DHS SVIP Industry Day - Human Performance and Resiliency

DHS SVIP Industry Day - Human Performance and Resiliency

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♪♪♪ Melissa Oh: Hello, everyone. Thank you for joining us today for the Department of Homeland Security's Silicon Valley Innovation Program Virtual Industry Day. My name is Melissa Oh and I'm the managing director for the DHS Silicon Valley Innovation Program. SVIP is part of the DHS's Science and Technology Directorate where we are focused specifically on working with tech startups where their product road maps align well with what we're looking for.

Today, we're going to cover a new topic on "Human Performance and Resiliency," where we're calling on the startup community to partner with us to hear about our pain points and use cases and see how the commercial technologies you're developing can be shaped to help us too. This is a really important subject that many of us and the people we know and care about around us have and may be facing personally and professionally. And as we recognize and remember the veterans who have served us and protected us, let's find a way to care for one another.

So, we're looking for innovative solutions as support tools to keep us from getting too close to crisis conditions and how can we use these tools to help us keep a better eye on ourselves? So today, we have some great speakers lined up to help you innovators better understand the mission our operators carry out and to help frame out the problems that and use cases we'd like your help to solve. Next slide please. So, our agenda for today is we're gonna hear from our keynote speaker who will talk about "A Day in the Life of a Homeland Security Professional," and then go over the Human Performance and Resiliency Overview, as well as discussing the problem framing of the three technical areas that we're looking for help with, specifically in AI-Enabled Mobile App, Sleep Recovery/Enhancement, and Biometric Wearables. Then we'll have a--the panelists get together for a Q&A session and then I will jump back onscreen to talk about the Silicon Valley Innovation Program in more detail, telling you how we work with startups and what it takes to work with us and what we're looking for as far as the application process.

So that's our agenda for today. Next slide please. A little bit of housekeeping items.

Questions: we want you to ask questions through the Q&A box, so down at the bottom of your Zoom screen, you'll have a Q& A box. If you have questions throughout the presentations, please ask your questions to us and, where possible, please identify if there's a specific technical topic that you're asking your question about, and we'll make sure to tee those up during the panel Q&A session later. And then also during my talk about SVIP, feel free to ask questions during that time 'cause I'll have a Q&A session as well. Just for your background, the presentation will be available and we are recording today's session, so feel free to not worry too much. You will get a link to access the presentation as well as the recording by Friday. And there are a lot more details about what we're asking for as far as the specific topic details that we're looking for, so there's a link there, to get a lot more details about eligibility, the specific technical area, the operational need, so the link's available there, and then our QR code for SVIP's there to get to our website if you wanna learn more about the program.

Next slide please. So, just before we jump into some of the details, a little bit of high-level context. The Department of Homeland Security is a very large organization of over 240,000 employees with multiple operational agencies. You may have actually heard of some of these agencies before when you either travel or when you hear about disasters. Those agencies include, you know, Customs and Border Protection, Cyber Security and Infrastructure Security Agency, FEMA, TSA, the US Coastguard, US Citizenship and Immigration Services, and the Secret Service.

So, you know, our mission statement is, you know, to, with honor and integrity we will safeguard the American people, our homeland, and our values. So the technologies we're looking for can help all of our Homeland Security professionals and to help you get a better understand of how it looks like for one of our agencies and give you some perspective of the day in the life of a DHS professional, I'd like to introduce you to our keynote speaker. Next slide please. So, Chris Pietrzak is the director for the Customs and Border Protection Innovation Team.

I worked with Chris for several years and he has a wealth of knowledge, having worked in the field and also worked alongside innovators like you. So happy to have him here today, to be your keynote speaker. Over to you, Chris. Chris Pietrzak: Thank you, Melissa, and I certainly appreciate the opportunity to talk about this topic that is very, very near and dear to my heart. So just, not to bore everybody with my background, but just very briefly, so, you know, I'm a Border Patrol agent and I have been since the days that preexisted CBP. So about 23 years of this and along the way, I have seen the toll that this profession and law enforcement, you know, writ large and I share the same, I think, with my brothers and sisters, that this takes on a human.

I've lost colleagues, very close friends, to suicide, you know, and I've seen, you know, agents and officers and other operators kind of succumb to the fatigue of the job, both mental and physical, and I can't think of a better way to apply technology in a more meaningful way than to make our officers and agents and our operators safer and more effective. And I think that the startup community just has a key role to play here. Very much like Melissa, my team is almost exclusively working with startups and I'm consistently impressed with the--just the bleeding edge, cutting edge, not to get, you know, too buzz wordy, technology that's coming out of innovation hubs and just how applicable it is across our mission space and I think no more so than this particular topic. So, I'm gonna kind of give you a onceover the world of what CBP is. And I think some of the members and some of the depth and scope of our operations in, still, 23 years in, is still staggering to me. But the intent is to give you some understanding of kind of what our operators are dealing with on a day-to-day basis and some of the challenges that we face in the field.

Slide please. And one more. Excellent. So, CBP's--the scope of our mission is bonkers, it's insane.

It's very, very vast. So, we're responsible for all border security in between ports of entry. So if you're a regular traveler and you're, you know, doing nothing nefarious and you show up at a land border, you know, that's one component of the mission and then in between the ports of entry is another component. And that's something on the order of 2000 miles on the southwest border, about 6000 miles on the northern border, and then, you know, coastal around Florida, Puerto Rico, California, et cetera. So the border security mission itself in between ports of entry is huge, not to--and that's not in any way diminishes, like, what we do at ports of entry which we'll get into some of the numbers, but, effectively facilitating all legal trade and travel through ports of entry.

