Chairman of SoldierStrong. SoldierStrong helps America’s servicemen, -women, and veterans take their next steps forward by identifying and filling gaps in the traditional systems supporting veterans and members of the military. Originally called SoldierSocks, 

SoldierStrong stems from Mr. Meek’s first project organizing donations of socks and other supplies from communities and businesses. 

Mr. Meek holds a Bachelor of Arts in economics and political 

science from Syracuse University and a Master of Business Administration and financial management from Pace University in New 

York City. 

Our third witness today is Ms. Martha MacCallum, Advisory 

Board Member of SoldierStrong. She’s here in that capacity today. 

Of course, we also know her as a Fox News anchor, where she has 

highlighted numerous military achievements on her show, The 

Story with Martha MacCallum. Ms. MacCallum’s coverage has included the accomplishments and personal stories of the Green Berets, Navy SEALs, and medal winners for extreme bravery in Afghanistan. She earned her bachelor’s degree in political science 

from St. Lawrence University. She also studied at the Circle and 

the Square Theater School. 

Mr. John Wordin, our fourth witness, is President and Founder 

of Project Hero. His work to improve suicide prevention and help 

veterans and first responders has earned him national recognition. 

He began his career as a professional cyclist, participating in three 

U.S. Olympic Trials and earning a bronze medal in the 1989 U.S. 

National Championships. Mr. Wordin was also President and 

Founder of the Fitness Challenge Foundation, which was the genesis of Ride 2 Recovery founded in 2008. Mr. Wordin holds a Bachelor of Science in finance from California State University at 

Northridge. 

And I did want to mention, someone just told me that the Vice 

President tweeted about the hearing this morning. I know when we 

first met, you had started your Ride 2 Recovery at the Vice Presi-
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dent’s house, so I guess he’s watching to catch up on this too, so 

thank you again for joining us today. 

Our final witness is Dr. Matthew Major, Research Health Scientist and Assistant Professor of Physical Medicine and Rehabilitation at Northwestern University. Dr. Major’s research focuses on 

improving mobility and function of veterans with neurological and 

musculoskeletal pathology through rehabilitation technology and 

therapeutic intervention. He holds Bachelor of Science and Master 

of Science degrees in mechanical engineering from the University 

of Illinois at Urbana-Champaign as well as a Ph.D. in biomedical 

engineering from the University of Salford-Manchester in the 

United Kingdom. 

So I now recognize Dr. Kusnezov for his five minutes to present 

his testimony. 

TESTIMONY OF DR. DIMITRI KUSNEZOV, 

CHIEF SCIENTIST, 

NATIONAL NUCLEAR SECURITY ADMINISTRATION, 

U.S. DEPARTMENT OF ENERGY 

Dr. KUSNEZOV. Thank you, Chairman Smith, Ranking Member 

Johnson, Chairwoman Comstock, Chairman Weber, Ranking Member Lipinski, and Ranking Member Veasey and distinguished Members of the Subcommittee on Research and Technology and the 

Subcommittee on Energy. I thank you for taking up this important 

issue and for the opportunity to address the members and share 

what the Department of Energy in collaboration with the Department of Veterans Affairs is trying to do at the intersection of nextgeneration artificial intelligence, supercomputing, U.S. innovation, 

and veterans’ health. 

At the Department of Energy, driven by where our missions are 

heading, we work at the forefront of technologies, and today we are 

embracing artificial intelligence. This coincides with diminishing 

returns from Moore’s Law, where squeezing the most of our 70-year 

supercomputing paradigm remains important. 

This post-Moore’s Law era necessitates novel artificial intelligence, or AI, inspired architectures to navigate an increasingly 

data-driven world. I believe that a cornerstone for progress will be 

how rapidly we embrace a next generation of AI-enabled predictive 

supercomputing tools. 

Precision medicine data can accelerate this technology change by 

driving the development with likely the world’s most complex data. 

This brings with us subject-matter experts and unique opportunities to rethink many of our traditional approaches from postMoore’s Law hybrid architectures to uncertainty quantification to 

computer codes. 

Our work with the VA is underpinned by several opportunities 

for innovation that were captured in the 21st Century Cures Act, 

the Cancer Moonshot in 2016, and the National Strategic Computing Initiative in 2015. More recently, Secretary Perry’s commitment to technology in the service of veterans as well as this Administration’s commitment to veterans’ issues has allowed the rethinking of traditional paradigms and facilitated novel approaches 

on how to solve complex problems. 
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The VA has a unique dataset of medical records, whole genomes 

and imaging data that is one of the most comprehensive in dimensions of time, scale, and breadth, and in many aspects, this dataset 

is considered to be the largest and most comprehensive in the 

world. Both the VA and the Department of Energy are alert to the 

unique privacy and security sensitivities of the veterans’ health 

data. 

Today, our artificial intelligence-driven Big Data Science Initiative includes MVP–CHAMPION and a complementary effort called 

ACTIVE. 

Last year in April, VA and DOE scientists, physicians, and leadership came together to develop technical roadmaps for driving 

high-performance computing and artificial intelligence while developing solutions to priority issues and caring for our veterans. VA 

priorities that were identified that could deliver early impacts were 

patient-specific analysis for suicide prevention, helping doctors 

make decisions around prostate cancer, and enhanced prediction 

and diagnosis of cardiovascular disease. Since then, additional 

areas of interest from polypharmacy to traumatic brain injury have 

surfaced. The fiscal year 2019 VA budget request includes $27 million to support these initiatives. 

We recognize the critical role of the private sector in this effort. 

Recently the VA and DOE held a meeting with technology startups 

focused on precision medicine to understand the direction of the 

technology in the commercial sector. As with the Human Genome 

Project or the exascale initiative today, partnerships with labs, academia, and the private sector are important. A concerted effort 

here will lead to innovation tied to design and development of 

DOE’s next-generating supercomputing that will merge big data, 

artificial intelligence, and high-performance computing; to better 

healthcare via our strategy for precision medicine through supercomputing and artificial intelligence that could inform when and 

how to treat our veterans to improve outcomes and control costs; 

to better science via a cadre of researchers and clinicians who specialize in healthcare with DOE experts in big data, AI, and highperformance computing; and to better government via interagency 

collaborations bringing to bear the full capabilities and expertise 

within public and private partnerships. 

Thank you, and I look forward to answering your questions. 

[The prepared statement of Dr. Kusnezov follows:] 
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Chairwoman COMSTOCK. Thank you, and we now recognize Dr. 

Meek for his testimony. 

TESTIMONY OF MR. CHRISTOPHER MEEK, 

FOUNDER AND CHAIRMAN, 

SOLDIERSTRONG 

Mr. MEEK. Chairwoman Comstock and Ranking Member Lipinski of the Subcommittee on Research and Technology, Chairman 

Weber and Ranking Member Johnson of the Subcommittee on Energy, and members of both Subcommittees, thank you for having 

me here today. 

On September 11, 2001, I was running floor trading operations 

for Goldman Sachs at Ground Zero in New York City. As I watched 

the first responders running into the carnage of that day, I resolved to do something to give back to those who serve. I’m still a 

financial services executive, now at S&P Global, but in the years 

since that day, my passion project has become SoldierStrong. 

SoldierStrong is a 501(c)(3) charitable organization committed to 

improving the lives of our servicemen, women and veterans. I chair 

the organization, and accomplish most of its work from a cell phone 

and an iPad on my daily commute to New York. 

SoldierStrong’s work started with a request from a forward operating base in Afghanistan to send basic supplies like tube socks 

and baby wipes for our forward deployed troops. Over the years, we 

assembled and sent over 75,000 pounds of supplies to 73 units in 

Iraq and Afghanistan. 

As the wars wound down, we contemplated closing down until 

one of our board members asked whether the troops we had served 

had everything they needed when they came back home and began 

life anew as veterans. 

In retrospect, one day in particular would bring this question 

into focus for me. April 27, 2011, was my daughter’s fifth birthday. 

We celebrated, like many families, with cake and ice cream and 

without a care in the world. Six thousand eight hundred miles 

away, Army Sergeant Dan Rose was being medevac’d from the battle field to Kandahar. The vehicle he was in had hit an IED, and 

his injuries would rob him of the ability to walk again. Dan’s experience that day was a personal reminder of how much we owe our 

veterans, and how their sacrifices allow all of us to take for granted 

the lives we’re blessed to live here. Two years after his injury, Dan 

would become the first recipient of our SoldierSuit, empowering 

him to walk once again. 

Today, SoldierStrong finds the most advanced mobility devices 

and prosthetics on the market and makes them available to injured 

veterans who otherwise would not have access to them. The collection of devices we currently fund comprise the SoldierSuit, which 

covers full-body, upper-body, and lower-body mobility devices. One 

example is the Ekso Suit, which allows paralyzed veterans to stand 

and walk again with robotic assistance. 

The physical and psychological impacts of being able to get up 

out of a wheelchair and stand at eye level with the world again are 

profound. In fact, we are partnering with the Denver VA to conduct 

a formal study on the mental health impacts of access to this technology. 
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Another example is the Luke Arm, which is the first and only 

prosthetic arm that replaces the full range of motion from the 

shoulder, through the elbow, to the wrist to the fingers and the 

hand. It is the first arm that works just like the original equipment. 

As with many advanced technologies, these devices tend to be extremely expensive, with our average device costing nearly 

$100,000. Two of our more capable devices cost nearly $200,000 per 

each. 

We’ve learned over the years that most of these devices were 

first evolved for frontline servicemen and -women via DARPA. 

America’s commitment to putting cutting-edge technology on our 

warfighters is exceptional, is a point of national pride, and should 

extend, but currently does not, to our veterans who bear the physical consequences of service to our country. We work closely with 

more than a dozen VA medical centers around the country which 

have received one or more of our devices. The people of the VA care 

very deeply about our veterans, but are sometimes held back by arcane regulations that have not kept pace with modern technological 

advancement. Thanks to SoldierStrong, nearly 25,000 veterans 

have access to one of these devices. We believe every injured veteran has earned the right to the best technology American ingenuity can provide. 