And you can imagine, and I think you see it now, with what's going on with supply chain, how absolutely critical, you know, facilitation of lawful trade and travel is to America as an economy, as a country. And then, you know, oh, by the way, we're responsible for all international trade and are the second largest revenue generator in the government after the IRS. So, you know, a very complex mission, a very, you know, in many cases dangerous mission, and certainly, you know, from a national security perspective, and economic security perspective, just vital to the United States. Slide please. And really, there are three uniformed services within CBP, so if you think parent-child, CBP is the parent, and the children in terms of uniformed services are United States Border Patrol agents, that's me or was me before I now sit in an office, but that--those are the folks responsible for all land border between ports of entry, our office of field operations is responsible for all activities at ports of entry and that's, you know, cargo, seaport, airport, land border. You name it, they've got that.

And our air and marine operations are responsible for patrolling the seas and the skies, you know, in America and beyond, in a lot of cases providing really, really critical mission. Often responding to disasters and other such activities in coordination with other DHS components. And in fact, it's the largest civilian air force on the planet at this point. So, just some sense of kind of how these uniformed components interact. Slide please.

So, these numbers may look large as I start to talk about them. But they're kind of maybe 50% or 60% of what they would be if we were not in a global pandemic. So, you know, this is based on fiscal year 2020 data, which means that, you know, this is largely representative in terms of volume of kind of the pandemic life that we're in, so 650,000 passengers and pedestrians processed on a typical day. That's down from a bit over a million in FY 19 so imagine coming out of this pandemic, and we will, you know, you could almost double what we've been seeing. So that's inclusive of about 170,000 incoming air passengers daily, 36,000 crew and passengers by ship boat daily, and, you know, 450-or so, thousand incoming land travelers.

So that, again, that's at ports of entry and that's about half of what we'd normally see in the non-pandemic world, so I'm not gonna go through every one of these numbers. You can read them yourselves and you're gonna have access to these slides. My intent is to kind of pick up highlights, but I will say this bottom bullet is really, really crucial, and that's $260 billion of duties, taxes, and other fees collected. So, that's a lot of money and it's, you know, incredibly vital to the United States that we can facilitate this travel and this trade, and particularly the trade, in a very efficient manner, and collect duties again. So, after the IRS, that's--CBP is the largest revenue generator in the United States Government. Next slide please.

So this gives probably a bit more insight into, you know, kind of the operational perspective so, you know, products is by the numbers. This is kind of what we do on a daily basis. I already talked about the duties collected.

So, on average, we apprehend about 1100 people in between ports of entry on a daily basis. About 40--39, 40 arrests of wanted criminals at ports of entry and, you know, the refusal of 600-plus refusals--I'm sorry, of inadmissible persons at ports of entry. So, you know, what you have to contextualize here is the volume that's coming at us and then, particularly at ports of entry, and our ability to kind of work that friction between facilitating lawful trade and travel as quickly as we possibly can and our law enforcement mission that we need to conduct there at the same time.

And you can imagine that that friction, you know, is one of the drivers of, you know, stress in the workforce. We also have an agricultural mission that I didn't talk to on the previous slide, but CBP is responsible at the ports of entry for identifying pests and other prohibited foods and fruits and meats and animal byproducts that can threaten our food supply. So, on average we discover 250 pests a day and then we seize just a lot of narcotics. So, about 3600 pounds a day as well as, you know, almost $400,000 of illicit currency and then, you know, we discover $3.6 million worth of intellectual property rights violations on a daily basis. I'm gonna not advance to the next slide and just talk a little bit more, I think, about some of the stressors that impacts, you know, us as law enforcement agents, whether it's at, between, or above a port of entry.

You see this picture here on the right of, you know, border patrol agents on horseback. They're fortunate to be riding horseback. In many cases, we have to walk exceedingly long distances over exceedingly difficult terrain with little access to any type of normal infrastructure in order to do our job. So, from a physical perspective, just the wear and tear on joints, knees, other things, you know, we're out there kind of pounding the ground, much like, you know, I guess a decent parallel's like an infantryman that's, you know, deployed on foot.

And they're doing this, you know, at 3 o'clock in the morning with no light and no moon because that's what the job requires and then, oh, by the way, several months later they're rotating from a midnight shift to a day shift. The same thing is happening at a port of entry, right? So, you know, I'm not a doctor but I know having rotated shifts for many, many, many years in my life that my sleep patterns were dynamically crushed on a--every time I rotated and it took me a period of time, a substantial period of time in some cases to kind of return to some type of normalcy and rhythm with respect to sleep. So there's kind of this aspect of job friction, right? These outside factors that play on our workforce with respect to, you know, just stressors, whether they be political or the friction between moving things and discovering bad things at ports of entry, to the physical stressors of either being on your feet all day or patrolling the border in, you know, very, very difficult terrain and very harsh weather conditions, you know, to just the nature of law enforcement which is a lot of rotational shifts and things of that nature that impact sleep. Next slide please. So, this is kind of a distribution of our workforce so, you know, we're talking about a relatively large number of people that are subjected to the stress and I didn't mention it before but we are the largest--CBP is the largest federal law enforcement agency in America, consisting of almost 26,000 CBP officers. Those are the folks that work at ports of entry.

We have, you know, agricultural specialists that also work at ports of entry, almost 20,000 border patrol agents that work between. We have about 330, you know, marine interdiction agents and those are the folks that man our boats, and I would stop there for a second and just say that those folks get pounded physically. When they're out on the water, the physical stressors of the beating that you take on the water, and Garth, one of my colleagues, is gonna get into that in more detail later. It's pretty tremendous. We have about 338 aviation enforcement agents and a lot of--1000 trade personnel. Slide please.

You know, the other interesting thing about CBP and I really enjoy giving these talks because it provides me a perspective that I sometime lose in the day-to-day but, you know, we work in more than 106 countries so we have a global footprint with, you know, almost 700 CBP employees working internationally in a number of different functions and when we say ports of entry, there's a lot of 'em, right? There's 328 ports of entry within 20 field offices distributed across the entirety of the US, 131 Border Patrol stations, 36 permanent checkpoints, and, you know, 74 Air and Marine Operations where we're launching, you know, either aircraft or boats or whatever. So the geographic footprint, right, is large which means that environmentally, right, we're subjected to the, you know, winters at our northern border all the way to, you know, the most extreme heat that you can find in the continental United States in places like, you know, Yuma, Arizona. If you find, you know, rugged terrible terrain as well as extreme, you know, climate conditions, CBP is in it. Slide please. And really, this is how we view this wellness continuum, right? So as somebody that kind of lives this life, you know, I personally and I wanna see all my 65,000 colleagues be as far to the left-hand side of this spectrum as we possibly can, where, you know, the workforce is excelling. And I think this is really, you know, germane to the topics that we've identified that we're gonna discuss in greater detail today and that's all the challenge for all of us.