Yet one of the tragedies of the post-9/11 veteran care is that too 

many veterans must rely on charitable organizations like ours for 

the access to the medical help they need. 

Though it sounds like science fiction, it really hits you that these 

capabilities are quite real when you see a veteran roll into a room 

in a wheelchair, but stand for the first time in years and actually 

walk back out of that same room. 

I have with me a short video showing how this technology works. 

This video was made during one of our device donations to the 

Richmond VA. 

Madam Chair, Mr. Chairman, the video concludes my remarks 

today. I look forward to answering questions from the Subcommittee. Thank you. 

[Video Playback] 

[The prepared statement of Mr. Meek follows:] 
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Chairwoman COMSTOCK. Thank you. 

I now recognize Ms. MacCallum. 

TESTIMONY OF MS. MARTHA MACCALLUM, 

ADVISORY BOARD MEMBER, 

SOLDIERSTRONG 

Ms. MACCALLUM. Chairman Comstock, Chairman Smith, Ranking Member Lipinski, and Ranking Member Johnson, Members of 

the Committee, thank you so much for having me here today. 

In my work, I am fortunate to speak with generals, military leaders, and Pentagon officials, Navy SEALs and Green Berets as well 

as many other great men and women who serve or have served our 

country. In fact, yesterday I spoke with Vice President Pence, who 

was very interested in the subject matter of our discussion here 

today, and in particular the work of Mr. Wordin and also the work 

of SoldierStrong and the U.S. technology that can grow and benefit 

our veterans and other members of society. 

Like most of us, as a citizen, I am enormously grateful to them 

for their service and humbled by their sacrifice, knowing that as 

much as I love my country, I could never live up to the measure 

of their bravery and heroism. Like most of us, I want to show my 

gratitude to those who put their lives on the line, those who make 

the sacrifices, who face the danger, who go to the frontlines to protect us, and the freedom that we cherish as Americans. 

SoldierStrong was born out of 9/11 out of Chris Meek’s desire to 

prove to our patriots that we are forever thankful, that what we 

can do as citizens and as a country—through what we do as citizens and as a country is to make sure that we are willing to move 

forward in combat and that they will now be able to move forward 

in life. Whatever they lost on the battlefield or in injuries after 

they’ve served, we can help them overcome to the greatest of our 

ability. 

9/11 was a day that changed us forever. As a lifelong New York/ 

New Jersey resident, I watched the Towers come down, and with 

them, the lives of people I knew: the families of those who were 

lost, 13 fathers and one mother from my hometown. I vowed that 

day to tell the story of the war on terror and the battles that continue, and to support those who heard the call of President Bush 

when he said, ‘‘the people who knocked these buildings down will 

hear from all of us soon.’’ The men and women of our armed forces 

made that message heard loud and clear. Some paid the ultimate 

price carrying that message to our enemies. 

So when Chris Meek came to see me about the organization that 

he had started with the simple mission of sending basic supplies 

to our troops to show them we cared and how that mission evolved 

into opening up a world of possibility for our injured patriots when 

they came back home, I was in. I joined the Advisory Board in 2014 

and have been dedicated to using my voice and the platform that 

I have through my work to raise awareness and support and to 

spread the word about the cutting-edge technologies emerging in 

this field and the life-changing impact they could have for those to 

whom I owe so much. 

The response has been incredible. I believe our viewers and 

Americans across this country want better for our veterans, better 
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than a system that leaves gaps and does not allow them to the ingenuity of these new devices. 

I will never forget the day that Sergeant Dan Rose came to our 

studio to demonstrate how his SoldierSuit allowed him to get up 

from his wheelchair and take the steps that he never dreamed he 

would be able to take again. The look on his face said it all: will, 

possibility, and promise. 

As Americans we must make sure that we give back but give 

back in a way that is uniquely American, that relies on this cutting-edge technology, and never taking no for an answer. As JFK 

once said about the U.S. space mission, ‘‘We choose to go to the 

Moon not because it is easy, but because it is hard.’’ 

We live in a time when Ironman is not just a movie. It is moment when technology made in America can rebuild arms with full 

mobility and allow bodies with severed spinal cords to stand up 

and walk. Companies like Ekso Bionics, Bionix, Mobius Bionix, and 

Myomo are leading the way. 

But there is still a long way to go, and we will do it, not because 

it is easy, but because it is hard, and because it is the right thing 

to do. 

Embracing this technology is a winner for the United States, for 

our military and for those who will benefit from the growth of these 

industries and the jobs that it creates here at home as well. It 

makes sense on every level. 

Thanks to the work of a very lean and dedicated team, 

SoldierStrong operates on a budget that puts just 9 to 12 percent 

towards operating costs. More than 80 percent goes directly to 

bringing this technology to more than 25,000 veterans at rehab 

centers and VA facilities across the country so far. SoldierStrong 

has donated more than $2.5 million in high-technology medical devices that directly help our injured armed forces and $500,000 toward scholarships for those whose way forward is through education that opens doors for their next steps in their lives. 

I encourage you to think about how the funding that supports 

our fighting forces in the field can be extended to support the extraordinary research that’s being done with taxpayer funding that 

will ensure that our injured veterans have access to the scientific 

advances that come from it. 

I thank you very much for your time today and look forward to 

your questions. 

[The prepared statement of Ms. MacCallum follows:] 
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Chairwoman COMSTOCK. Thank you, and we will now hear from 

Mr. Wordin. 

TESTIMONY OF MR. JOHN WORDIN, 

PRESIDENT AND FOUNDER, 

PROJECT HERO 

Mr. WORDIN. Good morning, Chairman Comstock, Chairman 

Weber, and Ranking Members Lipinski and Veasey, and distinguished members of the Energy and Research and Technology 

Committee. I’d like to introduce Dr. Farzan Sasangohar, Industrial 

and Systems Engineer at Texas A&M, and we also have with us 

some veterans from the Project Hero Walter Reed hub program 

here today. 

Project Hero is an organization that brings our nation’s veterans 

and first responders together through sports, activities, and community, helping them overcome challenges associated with their 

visible and invisible wounds. 

Being the catalyst for the adapted sports movement, Project Hero 

continues to be the industry leader. Dedicated research, including 

a Georgetown University study, of Project Hero’s methods confirms 

that the work being carried out since its inception is changing and 

improving the lives of tens of thousands of veterans, first responders, and their families. Remember, the veterans volunteer; the families are drafted. 

Our mission is to save lives by providing hope, recovery, and resilience to America’s finest. We’ve had a tremendous impact. Sixtytwo percent of our program participants reduce or eliminate their 

prescription drug use including opioids and antidepressants. PTSDrelated stress attacks as measured by the HEROTrak are reduced 

by 83 perfect. The annual Project Hero participants saves the VA 

more than $9,000 including prescription drugs and healthcare costs 

annually. 

A soon-to-be-released report reviewed 3,000 suicides to evaluate 

the cause and effect, and recommend steps to improve care to our 

veterans and provides data to show why 20 veterans commit suicide each day. What are the risk factors, diagnoses, and family 

components that are at the root cause of suicide? The review found 

that the diagnoses most common in all suicides are depression, 

PTSD, anxiety, and alcohol use disorder with the average suicide 

having multiple diagnoses. The top risk factors are pain, access to 

firearms, worsening of health status, relationship problems, hopelessness and decline in physical ability. Most of the suicides were 

not identified as high risk in their medical record. Of the 20 suicides per day, only three were receiving VA mental health services 

at the time of their death. The reasons: inconvenience, long wait 

times, paperwork, transportation, and stigma. 

The top recommendation of this report is to come up with an enhanced suicide risk assessment and safety planning capability that 

addresses the complex care needs of our veterans, utilizing technology, clinician training, and extending more into the community. 

There is a need for a more systematic assessment tool that can document risk. 

The HEROTrak initiative solves this vital need for a technologybased objective solution for suicide prevention and mental health 
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care. Currently, no PTSD tool exists with remote capabilities to 

complement ongoing treatment. 

The HEROTrak will be a FDA-approved device that will allow 

continuous monitoring and detection of PTSD triggers using physiological sensors and machine learning algorithms and can measure 

frequency, severity, and duration of a PTSD episode within two to 

four seconds. The HEROTrak is a wearable monitor developed by 

Texas A&M and Dr. Sasangohar and tested exclusively at Project 

Hero events to learn a user’s physiological cues. 

Our goal will be to prevent and eliminate suicide in military, veteran, and first responder population, provide the active-duty component with a long-term focus on improving the overall readiness 

of the force by providing better health and healthcare analytics, 

and provide support for survivors of sexual trauma and other mental health diagnoses with the care they need. The result will be 

better therapeutic outcomes at less cost. 

Using a combination of heart rate and heart rate variability monitoring, the PTSD alarm will identify triggers. The tool creates a 

personalized profile that monitors patterns and variability to infer 

a PTSD episode. If an episode is detected, an alarm vibration goes 

off with a visual prompt that the user will set up four options of 

support: self-resilience tools; they can connect to a NoVetAlone 

peer-to-peer network that they program into the watch themselves, 

which can including family, friends, or clinicians; it can automatically call the VA crisis hotline or 911. The device pairs with a 

smartphone and can interface with a website to offer more features 

including direct connect to peers, military command, or clinicians 

either by phone or video as desired. The user will also be able to 

share information with peers in their social network that they wish 

to create for their own personal support system. 

The device can best be utilized when a person first joins the active-duty military to create a baseline and then constantly and consistently collect data on the mental and physical health, report 

stress events/traumas during their service. The advantage is to 

maintain objective rather than subjective data and feedback and 

integrate this information into one’s electronic medical records. 

This biometric collective data can then provide a medical clinician with the complete mental and physical health picture whenever the participant visits their healthcare provider, thereby understanding whether the prescription drugs they’ve been using are actually working or whether the care path that they’ve been put on 

by their VA or active-duty clinician is actually working. The overall 

advantage is a more comprehensive, objective measurement of their 

disability metrics that will lead to increased abilities and a better 

care continuum. 