Everybody on this call, everybody participating in this, our collective goal, right, between industry and government, is to do everything we possibly can to keep every human being in this workforce across DHS as far to the left-hand side of this spectrum as we possibly can. So, you know, I was kind of doing some self-assessment in preparation for this and, you know, me personally, I find myself mostly in the surviving category. I'm like, "Man, I would love to be able kind of shift one to the left." But, you know, we obviously wanna keep people as far out of crisis as we possibly can and the consequences, you know, are--can be really, really severe if we're not paying attention and we let that slip, right? So everything from depression to diminished performance to, you know, an unfortunate number of suicides that are endemic to CBP and law enforcement writ large, you know, family conflicts, concerns, you know, just general burnout. And then, you know, monetary expenditures on physical and psychological, you know, treatments.

And, you know, add to all this, you know, the fact that, oh, by the way, there's a global pandemic, right, that has really impacted our operations and how we live as human beings, but the flip side of the COVID piece, in my humble opinion, is that there has been a ton of both money and development in a lot of the technologies and topics that we're going to be, you know, that we've kind of previewed and we'll get into more detail today, that I think, you know, now is the time, not tomorrow, not a year from now, but now is the time to take advantage of those capabilities that industry has developed specifically as a result of this pandemic, adapt them as necessary and avail them to our workforce. So with that, I certainly appreciate the opportunity to talk to everyone. As you might tell, this is a subject and a profession that, you know, myself and my colleagues are gonna be talking about are very, very passionate about and I'm thrilled to death and just specifically wanna thank Melissa and her team for helping us launch this topic and I am very, very excited to see, you know, the responses that come in to this topic, to be able to work together to, you know, make safe--people safer, more effective, and more well-balanced human beings. So, with that, I'm gonna turn it over to Garth and he's gonna talk to you a little bit more about his side of things. Thank you. Garth Spendiff: Thank you, Chris, for that fantastic overview of Customs and Border Protection.

Good morning, good afternoon, and good evening to our vendors calling in from around the US and internationally. I wanna welcome you to the SVIP Industry and Vendor Day. My name is Garth Spendiff. I serve as a senior exercise physiologist with US Customs and Border Protection's Occupational Safety and Health Division and as a team member of this important DHS SVIP project. Over the next ten minutes or so, I will be providing a brief overview of "Human Performance and Resiliency."

The term "Human Performance Optimization," HPO, emerged across the Department of Defense around 2006 when the importance of human performance for military success on the battlefield was acknowledged and funds were appropriated to develop teams made up of health and performance scientists and coaches. These human performance initiatives mimic existing human performance programs found at Division I collegiate athletics, professional sports teams, and Olympic training models. Currently, Total Force Fitness, TFF, and the Preservation of Force and Family, POTFF, are the frameworks for enhancing and sustaining the health, wellbeing, and performance among US Armed Forces, Special Operations Forces, and their families. These programs are key to DoD's mission success. Given CBP's 60,000-plus employees, with approximately 46,000 of those being sworn federal agents, and its critical Homeland Security mission, building and initiating Human Performance Optimization and wellness-based programs within our agency is warranted and ongoing.

The Customs and Border Protection, Occupational Safety and Health Division, has recently initiated a Health and Human Performance Branch, focused on developing new human performance support services and initiatives. The statement that "humans are more important than hardware" made by General Richard Clarke, former commander of USSOCOM, speaks volumes to the critical importance of taking care of our organization's most valuable resource: our people. Through investing in initiatives that teach and support optimal physical activity, sleep and recovery, and personal nutrition, long-term workforce health and fitness is possible.

The common core tenets of human performance programs include performance and readiness focused, proactive and holistic approach, multi-domain cross-functional teams, evidence-based, centralized oversight and decentralized execution, and embedded and specialized professions. These specialized professions typically include teams made up of exercise scientists, strength and conditioning coaches, physical therapists, athletic trainers, psychologists, registered dieticians, and data analysts. Together, these core tenets focus human performance services with a simple aim best said by Colonel Francis O'Connor, medical director of the Consortium of Health and Military Performance, "To make as good as possible." Human performance optimization is defined within the Occupational Safety and Health Division as: "The process of applying knowledge, skills, and emerging technologies to improve and preserve the capabilities of law enforcement members, training cadre, and support staff to execute their essential job tasks safely and effectively." Human performance professionals recognize that a person's performance level and health status are a direct result of the combination of controllable and uncontrollable performance factors. These factors include an individual's genetic makeup; daily environment to include home, work, and training; sleep schedule and habits; personal nutrition; movement quantity and quality; physical and mental stress levels; personal attitude; and daily behaviors.

CBP human performance focus areas include injury prevention analysis and mitigation, physical fitness and performance optimization, performance assessment and evaluation, training and operational risk management, cardiovascular risk reduction, nutrition and dietary supplements, environmental safety, sleep and recovery, and mind tactics. A few example technologies recently used within CBP's human performance workspace include the Train Heroic Fitness app, Kestrel 5400 heat stress meter, In-body body composition assessment scale, Atlas biometric wearable, and Vicon's inertial sensors. There are many challenges to human performance optimization within CBP.

As you can clearly see in this slide, CBP is a high-risk organization. The bar graph shows the 2019 injury rates of CBP compared to other law enforcement and DoD organizations. CBP as a whole and the US Border Patrol in particular, has the highest injury rates across the entire federal workforce. In 2020, CBP experienced 5793 compensable injuries which are injuries that require medical assistance beyond first aid. Of those injuries, 2451 were lost time injuries which place a huge burden on CBP's frontline resources. The estimated cost associated with these injuries over the last fiscal year was approximately $114 million.

Challenges to optimal human performance include law enforcement culture, lack of fitness standards or incentives, 24/7 operations, arduous work, fatigue and burnout related to shift work, extreme environmental conditions, rugged terrain, occupational load carriage that ranges from 25 to 35 pounds, high stress occupation, and a long 20-year career path. Collectively, these factors and challenges place a heavy toll on the physical and mental wellbeing of our workforce. Recognizing these challenges, CBP strives to provide services and programs to address these issues.

Resilience as defined by the defense center of excellence is: "The ability to withstand, recover, and grow in the face of stressors and changing demands." Put another way, resiliency exists in people who develop psychological, behavioral, and physiological capabilities that allows them to remain calm during crises or chaos and to move on from the incident without long-term negative consequences. There are many quotes and stories that highlight the importance of resiliency. This one that speaks to rolling with the punches that life throws at us has always stuck with me: "Trees that don't bend with the wind, won't last the storm." Currently, the CBP Employee Assistance Program, EAP, serves to support employee wellness and resiliency through a centralized approach involving internal and external health care providers. EAP provides a wide range of wellness services across the physical, psychological, social, nutritional, financial, and spiritual domains.

Examples of these programs include health coaching on topics such as fitness and exercise, healthy eating, weight loss, stress management, and tobacco cessation. Additional services include AI and person-to-person counseling; critical incident response and suicide prevention services; adult care services; financial and legal consultant services; referral services to include child care, elder care, and academic services; and lastly, online resources and interactive webinars. I hope that I was able to effectively communicate an overview of the human performance and resiliency domains within CBP.

On behalf of the SVIP team, I am excited to see what technologies you, the vendors, will present to us so that we can leverage the best the industry has to offer and, through these collaborative efforts, we may move the ball forward in our human performance and resiliency space. We will now move on to problem framing for our three SVIP focus areas: AI-enabled mobile apps, sleep recovery/enhancement, and biometric wearables. Thank you. Jeremy Ocheltree: All right, so, good morning to all those folks out there that are on the West Coast.

If you're here on the East Coast with me, good afternoon, and if you're--if it's evening where you're at, hopefully it's not too late. But my name's Jeremy Ocheltree. I'm the deputy director for the CBP Innovation team and I, along with my colleagues, would like to thank you all for being here.

As has been stated before, this topic really, you know, it's of supreme importance to us. I personally lost someone that I knew in CBP to suicide, you know, just within the last month or two. So this, you know, throughout the pandemic, it's been a constant reminder that, you know, we need to--we need to look after our folks. We have to look out for our folks. So, thank you. Thank you very much and thanks to Melissa again for wanting to collaborate and do this topic with us.

So I've got a quick five minutes to kind of frame out the first technical topic area and, Garth, thank you. Supreme job of kind of framing out the human performance and resiliency space at large. So now we'll kind of take a look at the three specific areas that we called out in the solicitation and talk a little bit more about them and then do the Q&A, as Melissa mentioned before. So, first and foremost, we'll kind of speak to this slide and I'm gonna preface everything that I'm about to say with the fact that I don't wanna be overly prescriptive here because one of the great things about engaging with communities like this is, you know, well, it's you folks are innovative, right? And so it's not always that way in government so it's refreshing for us, for me personally, when we get to engage with the community like this.

But I don't wanna give--I don't wanna give too many left or right parameters here for fear of limiting something truly amazing or [inaudible] of all of it that might come in, but having said that, I think there are some general themes or vision, you know, in state that we could put out here to the community to help you kind of frame out your proposal. So, you know, first and foremost, with the lens of that wellness continuum in the back of your mind, this is the way we're looking at this AI-enabled, you know, application or software, right? There is a--if you look at the left-hand side of this slide here, there is a litany of different types of things, sensors, you know, qualitative, quantitative data that can collect information: activity trackers, those things that are ubiquitous in the market these days: smart watches, smartphones. Are they smart things that you can wear? Is it potentially a video capture that's analyzing range of motion? Is it a capture of somebody's voice and they can maybe sense things? And the sky's the limit here and, honestly, this is why, again, we wanna cast a wide net out to industry.

What types of things are new and innovative in addition to things that are established and backed by science that can be collected and analyzed and that kind of speaks more to the other side, that once we have this information, what types of tools, you know, what types of AI, ML applications might be leveraged against that data to enrich it and then ultimately inform our workforce and at least as a starting proposition we're focusing this on, you know, informing an individual versus informing, you know, a partner or a boss that there are valid use cases for those things and we would like to explore that. There are different hurdles, of course, associated with that so the focus, at least initially, is, "Hey, how can I inform, you know, Jeremy and, you know, improve his decision-making process as it relates to his own wellness?" So, again, like, some vision-type statements, right? So as we were framing out the solicitation language for this, one thing that came out several times from our HR folks was, you know, the wicked problem here is really how can we track--how do we define--quantitatively and qualitatively define and track wellness over time? And if you think about that over the backdrop of that wellness continuum that we have, that's the type of picture that we would like to be able to provide to an individual, you know, based on your physical and your mental and emotional state, this is kind of where you might fall in terms of your overall wellness and, you know, and even, you know, perhaps provide some things you might be able to do. So one thing that often comes to mind for me are heat-related illnesses. I'm a border patrol agent of almost 20 years. I've been a victim of heat exhaustion and almost heatstroke, so you know, I picture in my mind if I'm out in the field and I have something that tells me, "Hey, your core body temperature has exceeded this threshold," or "Hey, you've stopped sweating," or some of these very obvious indicators that, "Hey, you need to stop and cool down," that would be very helpful for me. Now, we've lost agents and officers to heatstroke.

That's just--that's just one example. So, in addition to tracking wellness over time, again, looking at that wellness continuum, how can we keep people left, right? How do we keep people left of crisis? Physical, mental, emotional. It's a wicked problem and, again, like, this is why we're coming to industry.