For the patient, it’s a creative way for them to have—for them 

and their family to understand the environment and surroundings 

that cause stress episodes in their life. They can look back at the 

minute, the five minutes, the 30 minutes prior to a PTSD episode 

and understand what was the trigger. 

Up on the screen, we have some of the screenshots of the app 

that the device pairs with so you can see your data. On here you 

can see your heart rate, your resting heart rate, your physical activity, the number of stress events, and your—and also your tools. 
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They will be provided accurate information on the mental and 

physical state of mind. It will be a patient-centered design that provides a 24/7 support network with medical, resiliency and peer-topeer support if you have a PTSD episode. It’s GPS-enabled so if you 

become disoriented or pass out, the person who’s been alerted to 

your PTSD episode will be able to know exactly where you are. 

Peer-to-peer support can provide motivation, feedback, and the support of knowing that you are not alone. 

For the clinicians, it provides a complete mental and physical 

healthcare picture of their patients, a more comprehensive measurement with disability metrics, which lead to increased abilities 

and provide a more informed care continuum. Up on the screen we 

have actual data that was driven from one of our testing where you 

can see how a PTSD episode would look to a clinician. It starts out 

during sleep, and then you can see the spike in their heart rate 

that causes the alarm to go off, and it also knows the difference 

between physical activity and an actual episode. 

For the DOD, it creates a baseline that consistently and constantly collects data on their mental and physical health so that 

they can know the readiness of their troops before going on deployment. It maintains objective data and feedback on the overall readiness of the force, and that information could be integrated into 

their electronic medical records. 

The most important need we have right now as a nation is to 

prevent more suicides and improve the mental health of those who 

serve our country. Although the conflicts may be winding down, 

there is a lifelong commitment we owe to these men and women. 

The HEROTrak is vital to that commitment to assure that they can 

see their children grow up in a supportive community. 

We all understand the need to reduce suicide and improve mental health for veterans that live and work in each of our districts. 

There are veterans in your district right now that can be saved by 

utilizing the HEROTrak. 

Thank you very much for your time. 

[The prepared statement of Mr. Wordin follows:] 
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Chairwoman COMSTOCK. And we’ll now hear from Dr. Major. 

TESTIMONY OF DR. MATTHEW J. MAJOR, 

RESEARCH HEALTH SCIENTIST 

AND ASSISTANT PROFESSOR OF 

PHYSICAL MEDICINE AND REHABILITATION, 

NORTHWESTERN UNIVERSITY 

Dr. MAJOR. Thank you. I’d first like to thank Chairman Barbara 

Comstock, Ranking Member Daniel Lipinski, Chairman Randy 

Weber, and Ranking Member Marc Veasey for the invitation to testify. I also want to recognize Chairman Smith and Ranking Member Johnson for joining us this morning. 

There exists a large and growing number of veterans with neurological or musculoskeletal pathology who rely on VA rehabilitative 

care for functional restoration. When medically indicated, an inter 

disciplinary clinical team delivers custom prostheses or orthoses 

and implements therapies to train veterans on how to use these devices effectively and ensure long-term rehabilitation success. 

I currently conduct studies on the factors that underlie balance 

and fall risk in persons with upper and lower limb loss. We do not 

yet fully understand why nearly 50 percent of community living 

persons with limb loss fall at least once per year, many of whom 

experience a fall-related injury. 

This has considerable implications to veteran qualify of life and 

VA healthcare costs. My studies aim to identify factors that are 

useful for fall risk screening and modifiable through balance targeted interventions. Uniquely, these studies utilize technologies for 

assessing how prosthesis users respond to walking disturbances. 

Moreover, these platforms can deliver therapies to train users on 

how to manage disturbances and avoid falls. 

I’ll provide two examples. In this first example, we use a robot 

that applies a controlled pull to the pelvis through a system of motors and cables. We’re interested in the lessons that can be learned 

from the unique strategies of the individuals you see here. 

In the second example, we see use of an interactive system, 

which provides both virtual and augmented reality as a means to 

deliver walking disturbances. This system is used to deliver physical training that requires controlled movements and is combined 

with cognitive behavioral therapy as part of a holistic treatment. 

The remaining projects focus on development and evaluation of 

prosthetic devices. We’re addressing the unique prosthetic needs of 

women with limb loss and developing prostheses that can accommodate changes in footwear. We’re also developing a new method 

to deliver personalized prosthetic feet and knees based on an individual’s body structure and activity level. 

Finally, we’re designing technology to suspend prostheses from 

the amputated limb using vacuum suction to improve mobility and 

limb health. 

While prosthetic and orthotic technology is advancing rapidly due 

to progress in robotics and material science, the most critical aspect 

to successful rehabilitation are the veterans using these devices. 

Research and development has granted us the ability to empower 

veterans with functional impairments but understanding how veterans interact with this technology is crucial. Therefore, we should 
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support parallel research efforts on development of technology and 

its clinical application. The success of the rehabilitation process is 

dependent on clinicians’ use of evidence-based practice, which is 

generated from quality clinical research that considers the holistic 

needs of patients. 

Furthermore, veteran rehabilitation does not end once they are 

fitted with a device and deployed into the community. Real-world 

use of this technology provides a window into rehabilitation 

progress and quality of life. Advances in wearable sensors have improved our ability to collect data on community-based outcomes 

such as activity level and participation. Research is needed to explore ways in which we can best integrate sensors into devices to 

monitor user status with minimal interruption to daily living. We 

also need to examine how these data can guide device designs and 

rehabilitation strategies to better support independent function. 

Overall, veteran rehabilitation research must continue to be 

interdisciplinary to accelerate its progress, integrating science from 

engineering and medicine. I argue that we still lack a thorough understanding of the interaction between the human element and rehabilitation technology. More research is needed to better understand: A, how the body responds to different prosthetic and orthotic 

designs; B, which therapies are most effective; and C, what the 

long-term outcomes of rehabilitation are on veteran health and 

quality of life. Filling these gaps will improve personalized rehabilitation interventions and help close the loop between technology and 

clinical practice. 

Ultimately, I believe that technology is driving us towards a future where we can fine-tune rehabilitation interventions with extreme precision, accuracy, and speed. Devices and therapies will be 

personalized based on individual patient characteristics and smart 

prostheses and orthoses will collect diagnostic data through onboard sensors. Clinicians will use these data to monitor rehabilitation progress and design interventions while the devices themselves will automatically adjust in real time to meet the demands 

of daily activity. Combined with advances in telehealth, therapies 

will be administered remotely without traveling to a clinic and 

thereby improving access to care. 

Real-time monitoring and remote intervention delivery will promote rehabilitation of veterans while permitting continued community engagement. Our end goal is to restore the greatest level of 

independence, ambulation, and quality of life to veterans which reflects a main priority of the VHA. 

I once again thank the Research and Technology Subcommittee 

and the Energy Subcommittee for this opportunity to testify, and 

I’m looking forward to the discussion. Thanks. 

[The prepared statement of Dr. Major follows:] 
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Chairwoman COMSTOCK. Great. Thank you all so much. What inspiring work you’re all doing, and the innovation is really exciting. 

So I kind of picking up from when we had our veterans’ roundtable yesterday, one of the things was how we can integrate these 

services. First of all, Mr. Wordin, and then I wanted to kind of ask 

everyone this question, what three things can we do, and maybe 

give us some action items for each of you to get what you’re working on advanced and out to more of our veterans. 

Mr. WORDIN. Well, the first thing is easy. It’s funding. I mean, 

the technology groups I think in all the speeches talked about funding and the need for more technology for technology because it has 

such a—it’ll have such a large impact. I mean, we talked yesterday 

in the forum about how, for example, people are trying to justify 

or understand how valuable equine therapy is. Well, if every participant was wearing a HEROTrak device, you’d be able to tell immediately the overall mental and physical impact that that therapy 

was having on that particular person, and so then you can make 

better informed decisions as both a patient, as a clinician, as a 

Congress on where to appropriate and prioritize that funding. 

Technology will continue to evolve, and I would say that’s the 

second issue is as technology evolves, particularly our device will 

become even more powerful. As phones become more powerful, as 

the wearable technology becomes more powerful, battery life improves, the reliability of the algorithm improves, the device will become even more efficient and even more valuable. 

And then the third thing is just being able to work within the 

VA system, which I think is the biggest source of frustration for 

veterans. In that study that was quoted where they talked about 

inconvenience, long wait times, paperwork, transportation and stigma, you know, the VA has its challenges and—but also the way 

that VA treats nonprofits, outside groups and how can we interact 

with them is very, very complicated. I mean, we’re lucky. We’re one 

of the few—we were the first with Secretary Shulkin to be an authorized mental health and suicide prevention program of the VA, 

but even with that official designation, we still have a hard time 

working with individual VA Medical Centers. And so how can we 

fix—I don’t even know if fix is the right word but how can we make 

it so that while it’s a lot easier to deal with active-duty component 

with DOD, it’s very, very complicated with the VA, and it’s still the 

federal government. There’s still supposed to be one rulebook. 

Chairwoman COMSTOCK. And Ms. MacCallum and Mr. Meek, 

what has been your experience in working with the VA and how 

can we help advance—and obviously I think we all agree getting 

more funding directed to this but how can we integrate better? 

Ms. MACCALLUM. Just looking at the VA request for 2019, $198 

billion, $727 million of that request is for medical prosthetic research. So funding is clearly one of the big issues. And when I 

think about SoldierStrong, there’s 170 VA Medical Centers in the 

country—and this goes to what Mr. Wordin was saying—we have 

devices in 12 of them so far. So the issue of scale and scaling up 

so that these devices are more available to veterans across the 

country is clearly one of the big goals here, and then, you know, 

in terms of what I do, I just think communication and helping people to understand across the country what our veterans go through 
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when they get home. I mean, I think that’s a message that we need 

to continue to spread and that’s something that, you know, I would 

like to see more news organizations spend more time on, and that’s 

an effort that I would make. 