What ideas do you have, you know, to help us--to help us solve this problem? So if you'll allow me to pivot just for a second, it's just as important I think for me to describe what we do not this--you know, what we do not envision this being. And I understand it's kind of a gray area or fine line but this is not, or we're not, envisioning a solution from industry that is a telemedicine app or a teletherapy app. This is not a replacement for a doctor. It's not a replacement for a therapist.

In the previous briefing, Garth had an entire slide about the employee assistance program and within DHS all of our component agencies have employee assistance program where 24/7 I can call and I can talk to somebody about whatever problem I may be experiencing in my personal or professional life and so I would like to--I would like to consider this or, you know, the outputs in real world application, you know, this is potentially a vehicle by which we could direct people to these existing support mechanisms like EAP. If it's an example like the one I gave, if I'm in the field and I feel like I'm gonna drop from heatstroke, and maybe I need to call EMS, whatever the case may be, but we wanna inform the individual, you know, to improve their decision-making processes and to existing vehicles. There were some questions that came in, some of the preliminary questions about, you know, diagnoses and things like that, like that's not the vision we have here. So as the applications come in, and I'm sure Melissa will talk about this, that we've got a team of experts, you know, in addition to Garth and the exercise physiologist, medical doctors, technology experts, et cetera, that we can kind of talk to in some of these issues. You know, and on various--there are a couple requirements as we go forward and one of them is privacy and, to be frank, you know, some of these things we may figure out as we go but I can tell you that in looking at some of these technologies before, some of the issues that we had was some folks in the industry not wanting to, for example, you know, deploy their capability behind the CBP or the DHS firewall, so for things like, you know, sending information from our workforce to a commercial cloud instance for example, is--that's not gonna fly.

So, you know, ways that we can do this anonymously and, you know, in addition to where it happens, you know, behind a firewall obviously being preferable but, you know, different other types of anonymizing data so to, again, you know, limit the data going to the individual. There are additional, without a doubt, legal and medical collaboration that will need to take place on the government side depending on what comes in from industry and we'll kind of cross some of those bridges as they come but, again, I don't wanna be overly prescriptive at this point. So I'm gonna stop for a second.

I know we're gonna have a Q&A portion. I'm hoping that I addressed some of that stuff now, but I'm probably over time, so I'm gonna stop here, go to the next speaker, and I look forward to having a robust Q&A with the group. Thank you so much. Garth: Thank you, Jeremy. I want to just take a second to let everybody know how much I appreciate their attendance today.

This is an important topic area that I have a tremendous amount of interest in. I've been working with CBP going on about 16 years. Prior to that, I worked with DoD and then in the academic domain for a number of years.

And I think in many ways we're still in our sort of infancy in terms of developing out a human performance and resiliency program that's--serves our population in a way that's deserving and so the idea of tapping into the latest and greatest technology to help improve our efficiencies is something I'm super-excited about. I hope that everybody has had their afternoon cup of coffee or their morning cup of coffee. We're gonna talk about sleep recovery/enhancement and I hope that everybody stays awake for my five- to six-minute piece here. We can go on to the first slide please.

Right, let's see, I'm getting a little lag here. Stand by. Okay, there we go. All right, so, there's clear scientific evidence that sleep is essential for a healthy lifestyle.

According to a joint consensus statement, the American Academy of Sleep Medicine and Sleep Research Society, adults typically need seven or more hours of quality sleep each night for optimal health and recovery. Insufficient sleep which we also call short sleep is defined as less than seven hours of day--of sleep daily. And according to the CDC, more than a third of US adults report insufficient sleep.

Organizations like CBP that have 24/7 operations and other military and law enforcement groups report even higher levels of inadequate sleep than the general public. We know that as chronic diseases are becoming more and more apparent in general--in our general population, and we have done a tremendous amount of research to the causal factors of those chronic diseases, we see that sleep becomes something that's one of those things that is a controllable factor for chronic diseases. Not getting enough sleep is associated with increased risk for a number of chronic diseases in the United States to include Type 2 diabetes, cardiovascular disease, stroke, obesity, and depression. We also know that not getting enough sleep also contributes to motor vehicle crashes which is a major concern within our organization, also drowsy work conditions leads to problems with working with machinery and machinery-related injuries, and then, of course, all of these things cause substantial injury and disability each year.

Next slide please. Daily sufficient sleep has been identified by the CDC as one of the five key health behaviors to prevent chronic disease. Other behaviors on this list include not smoking, regular physical activity, moderate/no alcohol consumption, and maintaining a healthy body weight. Causes of insufficient sleep include lifestyle, to include bed--inconsistent bedtimes, also using technology or watching TV late at night, and occupational factors which we deal with in pretty much all three of our law enforcement arms which is shift work and long work hours.

And then in addition to that, individual issues like medical conditions, medications, and sleep disorders like sleep apnea affect how long and how well you sleep. Next slide please. Okay, and if we look at sleep as it relates to CBP, we have done some research in this area and I know that was one of the vendor questions that came up.

In 2009 we did a comprehensive study along the southwest border on our border patrol agents, and one of the things that we did wanna look at was sleep quality and fatigue. And so this is some of the data that came out of that study: 76% of agents indicated that physical and/or mental fatigue affects their daily ability to perform their job safely, either occasionally or frequently. We saw that approximately 70% of agents reported monthly shift rotation which is actually the worst type of shift rotation. Obviously, the longer the shift rotation, for instance if you shift every three months or every six months, those are much better than monthly. Ninety percent of our agents stated that their shift work rotation pattern had moderate or severe impact on their sleep patterns.

Fifty-one percent of agents stated that their shift rotation policy had substantial negative impact on fatigue and stress. We saw a third of our agents getting less than 6 hours of sleep per night and only 1% of our respondents were getting 8 hours of sleep or more a night. It's no wonder that 62% of our agents indicated using products containing caffeine with the intent of boosting energy or alertness. In a separate study in 2017, our Occupational Safety and Health Division worked with Circadian Workforce Solutions to look at CBP time and attendance data to evaluate fatigue.

What we showed in that research is that using a 100-point scale, Circadian Workforce Solutions showed that the US Border Patrol had the highest average fatigue risk among our law enforcement operation groups, followed by our Air and Marine Operations at 28, and then the Office of Field Operations at 17--about 17 1/2. And by the way, those actually correspond exactly with the level of injury rates across our organization where the Border Patrol is the highest, followed by AMO and then OFO. Individual values ranged from 10 to higher than 80, suggesting that there are subsets of the population that have working schedules that are much more high risk and so obviously, a deeper dive into that would be something we would be interested in looking at. Next slide please. In a recent study in 2019, we evaluated Marine Interdiction Agents, MIAs, and part of that evaluation was to do a survey instrument where we surveyed 70% of the workforce population and these were some of the--this is some of the feedback we got back from MIAs related to sleep and fatigue.

So, 64% of MIAs get less than 7 hours of sleep per night, with 78% reporting that they need at least 7 hours to feel rested. Seventy percent of Marine Interdiction Agents believe physical or mental fatigue affects their ability or their coworkers' ability to perform the job safely, and then approximately seventy percent of these folks report using caffeine and energy drinks in order to boost energy levels and alertness. There have been many studies in military organizations.

One of the largest studies that was done by Luxton et al in 2011, looked at 2,717 army soldiers. You can see the bar graphs in the center of the slide. In that particular study, they showed 43% of the subjects reported getting less--5 hours or less of sleep per night and only 28% actually reaching the, you know, quality sleep level of 7 or more hours. This study was--a similar study in 2013 was conducted by Mysliwiec and almost identical datasets were recorded. These are obviously, if you showcase that data versus the bar graphs to the right which Krueger and Friedman in 2019 evaluated 10,441 civilians, you can see that, you know, we have challenges with sleep in the civilian population but it's nowhere near the challenges you have in military populations.

And my guess is that through our survey instruments that we've used, that if we actually evaluated sleep quality and quantity, using some sort of instrumentation or technology that we would find our results much more similar to what the military organizations are experiencing and far exceed the challenges that we see in civilian populations. The infographic to the right of the bar graph infographic shows, you know, the challenges that the general public deals with, with regards to drowsy driving. Fatal car crashes within CBP is probably in the top three causes of morbidity in CBP employees, and so it's something that we're always concerned about. Most of our employees are operational employees, drive long distances in their daily occupational duties but also they live long distances from where they actually work. So, sleep is something that we're very interested in studying.

We know that there's a tremendous amount of work that's been done over the last ten years with regard to sleep evaluation. The accuracy, specificity, and sensitivity of the wearables now is getting to the point where, you know, there's some consensus on products that actually work, that you don't need to wear these big heavy garments and, you know, in uncomfortable sleep studies. A lot of the data can be collected in the comfort of your own home. And so we're very excited to see what the latest and greatest technologies are in this workspace. I'd like to now turn it over to one of my colleagues, Greg Hovey, who's gonna be speaking about biometrical--biometric wearables.

Thank you for your time. Greg Hovey: Thank you, Garth. My name's Greg Hovey, exercise physiologist, working on Garth's team.

Prior to joining the agency, I worked for the Department of Defense and I had the good fortune of working with three different special operations communities. So, as you can imagine, within each of those groups, we used quite a few pieces of technology to help support our efforts and so I'll be speaking just briefly from a practitioner's standpoint on my experience with those. Next slide please.

So, this first slide kind of represents what we were looking for in terms of our wants and needs in terms of using technology with our high performers. The first was to look at individual workloads. As previously mentioned, these guys wear a ton of different hats and, as a coach prescribing programs, I wanted to have some indication of how much workload's being placed on the individual. You can think of it another way.

If all of us went out and ran, say, 5 miles, for some that would be a nice warm-up to their normal workout. For others, it might represent a max effort and we want to be able to know that type of information. The second piece we wanted to look at is when someone comes in, what is their readiness to actually do the training session on that particular day. As we mentioned before, you know, we wanted to be able to adjust and modify programming appropriately so we were actually producing adaptation but not causing potentially over-training syndromes. The next piece was to look at the individual's recovery capability.

So, similar to points one and two, we wanted to see, okay, we're prescribing you these workouts but are you actually recovering from them and getting the adaptation we're seeking as part of this training. And then the last piece was to use the technology in conjunction with education to create potential behavioral changes that we were seeking. Next slide please. So those were our wants and next would be the major challenges we uncovered. First and foremost was trying to find technology that could provide valid reliable data and that really was a big challenge for us. When we look at the workloads, for example, we used technology to look at aerobic capacity VO2 max and then prescribing workouts to help facilitate that.

Well, after a couple of weeks of using it, we came to find out that the normative data that we were using was based on Finnish cross-country athletes whose VO2s were anywhere between 20 to 25 milliliters higher than any VOs I was working with, so, of course, they were not able to get into those workloads that were being prescribed. The second was looking at readiness, and this is where, with a lot of people I've worked with, they start to lose their faith and confidence in the technologies because the technologies would report that they're in a low readiness to train; however, oftentimes, they would have a personal best or a personal record in that particular training session and so, when that would happen, the people I worked with basically felt that it was a no-go on the technology at that point. And then the last was similar to a sleep. We were using some sleep technology and come to find out they were just using a gyroscope which looked at body position and body movement to determine how many hours of sleep you were getting. Well, you know, if the guy's watching "Monday Night Football" on the couch, that was tracking it as sleep, even though he was not getting the sleep as prescribed.

And the next point would be then also validating and having reliable data technologies in this emerging field. It seemed like every few months something new was coming out and we really didn't have the time to properly vet the technology prior to implementing it. And I think that kind of played into why we were not getting good valid and reliable data. The next piece was while this technology was great in identifying problems, it provided no types of solution so we needed to have some type of solution for any type of problem we identified and then that solution needed to be sustainable. And that presents challenges when you're dealing with a dynamic workforce and/or a cadre who may have, you know, training wickets that they have to accomplish as part of their selection or academy or boot camp or whatever it might be.