You know, I look at one of the quotes from one of the veterans 

that we’ve spoken to. He said, you know, you feel like a burden and 

you avoid social situations, so that alone is such a hampering factor 

to moving forward. So we want to find a way to, you know, help 

veterans feel, especially when they’re using these devices, that 

they’re not in the way, that they’re normal, that they’re part of society, and I think raising awareness through great communication 

is something that will go a long way to that. 

Chairwoman COMSTOCK. Thank you. 

Mr. MEEK. I think I’d agree with Mr. Wordin. I think the two 

things that you can do are first to pass legislation making this 

technology available to all veterans, and more importantly is funding the appropriations. It’s one thing to pass a bill, but if you can’t 

pay for it, it’s not going to do anybody any good. 

You know, there’s several great organizations up here all doing 

some great things, but at the end of the day, we’re all fighting for 

the same private sector, private donor dollar. There’s only so much 

of that out there, and so getting help from people like yourself and 

this Committee will really help transform the lives of those veterans who need it. 

Chairwoman COMSTOCK. And I think one of the things I think 

you’ve all demonstrated in testifying, when these devices and these 

things are made available, it’s lowering PTSD, it improves lives, 

and we actually do have long-term savings here as well as obviously improved quality of life and the right thing to do, so there 

is a win-win result from this. 

Mr. MEEK. Well, and as you mentioned before, a lot of these devices were originally funded through DARPA, and what we’re finding now is that there’s no DARPA for veterans when they come 

back home, and so that’s why I think organizations like ours are 

trying to backfill here is to step up and fill that void. 

Chairwoman COMSTOCK. Thank you very much. I see my time is 

up. 

I now recognize Mr. Lipinski. 

Mr. LIPINSKI. Thank you, and I want to thank all the witnesses 

for their testimony. A lot of interesting work in different areas to 

help our veterans with technology. 

I wanted to start with Dr. Major. You mentioned the potential 

of smart prostheses that can incorporate onboard sensors and realworld data to improve rehabilitation progress and design interventions. What are the current challenges that the field faces in 

achieving the goal of smart prostheses and what federal resources 

are needed or could be leveraged to reach this target? 

Dr. MAJOR. Thank you for the question. Yeah, I think in terms 

of the challenges that we face this early, it’s difficult actually to 

find ways to effectively integrate these sensors. I mean, there are 

a lot of sensors that are available. Miniaturization of these sensors 

actually helps provide the ability to be able to include them in such 

devices like these, but again, I think what we’re lacking is once the 

sensors are actually included is trying to essentially use that map-
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ping between the data that is being derived from real-world use 

and what it essentially means and how we should direct that to 

how these devices either interact with the patients, help the user, 

learn from the user, and improve their mobility essentially. So I 

think there’s still some gaps that are missing in terms of research. 

A lot of this is essentially basic research in the sense that again 

once the data is available, how do you effectively use it, and I think 

we need to make certain that research is being directed in a way 

that we can answer some of those questions to fill those gaps. Because, again, the sensor technology has improved dramatically and 

it’s rapidly advancing because they’re getting smaller and smaller, 

and our ability to include them in devices such as prostheses and 

orthoses at this point is much improved. I don’t necessarily think 

that’s one of the bigger challenges. 

Powering those devices, powering those sensors, that is a challenge of course because they do require onboard battery power as 

well, and obviously in advances in battery power and miniaturizing 

that technology will obviously help in this case, but again, research 

does need to be directed to answer those questions on how we use 

the data effectively, how we can do that, collect the data, how clinicians can then use the data but at the same time also protecting 

the privacy of the patient because once you have all this data that 

is streaming in, one of the important things obviously is to make 

sure that patient privacy is being considered in that case. 

Mr. LIPINSKI. Are we training or have we trained the next generation of scientists to do this work that’s needed that reaches 

across a lot of different areas? Do you think we’re doing an adequate job of that? Do we need to do more and focus—well, do we 

need to do more there? 

Dr. MAJOR. I’d be hesitant to speak more broadly but in my experience, I think we are. I think one of the benefits of this type of 

research is that it is interdisciplinary and we need to make sure 

that it continues to be so, right, because again, it is this combination of engineering and medicine but we need to start of course integrating other disciplines as well, whether that’s material science, 

robotics, psychology, whatever it might be, but we need to make 

sure that we’re still promoting that type of integrative, interdisciplinary research to make sure that we’re staying competitive 

and we’re advancing the process of this particular science. 

So I think we are doing an excellent job. Of course we can always 

do better, and as long as we continue on this track, I think this 

particular research will remain competitive and we’ll be able to 

take the steps that we need to elevate this type of technology. 

Mr. LIPINSKI. Moving on, it’s great to see, Mr. Wordin, the work 

that you’re doing with HEROTrak, and we still—veteran suicide 

data is inconclusive. We’re still trying to understand this. What 

does your—you know, what does HEROTrak really provide in that 

direction and what else more do you think can be done to leverage 

commercial technologies in order to do this? 

Mr. WORDIN. Well, this report that’s about to come out is pretty 

clear on what the root causes and diagnoses of suicide are, and 

when you get into depression, anxiety, hopelessness, you know, 

those are all factors, and what we found in our research so far in 

our testing of the HEROTrak is that veterans feel like they have 
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a support system with them 24/7 right on their wrist because it can 

connect to a loved one, a clinician, a family member or a peer so 

that if they have an episode, they’re able to get help immediately 

and it’s something that they direct so they’re in control. And so the 

feedback that we’ve been getting from our focus groups has been 

really remarkable in the acceptance of being able to wear basically 

a technology monitoring device that understands what’s going on 

with you mentally and physically. And so that power helps alleviate that hopelessness. So if you are feeling depressed, you know, 

hey, if I have an episode, you know, it automatically will text-message my buddy from Iraq or my wife or my girlfriend or my father 

or whatever, you know, you particularly program in, and that ability really creates that sliver of hope that’s the difference between 

suicide and not suicide. 

Mr. LIPINSKI. Thank you very much. My time is up. A lot of 

things to talk about here but I thank all of you for the work that 

you’re doing. 

Chairwoman COMSTOCK. And I now recognize Mr. Weber. 

Mr. WEBER. Thank you, Chairwoman. 

Dr. Kusnezov, in your prepared testimony, you talked about how 

the DOE national labs have a history of research collaboration and 

the ability to confront short- and long-term complex science challenges. Hold that thought in mind for just one second. 

Ms. MacCallum, you said you talked to a vet who felt a stigma 

when trying to interact with—— 

Ms. MACCALLUM. Going out and socializing and being in a wheelchair and trying to get around people and feeling that he was, 

quote, in the way. 

Mr. WEBER. Perfect. Mr. Wordin, you listed all of the causes of 

suicide, and do you have that list available for us where we can get 

that later? Anxiety, depression. Was stigma one of those causes? 

Mr. WORDIN. No, but stigma is one of the reasons why they don’t 

receive VA medical services. 

Mr. WEBER. Okay. Thank you. 

Now, Dr. Kusnezov, back to you. The DOE has a history of working with some of those other agencies where you said earlier, I 

think quite frankly, and Mr. Wordin, you said that the VA has 

trouble working with outside groups. Well, I would proffer up the 

point that the Department of Energy does not, and they do a lot 

of good research, so I’m coming back to you, Doctor. I’ve got a point 

to this dialog here. How does the Department and the national labs 

benefit from performing data analytics and computational research 

on behalf of the VA, and then how do we meld this problem together? We’ll come back to you all later. Go ahead. 

Dr. KUSNEZOV. Thank you. That’s the right question to ask. For 

us, the data with its unique complexity that comes with subjectmatter experts, that is curated by experts brings with us a team 

of specialists that allows us to attack the artificial intelligence and 

technology challenge with our experts. And so the meeting, the 

intersection happens at that place where we look at the priority 

questions that the Veterans Administration to surface. We bring together the technology specialists, the hardware, the software, the 

engineers and ask how do we answer those questions. 
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Mr. WEBER. And many times, those are outside industry and 

groups. Keep going. 

Dr. KUSNEZOV. Yes. So the nexus is the two agencies coming together. We draw from the breadth of the laboratories. We engage 

the private sector and academia as needed. We bring in as many 

people as we can because we recognize it’s going to be an all-of-theabove type of activity to answer these priority areas the Veterans 

Administration has defined. 

Mr. WEBER. So I mean, actually, that’s a perfect marriage, if you 

will, in that we have that ability and we’re able to do that and 

thereby do away with the stigma, do away with the non-ability to 

work with outside groups and to make this as seamless as possible. 

I’m still going to come back to you for one more. 

These research partnerships have the potential to accelerate scientific breakthroughs and healthcare delivery systems and biosciences. Should the Department replicate this model in other 

fields of research, and what steps can we as Congress take to facilitate that? 

Dr. KUSNEZOV. So I think the answer is yes in terms of replication. Our focal point right now has been on the veterans’ health 

data and on the precision medicine dataset because of its unique 

complexities because it comes with annotations, with handwritten 

notes, with data streams and imagery and collections of 

multimodal data that talks to a situation in unique ways that was 

going to test how we develop predictive technologies, artificially intelligent-based computing. When we start to get our head around 

what those hardware and software technologies are, these are ones 

we want to apply to other areas but we find that the highest leverage opportunity for us is around this dataset because it draws in 

so many other partners who want to come, who want to participate, 

and it’s a force multiplier for our activities. 

Mr. WEBER. Well, that brings up another question, and so do you 

see any problems with the DOE and the VA working together? 

Dr. KUSNEZOV. No, not at all. In the beginning of April, Secretary 

Perry and Acting Secretary Wilkie did sign a new MOA to work together that we have started to implement now. It identifies more 

data than we already have resident that we plan to aggregate so 

we have a very nice path forward. 

Mr. WEBER. What process would you use to report back to Congress, in other words, to say, this is working, we’re making huge 

steps in the right direction? How do we get that from you? 

Dr. KUSNEZOV. I think at your discretion, coming to you with the 

VA side by side would be an effective means to do that. 

Mr. WEBER. Okay. Thank you, Madam Chair. I’m going to yield 

back at this time. 

Chairwoman COMSTOCK. Thank you, and I now recognize Mr. 

Veasey for 5 minutes. 

Mr. VEASEY. Thank you, Madam Chair. 

I wanted to ask a couple questions on data privacy and cybersecurity. Dr. Kusnezov, the information collected for the Big Data 

Science Initiative is obviously very sensitive information. Almost 

600,000 veterans have voluntarily given DNA and other samples 

that can be used, and what I want to know is, how is the VA and 
82 

the DOE working together to implement federal requirements for 

cybersecurity? 

Dr. KUSNEZOV. Thank you very much. I would add to your list 

of the veterans who have signed up the Secretary of Energy. Secretary Perry also joined personally in May of 2017 donating his 

DNA and his medical records to the set so security of course is important. The personal health information enclave, the initial one 

we launched at Oak Ridge National Laboratory is what’s considered moderate with enhanced controls under the FIPS 199 standard that meets both HIPAA and HITECH Act requirements. So 

we’ve set up an enclave consistent with the protection standards, 

but in addition, through our CIO Office, through our cybersecurity 

specialists and privacy specialists, we do external reviews of the 

enclave. We also have engaged the VA counterparts in the information security offices for their assessment of how we protect the 

data. 

In addition, we were very sensitive to appropriate use. Housing 

the data is one thing but who gains access is done through training 

program. We identify laboratory people who will be engaged but we 

run that through the VA. We have created teams, VA and DOE 

laboratory scientists, who are attacking the key problems that the 

VA has surfaced. The members of the teams that are allowed to access the data is controlled by the VA once we go through the training requirements, and so just housing the data doesn’t give anyone 

access to the data. We worry about the control. We worry about the 

use of the data for the purpose and we monitor that through IRB 

processes as well. 

So, you know, we’ve set up certainly an enterprise sensitive to 

the use and protection of the data for the very reason you remarked. 

Mr. VEASEY. With—you know, with you putting in all those parameters to protect the information, are there any challenges to accessing the complete medical records of veterans when need be? I 

guess what I want to know is, is it easily accessible, quickly accessible in situations where it needs to be? 

Dr. KUSNEZOV. So there are two parts to your question. Technically it is easy to access now in terms of the tool, the infrastructure we’ve set up, hardware and software, the learning environment. What is still a bit of a challenge is the IRB process. You 

know, what we’ve been doing here is new. Every step we take is 

new for everybody in terms of how we access data, and I think as 

we try and create the IRB structure for accessing veterans’ data, 

we’re sensitive to the fact that machine learning and artificial intelligence will kind of invert the world that people are used to. Normally when you have a researcher looking at data, they will pull 

the specific data they want to address a particular problem. If 

you’re trying to learn from more than 22 million veterans’ health 

records that span decades from genomic data, from images and so 

on and apply machine learning, the way you access the patterns of 

use are quite different than how anyone else has ever looked at 

this data, and so walking through the IRB and setting up the right 

protocols to allow access is a process that we’re still working 

through. So we’ve done some. We can technically access the data. 

We have accesses and controls in place but the policy side, we are 
83 

still working through how we get everyone to think about where 

the future is in terms of learning from data. 

Mr. VEASEY. Thank you. 

Madam Chair, I yield back. 

Chairwoman COMSTOCK. And I now recognize Mr. Rohrabacher. 

Mr. ROHRABACHER. Thank you very much, and thank you to our 

witnesses today. 

Let me just—this is not directly on technology, but it’s dealing 

with a VA issue. Some of the things that you’re describing that 

have motivated you to focus on trying to find technological solutions like depression, sense of hopelessness, et cetera, a lot of that 

can be traced, some of us believe, to the use of opiates by the VA, 

and some of us believe that the VA has taken the easy way out 

simply by prescribing opiates to somebody with a problem, which 

when we you supply that kind of drug, you’re going to end up with 

somebody with serious problems. 

Now, should the VA be permitted to use cannabis? Should they 

have that as an option rather than just opiates? And I’ve got some 

other questions that go directly to technology but could I have your 

opinions on that just a yes-no or something like that? 

Mr. WORDIN. All right. I’ll jump in. 

Mr. ROHRABACHER. Okay. Should should cannabis be an option 

for VA in terms of treatment of our folks rather than just opiates— 

well, it’s not just opiates? Do we know opiates—— 

Mr. WORDIN. I understand your question. 

Mr. ROHRABACHER. Okay. 

Mr. WORDIN. Well, I’ve been doing this for 10 years. 

Mr. ROHRABACHER. Yes. 

Mr. WORDIN. And I’ve had over 30,000 veterans come through 

my program, and I will tell you unequivocally that many of the veterans in our program use cannabis and they use it as an alternative to opioids, so—— 

Mr. ROHRABACHER. Is that good? 

Mr. WORDIN. It seems to be working because they’re all still 

alive. 

Mr. ROHRABACHER. All right. Does anybody else have an opinion 

on that? Okay. I won’t force you into commenting publicly on that. 

Okay. 

Yes, there are controversial issues. I would suggest that it is sinful that we do not permit our veterans that option. The veterans, 

doctors that I know, countless—not countless. I know a number of 

veterans who the doctors have had to pull aside and go to them in 

an off-campus, you know, situation where they could then recommend marijuana, and it’s ridiculous that we have to put doctors 

in a situation like that where they can’t even recommend what 

they think is the right treatment. 

Mr. Meek, you mentioned that it is difficult for medical devices 

to get approval. We find the same is true with commercial items 

as well like the FDA and others as well as other regulatory things. 

Could you give us a little more detail on that? 

Mr. MEEK. Sure, and you talked about the FDA specifically and 

I’ll reference the Ekso Suit, which is the primary device that we 

fund. You know, certainly you have to go through many phases of 
84 

the clinical trials. Then you have to go through different phases for 

FDA approval, and that takes years, I mean literally years. 

Mr. ROHRABACHER. And people are suffering during those years. 

Mr. MEEK. Exactly. 

Mr. ROHRABACHER. And do you have an example of a device that 

was left behind or delayed so much that people were left to suffer? 

Mr. MEEK. Well, again, not to beat a dead horse, but the Ekso 

Suit, you know, this has proven to—I mean, I know one specific 

veteran from Iowa who was told he’d never walk again and going 

through six months of rehab in the Minneapolis VA with a device 

we donated, he was able to walk his daughter down the aisle at 

her wedding. So it does work. 

Mr. ROHRABACHER. Let me just note that I had serious troubles 

in my arms, and I know a lot of veterans get this as well. Actually 

all of the cartilage was gone. I’m a surfer and I ended up surfing 

all the cartilage away in my arms. I know how painful that was, 

and what’s really helped is, I have had shoulder replacements that 

were, I believe, developed to help our veterans and now they’ve 

helped all of us. Do we have a situation where veterans are having 

to wait? Because I know how painful that was. Are our veterans 

having to wait to use the technology that we’ve developed? 

Mr. MEEK. I think the question is whether they’re actually getting the technology via the VA or through private facilities. So private rehabilitation facilities will get it much more quickly and it’s 

much more accessible than going through the VA process of them 

going through the FDA approvals whether to get the funding or 

not, because it doesn’t come from the VA here in Washington; it’s 

each individual VA has its own budget and so it’s up to them to 

figure out what they deem appropriate or necessary for their veterans’ care and so that’s where we step in. 

Mr. ROHRABACHER. Well, new technologies and new medicines 

are really elongated in the process for us to use them, and when 

you mentioned batteries, about how new batteries will probably 

help and many of these challenges that we face are helping the disabled. 

Let me just note that there are new batteries on the way, and 

Dr. Goodenough, the inventor of the lithium battery, has had a 

major breakthrough that should have an incredible impact on the 

things we’re talking about, but then again, we have to make sure 

that the FDA approves the use of these batteries and everybody 

else approves the innovation all the way down. 

So I’m very pleased that you alerted us to the bureaucratic problems that have to be overcome in utilizing new technologies for our 

veterans. Thank you very much. 

Chairwoman COMSTOCK. Thank you, and I now recognize Ms. 

Esty for five minutes. 

Ms. ESTY. Thank you, Madam Chairwoman. I want to thank the 

Chairwoman and Ranking Member Lipinski and Chairman Weber 

and Ranking Member Veasey for joining us here today. 

As a member of both the Science, Space, and Technology Committee and the Veterans Committee, I want to thank all of you for 

your important work here today and give a real shoutout to Mr. 

Meek and SoldierStrong based in Connecticut, and we’re really 

grateful for the work that you’ve done. All of us in Connecticut 
85 

know people who died in the Twin Towers, and that’s a searing 

memory and your commitment to that. My niece was one of those 

who answered that call and served in Afghanistan, and I know how 

important the work all of you are doing. 

I think it was you, Mr. Meek, mentioned no DARPA for the VA, 

and Dr. Major, you’ve also talked about the VA does not—has 

aging facilities doing research. So I have a couple of questions here 

so I’m going to ask all of you to say whether you think there ought 

to be a DARPA for the VA or rather whether we should be using 

DARPA as it exists but task them with VA-specific goals because 

that’s what’s happened around exoskeletons. I mean, that early 

work was around exoskeletons through DARPA. They’ve kind of 

dropped it. It’s now been left for VA to pursue, so if people could 

opine on that, please? 

Dr. MAJOR. If you don’t mind, I’ll begin. Yeah, I mean, essentially, in terms of funding mechanisms, we’re obviously for additional funding, the typical way that the mechanisms run in the VA, 

there are certain priorities that research is directed towards. I 

mean, for instance, the prosthetic needs of women, for example, 

that’s something that’s come about mainly because of the growing 

population of women veterans, but essentially those type of priorities are fit into existing mechanisms, right, and I actually would 

look forward to something where there is maybe more targeted 

mechanisms, targeted funding mechanisms, speaking specifically 

towards certain priorities. DARPA may be a way to do that or some 

different formation similar to that which could be implemented in 

the VA, and I think that would actually be quite effective. Again, 

maybe not DARPA in and of itself but something that could work 

effectively in the VA that would allow individuals to target certain 

priorities, and I think that would help with the technology development, the advancement, and the implementation in the VA specifically which I think essentially is badly needed. 