And then the last challenge we faced was budgeting and funding. Typically, you may have a grant that you're working off of. We used several grants in the time I was with the DoD and then we also had earmarked money that we used specifically for different technologies and beta testing those and trying to find long-term solutions for--or high performers. Next slide please.

So at the end of the day from practitioner's standpoint to help you guys is, number one, the technology has to be easy to use. As previously mentioned, these guys wear a ton of different hats. They have a already full plate and, you know, if the technology has more than three steps it may not get used. It has to be easy to implement as well.

Like Garth had mentioned, sometimes these sleep pieces have all these leads and other devices you have to wear that actually make your sleep almost more problematic because you have to deal with these other things that it may not actually be implementable. The next is it has to be able to interface with other types of systems. We use several different types of systems to maintain kind of a database for all of our metrics that we were collecting and, oftentimes, these different technologies were not able to crosstalk, or not able to share the data amongst the different technology pieces. Like I mentioned before, we have to have some type of sustainable solution. It's one thing to identify a problem and it's another thing to actually have a workable implementable solution that can be used long-term. And that's really what I'm looking for, as a practitioner, is a long-term solution that can be sustained.

And an important question, I think, to ask too is does it actually affect the behavioral change you're seeking? Oftentimes, it would temporarily and then it would lose some momentum we're seeing. And that's where the last point, I think as practitioners and people implementing this technology, we have to come up with a way and a plan for what are we gonna do once the novelty of the item wears off? 'Cause I've seen that numerous times where, yeah, it's cool when it first comes out, we use it for a couple of weeks or months, but after a while the novelty does wear off and it's just sitting in the corner collecting dust. So I think that's something we need to consider as well.

Next slide please. Yeah, so, thank you for your time. I appreciate you guys being here and now we open it up to the Q&A. Melissa: Great, thanks, Greg, for that talk.

Really appreciate you framing out the wearables piece. If I can ask Garth and Jeremy to rejoin us on camera, and love to go through a lot of the questions that we got today during all the presentations. So, I'll kick it off with some of the questions that--it's a kind of a blend of the questions but it does address some of the--a number of questions that did come in is: Will it--will this technology, will these solutions, be a mandatory requirement for employees to wear and participate? And kind of to that same--in that same regard, you know, what type of information will be shared with supervisors versus the users having kind of that--maintaining responsibility for it? One of you guys wanna take that? Garth? Garth: Yeah, so I'll jump in just from my past experience with implementing technology into the workspace. Typically, what would happen is we would start with a small pilot group to see how the technology interacts with the--a small section of the workforce, and then we would work through all of the other pieces of that. A mandatory anything in our organization is very difficult.

We have a highly unionized workspace. If the technology is something that's extremely useful, very beneficial to the workforce, it could be obviously incentivized and things like that to get people to use it, but in most cases, you know, technology would be something that would be a personal choice to use or not to use. Melissa: That's great. Yeah, and it kind of builds off of another commented question is, you know, in terms of building for us in the technology and getting buy-in from the users, are there concerns about, you know, what you guys are doing that may fail to reach users who are dealing with, you know, mental health issues and considering suicide, for example? You know, what are some things that you guys have been thinking about as far as addressing the buy-in and the trust in the technology and how that information will be used? Jeremy: I mean, I can--I'll take that one.

I think it's kind of a follow-on to the previous question and Garth's answer, right? Like, I think we have to--continuing along with-- pulling on the same string, like, hey, conduct a small pilot, right? Like, that's the smart way to do this. Get a small group of willing participants, conduct a pilot, and they, you know, if it's successful I think Garth used the word "incentivize," but you gotta change hearts and minds with good stories and wins, right? So I think that's the answer. Like, you do a pilot and if it works you can start to evangelize and spread the word.

That's the bottom line. And I think in order to do that, you know, to put--stomp on a few other--a few of the points, right, so the stuff that comes in being backed by science, things that are gonna legitimize the applications and the stuff that we're looking at, I think that goes a long way as well. 'Cause, frankly, like, and speaking for myself, there's some skepticism, right? There was even some skepticism in putting this topic out. I tend to be a little skeptic myself.

I think that's--I think that's a good thing. But, yeah, we gotta win some hearts and minds. We've gotta have a successful pilot and we'll go from there. Melissa: Great, thanks, Jeremy. We've got a question about, kind of, the readiness of the technology. Are you looking for solutions that are immediately ready to be implemented or, you know, as a product or is--are you looking for solutions that require some development, you know, what's the--what's sort of the maturity level of what you're looking for, and I can also talk about a little bit of how the program functions too.

But in terms of what CBP's looking for in terms of immediate readiness, where you guys--where do you guys land there? Melissa: Jeremy, you wanna take that? Jeremy: Yeah, I'll take it. So, I think it's all the above, right? If there's something out there that we could bring in and it immediately helps, it helps to address this problem in a meaningful way, let's do it. If there's something that needs some development, you know, if you guys are--you happen to be on a really interesting or compelling path with your company and there's something that might be ready a year from now, two years from now, well, I--you know, why wouldn't we consider that as well? So I think the answer is both. Like, we wanna consider anything that seems viable and might help this problem. Melissa: Okay, great.

There's a question about sort of the--on the IT side of things that you mentioned before about existing firewall. Are you looking for a custom OS that integrates with the existing firewall protective platform? Or can you comment a little bit more on that piece of things? Jeremy: I would say more so than anything else and I think Greg hit on it, we want--we want open-data standards, right? We don't want stove types, or stovepipes, excuse me, of data that can't be integrated in a meaningful way. You know, I think we answered a question about the cloud environment, yeah, with CBP; my presumption is DHS is probably the same way.