Ms. ESTY. Mr. Wordin, I know that actually under Dr. Shulkin, 

his only clinical priority was on suicide prevention. You’ve talked 

about a lot of feedback information. A question I have for you is, 

you’re collecting a huge amount of important information, and 

much of it tracks with what we know anecdotally as well as, you 

know, the research beginning to be done about feedback. Do we 

have an ability to share or how would we go about sharing that important information that basically you’re developing with the privacy concerns and as proprietary to you? And so here’s part of the 

challenge. We have innovative work being done in the private sector in order to push it through all the VA. Then we have these 

questions about access, who has access to the data, how do we safeguard it and how do we share that information that you’re developing that would help us develop better programs for veterans? 

Mr. WORDIN. Okay. Well, that’s a—I’ll tackle that in pieces. 

First off, under Secretary Shulkin and under President Trump, 

suicide prevention and mental health is the number one priority 

and yet they don’t—there’s no visible funding for technology that 

addresses those issues, not a single dime. So that’s one area of concern that we have. 

With the testing that we’re doing right now, we’re not collecting—we’re collecting individual information but we’re not iden-
86 

tifying the individuals. So it’s a blind study so there’s no privacy 

concerns with that. With our program in general, we partner with 

the VA and we track particularly mental health status and suicide 

ideation of every participant in our program, and we have done 

that on a longitudinal basis for some time, and that information is 

contained or housed in their VA medical records so we’re able to 

deal with the privacy in that regard. So as long as the VA medical 

records are private and they have security, then the information 

that we’re gaining will have that same security. 

Ms. ESTY. I want to follow up with you afterwards because we 

had some interesting testimony over in the Senate on gun violence 

issues and work that L.A. is doing through texts to deal with students who have suicidal ideation and other issues. So I think there 

may be alternatives that we can look at that have been developed 

elsewhere that could help marry the technology that you’re developing to connect to, say, the VA hotline. You know, how can we 

have an ability to connect because that’s one of those issues we’ve 

had. How do people even know about the VA hotline? Make sure 

you’ve got it staffed, I don’t know if you’ve looked at that at all? 

Mr. WORDIN. Well, actually, when we do have focus groups, and 

as the device has been developed, it has four options when you 

have a PTSD episode, whether it’s self-resiliency or it’s contacting 

a family member or a peer or whether it’s contacting the VA hotline or 911, and what we find is that most veterans, I would say 

over 80 percent of veterans, would rather connect with a peer or 

a family member rather than a stranger on the VA crisis hotline. 

Ms. ESTY. That tracks with all the other research we have that 

they’d rather have peers, so again, I’m over time but I really want 

to thank all of you for your important work on these initiatives and 

urge you to continue to bring your ideas forward so we can do a 

better job to serve those who have served this country. Thanks very 

much. 

Chairwoman COMSTOCK. Thank you, and I now recognize Mr. 

Hultgren for five minutes. 

Mr. HULTGREN. Thank you, Chairwoman. 

Thank you all so much. This is really important. There’s nothing 

more important that we could be doing than caring for our veterans, letting them have every opportunity for full lives that are 

fulfilling and continuing to be amazingly productive, so thank you 

for your work. 

Dr. Kusnezov, if I could first address a couple questions to you. 

A unique feature of the DOE–VA partnership is that the Oak Ridge 

National Lab facility will be able to host protected VA health data. 

It’s the only institution outside the VA to be able to do so. What 

steps is DOE taking to protect the personal information of our veterans? And also a follow-up, should DOE also be allowed to host 

secure data from other sources such as private industry? 

Dr. KUSNEZOV. So thank you very much for that question. The 

data security piece is very important to us. Certainly, compliance 

with HIPAA and HITECH are important. We have a process we 

put in place to secure the data in the enclave. It includes an annual external review from a third party that reports back to the 

feds, and then we provide the authority to operate the enclave. We 

engage our cybersecurity and privacy experts and counterparts 
87 

from the VA to oversee all of this so we’re very careful about data 

use and protection for this enclave. 

Mr. HULTGREN. Do you think there is opportunity to host other 

secure data from other sources? 

Dr. KUSNEZOV. These are things we already do across DOE for 

many different reasons from other agencies, for many different reasons, so yes. The simple answer is yes. 

Mr. HULTGREN. DOE houses four of the top ten fastest supercomputers in the world and is the principal federal agency for leadership in computing facilities. How will providing DOE with access 

to the VA dataset benefit healthcare research specifically for veterans? 

Dr. KUSNEZOV. I think what we’ve started to find in applying the 

basic existing tools and artificial intelligence is they break rather 

easily at the scales of the veterans’ data set. The complexities, the 

size, the amount of information contained already exceed what 

standard toolsets are allowed to—you know, can accommodate. 

DOE is very interested in pushing the limits of technology and 

supercomputing and AI, and these kinds of stresses are very interesting to us in terms of where the next generation of more cognitive tools will come from. So we’re going to be pushing this data. 

The data itself is the mechanism in which we set up this next frontier of AI-inspired simulation. 

Mr. HULTGREN. Great. 

Dr. Major, thank you for being here, grateful for your work, so 

proud of Northwestern, and incredible accomplishments that continue to come out of your work and others’ work there at Northwestern, so thanks for being with us. Getting older brings with it 

many challenges including the danger of falls. Does your research 

provide any quantitative data on how much more of a danger this 

is to veterans in need of prosthesis or orthosis as compared to veterans who don’t require such devices? 

Dr. MAJOR. Thank you for the question. Yeah, I’m not particularly aware of any research that has targeted specifically veterans 

of that nature and what that distinction is between those again 

who do use prosthetic devices and those who may not in terms of 

fall and fall risk. That type of research I think is certainly needed. 

I think anything in terms of looking at specifically different types 

of veterans, the era which they come from, the combats in which 

they maybe perhaps served, I think that particular research certainly would be helpful in trying to target certain rehabilitation 

technology, whether it’s prosthetic and orthotic devices or other 

types of rehabilitation technology in order to target that specifically 

to individual cohorts. I think it’s something that can be done, and, 

you know, speaking again to some of the issues that were brought 

up today, the veteran statistics, the type of data that we have because it is such an integrative healthcare system, it’s ripe for that 

type of research essentially that cannot be conducted necessarily on 

a wider scale. 

I think the resources we have available to us through the VHA 

is just a perfect opportunity to do that type of work. Some of which 

is currently being done, but again, I think we could take better opportunity of that. 
88 

Mr. HULTGREN. Great. Quickly, Dr. Major, if I can follow up. 

Clearly, our goal is to continue to improve the quality of life of veterans but also for all people. I wonder with your research and work 

in prosthetics, how is it making its way to companies that develop 

such devices that could benefit from your findings and in turn provide better technologies to veterans and to all people? 

Dr. MAJOR. So one of the benefits that we have is oftentimes the 

partnerships that we develop through a lot of these research efforts 

so just to use an example, my research in particular, even though 

it is directed through VA funding, it also includes partnerships 

with academia, for instance, so Northwestern University, and in 

addition to that, even industry partners as well, so much of the 

technology that is developed and the patents that are then developed through those efforts are jointly owned, right, so it would be 

owned by the VA as well as industry partners or academia as well. 

And so that is a way, that’s a method in which the technology that 

is developed by funding supported by the VA that then can be 

brought out and benefit civilians. So we do a lot of that, in fact, 

and I think it’s a great mechanism. 

I will say that, you know, in terms of technology transfer, I think 

if certain mechanisms could be developed within the VA to help 

that, to help advance that process would certainly be beneficial because there is a lot of great technology that is developed in the VA, 

and these efforts and the funding through the VA does support 

that but I think trying to get that out to the civilian population 

would certainly be of great benefit. 

Mr. HULTGREN. I’d love to see that. 

My time’s expired. Thank you all so much for your work. I yield 

back. 

Chairwoman COMSTOCK. Thank you, and I now recognize Mr. 

McNerney for five minutes. 

Mr. MCNERNEY. I thank the Chair. I thank the Committee for 

having this hearing, and I have to say, I got excited listening to 

your testimony. 

Let me start with Dr. Kusnezov. A federal government scientist who had worked for the VA since 1983 made more than $400 million when he sold a company for $11 billion to this pharmaceutical 

giant Gilead in 2012. The drug was then discovered with federal 

resources and intended to treat veterans with Hepatitis C but, unfortunately, once the drug was sold to the private company, it was 

out of reach for veterans and for the VA both. So as the VA and 

the DOE work together with the private sector, how do we also ensure that the data and technology resulting from taxpayer resources and labs is not exploited by startups and private sector entities solely for the commercial gain for a few individuals? 

Dr. KUSNEZOV. Thank you. No, that’s a great question. In our 

partnerships, there are some fundamental tenets we have. One is 

open source for the tools we create for the very reason you mentioned. We do have some partnerships with pharma, for example, 

with GlaxoSmithKline right now, an effort called ATOM, also related to all of this activity. What we do in the space with pharma 

and the technology companies is precompetitive so it’s by definition 

open to other entities to join and openly available and accessible 

for that reason. So we’re sensitive to the question you’re asking, 
89 

and we have to manage the middle ground in a suitable way so 

that it does draw in the right kind of risk mitigation from the private sector, which adds value to this, but does not do this at the 

expense of others. And so we are keeping an eye on it, again, open 

source and precompetitive are foundational here. 

Mr. MCNERNEY. Okay. Well, I mean, we’ve seen this happen in 

other cases too so it’s a very difficult situation when veterans can’t 

have access to medicines that were developed with federal money. 

We need to work on strengthening those protections. 

Mr. Wordin, I was pretty excited about your PTSD alarm, and 

you’re using data, and the graphs you showed saw a spike in the 

heart rate and then additional sort of physical indicators after that. 

Were you able to identify in those cases the physical event or the 

emotional event that triggered those reactions? 

Mr. WORDIN. We aren’t able to do that but we asked the participants in our study right now to keep a journal, and they were able 

to document what the environment was. We try to look at both immediately before, a few minutes before, and maybe a half-hour before, and it’s great empowerment to an individual veteran to understand what causes a PTSD episode for them because it’s different 

for each veteran. 

Mr. MCNERNEY. Absolutely, and if—I mean, if you could understand what’s triggering it, then that leads to all kinds of opportunities for treatment and mitigation of those sorts of triggers. 

Mr. WORDIN. Absolutely, and the great thing about the device is, 

it will measure that and see if what you’re doing to mitigate is actually working or whether you see whether the prescription drug 

or the therapy options that the VA or your healthcare provider has 

given to you, you can objectively understand how it’s working, what 

is working, if it’s working, and so it’s—I mean, that’s the great 

thing about the device is, it’s completely objective. It is what it is. 

Mr. MCNERNEY. And do you see similar sort of characteristics, 

you know, data characteristics, from different individuals with regard to PTSD triggers? 

Mr. WORDIN. Well, yeah. I mean, when you look at the spike, if 

that’s what you’re referring to, yes. I mean, that’s a common 

theme. If someone’s having a PTSD episode, that’s how the device 

detects that PTSD episode is through that spike in heart rate or 

the heart rate variation. 

Mr. MCNERNEY. Well, we saw a spike and then we saw a little 

bit of quiet period and then we saw additional—— 

Mr. WORDIN. That was—yeah, because we—the graph that you’re 

referring to, that showed physical activity, because I wanted to differentiate, because one of the questions I always get is, how does 

it know whether it’s physical activity or whether it’s a PTSD episode, and the device is able to detect because the steepness of the 

curve when you’re having a PTSD episode versus when you’re, say, 

riding your bike, there’s a different in how your heart rate elevates 

and how fast it elevates. 

Mr. MCNERNEY. Thank you. I yield back. 

Chairwoman COMSTOCK. Thank you, and I now recognize Mr. 

Webster. 
90 

Mr. WEBSTER. Thank you, Madam Chair. Thank you all for appearing. This is great work you’re doing and we really appreciate 

it. 

Mr. Meek, you talked about—I don’t know your exact words but 

you talked about the fact that technology was ahead of the VA’s 

practice in a sense and that you get these technological advances 

that are not a part of the normal VA treatment. I would assume— 

I don’t know this is true but I make the assumption that advances 

in technology usually cost more, and that if it does more, probably 

costs more, but my question would be, how do we balance that? 

How do we mold together availability and advancement so that— 

I mean, you could have the scenario where you make an advancement, and if you spend all your money making advancements, then 

you could come up with something that helps a veteran 10 times 

better than current practice. However, you could only afford one 

out of 10 where under the old technology, you could afford 10 out 

of 10. Is there a balance there? Do you see what we might be able 

to do to—we certainly want to make advancements but we also 

want to be able to pay for it. 

Mr. MEEK. Sure. So I think to go back to your other question 

about whether the DARPA should be a model to transform to the 

VA, I think it should be. You know, we put the most advanced 

technology we can in our warfighters, but once it’s done meeting 

DARPA specs for the battlefield, that’s it, the funding stops. 

There’s nothing to commercialize that for the private sector back 

at home, and so you look at a lot of these devices. I mentioned how 

the average cost that we fund is $100,000 with a couple of them 

almost $200,000. Think about the original cell phone. It was the 

size of a small suitcase, you know, and cost a thousand dollars. 

Well, today it’s the size of a calculator and it fits in your pocket, 

and it’s a supercomputer. So having that continued research and 

development on a specific device, whatever it may be, for advancement, you know, where the funding comes from, there are separate 

pools that we could look at but you have to keep that funding going 

because over time it will bring costs down. You know, a lot of these 

devices are so advanced that yes, they cost a lot right now but 10, 

20 years from now, knowing some of the work that Dr. Major’s 

doing, you know, they’re hardwiring some of these devices in individuals’ brains. You know, I’ve seen virtual reality where somebody 

lost their arm in Vietnam, and through virtual reality actually felt 

himself opening a doorknob, and he cried because it was the first 

time he touched something in 25 years. 

So this funding has to be found somewhere, because in time, not 

only will it reduce the cost of those devices, it’s going to reduce cost 

of medical and VA care for those patients. 

Mr. WEBSTER. Well, I saw a live presentation of the type of technology you showed in your video, and I was just totally astounded 

someone could actually go from a sitting position and rise with no 

help at all, not even necessarily using their arms. They could just 

get up. So I want everybody to have that. It’s just the idea of making it available. It’s expensive, and sometimes that would come at 

the expense of any more technological advances. 

I had another question. That was Mr. Wordin. You mentioned— 

this doesn’t have anything to do with that particular issue, it has 
91 

to do with self-directed mental health care, which I have—you said 

something about that, I don’t know exactly what you said, but it 

struck a note that that’s what you were talking about in that the 

person would help in the direction of what they would be choosing 

for their mental health care. I have seen that work in the private 

sector. Do you think that ought to be more uniformly applied in the 

VA? 

Mr. WORDIN. I don’t know if I’d use the word ‘‘uniformly’’ but I 

think it needs to be available because every veteran that suffers 

from PTSD is different. If you’ve seen one veteran with PTSD, 

you’ve seen one veteran with PTSD, and I think what they find as 

their support system individually is the most important path, and 

the great thing about the HEROTrak device is, it gives them feedback individually so then they can make decisions for themselves 

based on how their quality of life is that they want or that they 

have right now. And so if you go to the VA and you see your mental health clinician and he goes well, how are you sleeping; well, 

I’m not sleeping so good; well, we’re going to give you some 

Ambien. Well, how do you know whether that actually does any 

good for you? Well, with the device, you’re able to monitor and look 

at sleep patterns, look at PTSD episodes during sleep, and be able 

to decide whether or not that’s something—because every prescription drug that you take has a side effect or it has some kind of addictive quality, and that affects your quality of life as well. 

I mean, we have veterans in our program that literally have suitcases full of prescription drugs that the VA sends them on a regular basis, and then when they get into our program, they get off 

of those prescription drugs and yet the VA continues to send them 

the prescription drugs, and when you talk about costs for technology, technology is way cheaper than prescription drugs. 

Mr. WEBSTER. Yes. That’s not shocking. That’s awesome. 

Thank you all for appearing, every one of you. It’s been very encouraging, each of you and your work. I yield back. 

Chairwoman COMSTOCK. Thank you, and I just want to take a 

little prerogative too on that particular point, that if you can send 

us some of those examples with whatever way that protects the patient’s privacy, that would just be really helpful in us making this 

case, because I think this is great disruptive technology that is 

going to save money, and the more we can highlight examples like 

that, I think as we move forward. 

So I now recognize Mr. Dunn for five minutes. 

Mr. DUNN. Thank you, Madam Chair. I love these joint Committee meetings where we’re all gathered. It sort of underscores 

our interconnectedness. You know, we’re sitting here with the Energy Subcommittee, the Research Subcommittee. We’re talking 

about quantum computing for our national labs and it’s being applied to translational genomics, and all this on the subject of yet 

another committee, Veteran’s Health, so that’s the interconnectedness that’s great. 

I’m a urologist—Dr. Kusnezov, I’m a urologist. Prostate cancer is 

very near and dear to my heart. I know you’re working on ways 

to determine biomarkers that determine the lethality, relative 

lethality of prostate cancer, what needs to be treated and how aggressively. Can you briefly outline a couple of those for us? 
92 

Dr. KUSNEZOV. I can talk more to the technology side than the 

side that you might be more familiar with. 

Mr. DUNN. Oh, yes. I want to know the biomarker, but I do appreciate what you’re doing, and I think that that’s—you know, I 

think that that’s key. 

Mr. Meek, you’ve partnered with VA hospitals, also I suppose 

military hospitals like Walter Reed? No, they’re completely separate from you? Of course, they don’t need your help, so you’ve 

partnered with the VA hospitals. How do you select which ones? 

Mr. MEEK. So we work with the device manufacturer, you know, 

depending on what the device is. So if it’s for an individual, sometimes they fall through the VA cracks and the device manufacturer 

will find somebody that maybe the VA won’t fund it or the VA will 

fund the device but not the fitting and so they’ll reach out to us 

to fill that void. 

In terms of the exoskeleton devices, again, we work with the 

manufacturer. There are 24 spinal cord injury medical facilities 

within the VA center, and so we start with those that have the 

largest population that they serve with the goal of hitting all those 

with one device to begin with and then go back and circle back 

again. So, for example, Richmond, Virginia, serves the largest with 

5,000 spinal-cord-injured veterans. They have one device. They 

could use 25. Palo Alto has 3,000 to 4,000 veterans that they serve. 

They could use a few devices as well. So one doesn’t cut it. It’s a 

rehabilitative device where somebody goes in like going to the gym 

with a personal trainer and you set your 45-minute time and you 

do laps around the VA. 

Mr. DUNN. All right. And do you also—when you do provide one 

of these exoskeleton whatever type suits to the veterans, do you 

also provide continued support and maintenance upgrades? 

Mr. MEEK. We do. When we purchase it, it also comes with a 

four-year warranty as well as training for the entire staff at the 

VA. 

Mr. DUNN. And you mentioned regulatory burdens. I just want 

you to know that we have been tasked by no less than the President to streamline the regulatory burdens so if you have regulations that you think are bad regulations, duplicative, get in the 

way, bring them to us. We love to get rid of regulations, especially 

bad ones. 

Ms. MacCallum, you’re sort of a people specialist. You deal with 

a lot of people in a lot of different strata. Have you—in your opinion, have you seen the VAs and the veterans themselves, are they 

receptive to some of these new technologies? 