You know, we use AWS, we have Google cloud stuff, so, you know, industry standards I would say, so I wouldn't give any more specificity than that but as a general principle, like, we want--we want data that can be integrated and aggregated so it can be analyzed in a meaningful way, and I'll leave it at that. Melissa: Okay, so there's a question about sort of the data and the use of that data. Can the data received be cycled into another product that will address the injuries/long-term physical and mental effects of using current systems in an effort to find long-term solutions? Garth? Garth: Ha, ha, so, if that's possible, absolutely.

I mean, that would make a lot of sense if we can curtail the data that we're collecting into something that's meaningful with regards to injury prevention, I think that's--that would be great. The idea of having a system in place that takes, you know, individualized data and uses some sort of, you know, AI technology to aggregate and make sense of the information and to make suggestions or recommendations on preventative steps or, minimum, giving us a picture of what's happening. We already have systems in place that give us a general sense of how many injuries, where the injuries come from. We do lack a system that has narrative capability of immediately identifying patterns of injuries and, you know, highlighting, you know, all of that is still done, you know, by folks like me who look at tables and evaluate patterns and areas of where people are getting hurt and how. So I guess the answer is, you know, absolutely we would want, you know, people to push forward technologies that look to help us with injury prevention and to do it as efficiently as possible. Melissa: And there's a--there was a kind of a related question is what's the--you know, is there any work being done right now on the accuracy and precision of those body-worn sensors, especially if there are multiple sensors being worn? Anything you can offer there? Garth: And what body-worn sensors are we talking about? Melissa: There wasn't any specific about that, just more, sort of, understanding, you know, about the accuracy of--and precision of the information being captured, I believe.

Garth: Well, we would obviously wanna select a technology that was accurate and was, you know, a valid technology to help us in whatever space we're looking at, so that would be, I guess, at a first-level evaluation, right? Very early on we would be evaluating, you know, those types of things and doing cross-comparisons with other technologies out there to make sure that we have a, you know, something that's accurate. As far as a wearable's concerned, we've had a couple of small pilot studies with wearables across a couple of different components over the years and, you know, I don't know how far we wanna get into the weeds with it but there are one product in particular lacked fidelity so it was--it's amazing concept but it wasn't quite played out, you know, it didn't really reach fruition and so, because of that, it caused a little bit of challenge with the user interface and so we ended up not, you know, selecting that particular technology. We've had other issues with companies not willing to put the effort in coming behind our security domains and so that becomes a major challenge as well.

And so that's, I think, Jeremy, you know, touched on that just a second ago is that is absolutely critical that if it's gonna take personal data, especially if it has any PII, there's got to be a, you know, level of effort to come inside CBP's, you know, firewall. Melissa: Great, thanks, Garth. This is an interesting question: Are the challenges in current staff health--or are the challenges in the current staff health situation mainly due to lack of knowledge--lack of enough knowledge or not doing the right thing, even with enough knowledge? Or perhaps, lack of devices to provide health info prior to injuries to provide the solutions to prevent those injuries? Jeremy: That's a tough one. Can I ask you to read that one more time, Melissa? Melissa: Sure, sure. So the, you know, it's kind of like, are the challenges associated with some of these health situations due to not having the knowledge of those health situations, lack of enough knowledge, or just not doing the right thing, even though you have that knowledge? And, you know, perhaps, you know, is it because we also don't have the tools, the devices, to provide us that information to prevent injury? Garth: It reminds me of that question that was asked pre--of about the heat stress question, you know, are people getting in trouble with the heat stress 'cause they don't know or can't you just apply policies that would prevent them from getting into trouble? So I--Jeremy, if you had an answer you were about to--I know you were about to speak, so I'll let you go ahead first.

Jeremy: So, yeah, that's a tough one to answer, I think, with specificity. You know, you'd have to examine each situation, one at a time. But I think that--I think there's merit in both education and, you know, being able to provide information to an individual. So, yeah, I think both things factor into the problem, right? Either maybe I'm not educated enough to understand what a heat-related illness manifests itself like, or I don't have the data to understand, like, where I'm at on this wellness continuum or that--or maybe it's specific to heat, you know, illness.

I don't know that I'm exceeding a temperature threshold where I stop sweating so if I--if we could make that a more discrete example I would say that both things factor into whether or not I end up in a crisis. Either I know about heat-related illness or I don't, or I, you know, I'm aware of the indicators or I don't. So, hopefully, that's a fair answer. Garth: Yeah, I agree with that.

I agree with that and I think it--if we're talking about technology, you know, technology, one of the purposes of technology is to, sort of, preemptively educate us or give us some sort of indication of what we're about to get into, and related to heat stress, specifically. So, an example of, like, using wet-bulb globe temperature technology to evaluate what the conditions are that you're about to go into. Now, if you're, you know, let's say you're going out in a early shift and it's, you know, 0630 or 0730 and you're just walking outside and making the call that, hey, you know, it feels like a nice day, you know? I'm gonna make sure, you know, I have, you know, my normal water supply but the prediction is that it was going to be, you know, a black flag condition but you didn't have that technology available to you. You may pre-plan and act very differently if that technology was available and that it was clear that that's what the day was going to bring, you know, in terms of heat stress. So I think there's planning, there's policy, and there's technology, and there's all of those pieces that fit together and I think technology is one part of those things that help better inform us. Melissa: Great, thanks.

I know that was a tricky question but I thought it was, you know, a worthwhile question to have you ponder. And there's a couple of questions related to data in terms of, you know, whether DHS would be providing companies the data to help train is my understanding, is some of that historical health data or, you know, weight, body, BMI, blood pressure-type stuff data in order to help with training. You know, I'm not sure if that's something, you know, DHS is expecting to provide, you know, from the get-go versus, you know, expecting companies to do some of the lifting and then, you know, later on when piloting occurs, that data would be made available. Any thoughts around, and comment on that? Jeremy: Yeah, it's a--that's an interesting question too and I just think that we would need to be very--"we" being the government. We need to be very deliberate and mindful about things like this. I think that there's a way to do it, we just have to do it the right way, you know, respecting that data, respecting that information, while also wanting to enable, you know, the development of something that we need.

So I don't think I have a perfect answer to this qu

2021-12-11 01:52

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