Ms. MACCALLUM. Absolutely, you know, but I think about the 

fact that just demonstrating with Sergeant Rose on the set—on our 

set, we were able to raise enough money to buy an Ekso Suit for 

a veterans hospital in one day. So I just think that the awareness 

that people need to have, and also I think the partnership between 

public and private entities is so important, and I think about the 

new VA bill that is moving its way through Congress and where 

the gaps exist, and the VA can’t provide that assistance. They are 

now allowed to turn to a private entity in order to fill that gap, and 

I think we need to look for more ways to do that so that private 

enterprise and the VA can work most efficiently together, and then 
93 

I think you’ll see a scaling up of this technology in private facilities 

and in veterans facilities, and I think that the will of the people 

in terms of what we’ve seen is certainly behind it. And I also think 

that when you look at the cost-benefit analysis in terms of taking 

care of veterans long term, and you just heard what Mr. Wordin 

said about the incredible expense of pharmaceuticals, this psychological benefit and life benefit of these devices hopefully will make 

some of those pharmaceuticals unnecessary. 

Mr. DUNN. Well, I share your optimism, and I thank you for the 

gratuitous plug for the Mission Act, the VA bill that we’re carrying 

across the finish line right now. It’s near and dear to my heart. I 

sit on that committee as well. 

Looking at 20 seconds left on the clock, and it’s not fair to bring 

up the question, Mr. Wordin, that you brought up so cogently in 

your report of the stigma that we attach to PTSD and TBI in not 

just our veterans but in our active-duty troops, and this is a major, 

major problem that we have just been whistling past the graveyard 

on. If we could treat it perfectly, we still aren’t allowed to diagnose 

our active-duty troops lest we ruin their careers, and we don’t have 

time for you to comment on that but I’m glad you brought it up, 

and—— 

Mr. WORDIN. If I could, I’d like to say one thing about—— 

Mr. DUNN. With the Chairwoman’s permission. 

Mr. WORDIN. One of the things that we found in testing, one of 

the things that was brought up to us by the VA is that vets 

wouldn’t want to wear a HEROTrak because it would cause a stigma just for them wearing a device, but because it’s an Apple 

Watch, it makes them cool, and so the stigma has been removed, 

and therefore they’re getting help that they wouldn’t ordinarily get. 

So we’re very aware of stigma in our organization and the vets that 

we service and, you know, you’ve got to find creative ways to get 

around it. 

Mr. DUNN. Thank you very much. I yield back. 

Chairwoman COMSTOCK. Thank you, and it’s gathering general 

information that’s good for health and wellbeing along the way too, 

right, so, excellent. 

I now recognize Mr. Palmer for five minutes. 

Mr. PALMER. I thank the Chairwoman. I’ll be fairly brief. I have 

to preside over the House in a few minutes. But Ms. MacCallum, 

looking at your involvement in this, I really appreciate how this 

started with SoldierStrong providing things to the soldiers in the 

field. Some good friends of mine’s son, Lance Corporal Thomas Rivers’ sister started that program and sending everything from sporting magazines to staples to essential things, and they got to the 

point where her brother would get things and the other guys would 

say well, you know, could you share that, and it turned into a program called Support Our Soldiers. Unfortunately, Lance Corporal 

Rivers was killed in the Helmand Province on April 28th, 2010, an 

IED, but the program continues and has expanded, and we’re having a banquet next Thursday night, the annual banquet. These programs are incredibly important for morale but also for the families. 

A lot of these guys don’t get letters from home, they don’t get 

things from home, so thank you for what you’re doing. 
94 

Mr. Wordin, in your testimony you mentioned that Project Hero 

has reduced participants’ use of prescription drugs and opioids and 

others and antidepressant use significantly, and Mr. Dunn brought 

this up as well about—I think the process of dealing with these soldiers begins before they get home. The whole thing about PTSD, 

all of that begins before they get home, and one of my concerns, 

we’ve got 22 veterans per day that commit suicide, and I just have 

to wonder how much of that’s related to reactions to drug use and 

what you’re trying to do to reduce the dependence on drugs I think. 

Mr. Wordin, could you comment on that, how you think that might 

help us reduce what I think is an unbelievable tragedy that’s occurring every day with veterans? 

Mr. WORDIN. Sure. When you look at the report that’s going to 

come out, the risk factors that they looked at—worsening of health 

status and decline in physical ability—those can be directly related 

to prescription drug use, particularly when you have overprescribing of prescription drugs, and it’s not working, and therefore 

you start losing hope, and then it starts depression and then you’re 

on the downhill spiral and then eventually that’s what leads to suicide. So that’s where I think the prescription drug use comes into 

play is because for doctors, the easiest solution is here’s a pill, this 

is going to make you all better, whereas that’s not necessarily 

what’s in the best interest of that individual, and I think that’s one 

of the great and exciting things about the HEROTrak is, you’re 

going to be able to figure out what’s in the best interest of the individual and be able to prescribe for that person a healthcare path 

that is actually going to make a difference for him. 

Mr. PALMER. Well, I thank you. I told Mr. Norman if he would 

yield to me, I would hold to three minutes. I think I came pretty 

close to that, Mr. Norman, and with that, Madam Chairwoman, I 

yield back. 

Chairwoman COMSTOCK. Okay. We’ll now recognize Mr. Dunn— 

Mr. Norman. I’m sorry. 

Mr. NORMAN. Thank you so much. Thanks to each of you for taking the time to testify. It’s valuable. 

I’ll emphasize what Dr. Dunn said. As you move forward, if you 

see regulations that are impeding what you do, let us know because we’ve got a body here that is strong and will take your case 

to get needless regulations out of the way. It’s a goal of the President and it’s a goal of this body, this House. 

Ms. MacCallum, you’ve got an interesting role, as they described, 

in the people business, as an anchor and on the advisory board. 

What is your opinion on this and what’s been your experience on 

the specific technology for veterans that is effective with raising 

money and raising the awareness? Is there one or two that you 

could point to? 

Ms. MACCALLUM. You know, I just think when people hear the 

stories of these veterans the impact that it has on their lives, you 

know, here’s one veteran, Jason Geiger, who was a SoldierStrong 

Ekso Suit beneficiary. He said you cannot put a price on walking, 

you can’t put a price on someone’s ability to be six feet tall again 

and stand up and kiss your wife or stand up and hug your daughter or your son. You can’t put a price on that. And we talk a lot 

about money because we have to because it’s part of bringing this 
95 

technology to our veterans but, you know, I think there’s a will in 

America—I know there’s a will in America to provide for this, and 

I do think that people are very much aware—you talk about regulations—of the waste that exists in the federal government in its, 

you know, good efforts in many ways to solve some of these problems but I think everyone sitting here is working towards efficiency 

and improving the lives of our veterans, and I think that through 

technology and through awareness, a lot of these ideas can help us 

to cut some of the waste in these programs and to produce more 

benefit. 

Mr. NORMAN. And that’s—you know, we don’t know what we 

don’t know, and as—I’m glad you brought up waste because every 

agency, particularly now, can give us a roadmap as to where there 

is waste and specifics on how we can address it, and I hope you 

all will do that as you move forward because every dollar saved 

through waste goes back—would go back into potential good use. 

Mr. Meek, how did SoldierStrong decide which VA hospitals will 

receive the SoldierSuits? 

Mr. MEEK. So again, we worked with the device manufacturer, 

and within the VA medical system there are 24 facilities that have 

a spinal cord injury unit. In addition, we also work with those that 

have a traumatic unit as well, and so the spinal cord injury unit 

will be focused more on spinal cord injury versus traumatic could 

focus on stroke, and so we’ll take the recommendation from the device manufacturer with the goal of getting those that serve the 

largest population a device first and then going from there. 

Mr. NORMAN. Okay. Perfect. Thank you all. I think we’re at 

about 12 o’clock. We really appreciate your testimony. I yield back. 

Chairwoman COMSTOCK. Thank you so much, and I thank the 

witnesses for their testimony today and the Members for their 

questions. Without objection, Chairman Weber and Ranking Member Veasey’s openings statement, which they were not available to 

make when we started the hearing, are made a part of the record. 

[The prepared statement of Mr. Weber follows appears in Appendix II] 

[The prepared statement of Mr. Veasey appears in Appendix II] 

Chairwoman COMSTOCK. And I really so appreciate the great testimony here today. I think we’re really seeing disruptive, positive, 

innovative technology, and I think there’s no question that we need 

to reallocate resources, get new resources, and make sure we’re 

providing this choice because a lot of the things we’re talking about 

with our veterans and what we’re trying to improve are more veterans choice, and what you’re offering is more choice and more 

positive outcomes, and I really do think it’s a lot of win-win solutions that you have here. So we look forward to working with you 

on how we can redirect and reprioritize this so we actually end up 

with better outcomes that will ultimately most importantly save 

lives but also save money. So this is real exciting, and I think this 

is the beginning of what I hope will be continued discussion on 

this. We’re already discussing maybe some legislation and efforts 

that we can work on with our colleagues here on this Committee 

who are also on the Veterans Committee. So thank you for your inspirational work. 
96 

And the record will remain open for two weeks for additional 

written comments and written questions from Members, and this 

hearing is now adjourned. 

[Whereupon, at 12:05 p.m., the Subcommittees were adjourned.] 
(97) 

Appendix I 

ANSWERS TO POST-HEARING QUESTIONS
98 

ANSWERS TO POST-HEARING QUESTIONS

Responses by Dr. Dimitri Kusnezov 
99 
100 
(101) 

Appendix II 

ADDITIONAL MATERIAL FOR THE RECORD
102 

OPENING STATEMENT SUBMITTED BY SUBOMMITTEE ON ENERGY

CHAIRMAN RANDY WEBER
103 
104 

OPENING STATEMENT SUBMITTED BY SUBOMMITTEE ON ENERGY

RANKING MEMBER MARC A. VEASEY

Æ