Linking engineering and medicine has led to better diagnostics, drugs and treatments. But it’s not always easy to collaborate successfully.
Europe is at the forefront of medical technology: 25,000 companies now employ 575,000 people and produce more patent applications (12,200 in 2016) than any other field – even computer technology and digital communication.
Innovation is the key to maintaining this position, yet austerity and strained budgets are forcing many countries to curb healthcare spending just as ageing populations and chronic diseases place ever greater pressure on services. As a result, providers not only need to see health benefits in new technology but also cost and efficiency savings.
The best way to meet new medtech needs is to have physicians and engineers work together. The pragmatism and technical savvy of engineers often complement the medical profession’s understanding of practical challenges in a clinical setting. “The critical mass of people and resources delivers reliable results that no partner could have delivered alone”, explains Pierre Meulien, executive director of the Innovative Medicines Initiative in Brussels. “Yet some partners are concerned about intellectual property and there are often large differences in the culture and way of working.” Forming a crack interdisciplinary team is, in short, no mean feat.
Have a little patience
MedoPad is a London-based company founded in 2011 with the goal of improving healthcare through technology. “Doctors and nurses had troubles accessing the information they needed on a daily basis”, recalls co-founder Rich Khatib. “The iPad had just been invented and we thought, what if we could provide these data through mobile devices 24/7 at the point of care?” Working closely with industry, hospital groups and IT teams, MedoPad went to work.
Six years later, many doctors now view medical records, lab results and images through MedoPad’s mobile solutions. Essentially, MedoPad links all relevant data in a hospital to deliver a patient’s records at the touch of an iPad, and then offers tools to use those data effectively. Recent successes include the Harley Street Clinic deploying Medopad’s remote patient monitoring solution for its paediatric cancer patients, and the Leg Ulcer Charity making MedoPad’s app available to 25,000 patients.
Obvious as this approach may seem, MedoPad’s journey has been fraught with difficulties. “It’s a very slow industry”, says Khatib, “so you have to have a lot of resilience and patience”. The biggest hurdle, according to Khatib, is gaining approvals from various stakeholders – from ethical to security to compliance.
Based on the outskirts of Paris, DBV Technologies was created in 2002 to tackle a specific problem that Pierre-Henri Benhamou and Christophe Dupont identified in their clinic. Both paediatric gastroenterologists, they noticed an increasing number of patients with serious gastrointestinal issues caused by food allergies for which there were no safe treatment options. With the help of engineer Bertrand Dupont, DBV Technologies developed an original epicutaneous patch that would allow patients to be desensitised through the skin.
Their Viaskin patch delivers biologically active compounds to the immune system through intact skin without allowing the antigen to pass into the bloodstream, where it could cause life-threatening allergic reactions. Developed for peanut, milk and egg allergies, Viaskin is in clinical development. “Viaskin Peanut, our lead product candidate, is currently in phase III clinical trials for peanut-allergic children ages 4-11, with results expected in the second half of 2017”, says COO David Schilansky.
He argues that collaboration across various departments, including medical, scientific and engineering teams, has been central to developing the Viaskin platform. “R&D employees account for roughly half our workforce”, he notes. “The ability to remain agile and to continue to learn while working together across teams is key to the company’s success.”
Siemens Healthineers, a healthcare business of German technology giant Siemens, focuses on diagnostic and therapeutic imaging, laboratory diagnostics and molecular medicine. Recently they designed a novel mobile computed tomography (CT) system that reduces cost, increases consistency and simplifies workflow. Florian Belohlavek, head of Product Marketing Management, explains that the mobile workflow, supported by wireless tablets, is a completely new way of operating the CT scanner.
Called the SOMATOM go. platform, the system features an operating concept that guides users through a standard examination in a few steps that tell personnel how to position a patient, set the scan parameters and prepare images for diagnosis. This ensures the steps are precisely reproducible, which is crucial for follow-up examinations.
“The SOMATOM go. platform was designed together with customers for our customers”, says Belohlavek. To create the new system, the company surveyed more than 500 radiologists, radiology assistants, CFOs, patients and referring physicians, all focused on features that would make the respondents’ daily work easier. Belohlavek’s advice for anyone thinking of developing medical technology? “Include as many customers as possible in your process.”
“Engineers are problem solvers”
A leading researcher describes the merits of interdisciplinary cooperation.
Cell and tissue engineering is one of many fields in which partnership between engineers and physicians can produce remarkable advances. Dirk Busch, director of the Institute of Medical Microbiology, Immunology and Hygiene at the Technical University of Munich (TUM) tells us how.
Technologist: How do medicine and engineering come together in your current work?
Dirk Busch: We are trying to isolate and subsequently genetically modify defined types of immune cells to convert them into powerful living drugs that can fight infections or cancer. For this purpose, we need to develop technologies and machines that can be transferred to clean rooms so that we can engineer these cells under appropriate conditions. We recently established such a facility called TUMCells to foster this process of clinical engineering.
T. What is the greatest challenge when managing a team developing medical technologies?
DB. Medical technologies not only have to work precisely, robustly and reliably. They also have to fulfil additional criteria specific to clinical applications in humans, such as sterility, certified machinery, biocompatible materials,
in vivo safety and toxicity.
T. What has been your greatest physician-engineer success?
DB. We have developed several new technologies, such as the so-called Streptamer technology, for clinical cell-processing and purification, from which a spin-off company called Stage Cell Therapeutics recently merged with the US company Juno Therapeutics in a $200-million deal. By trying to bring different disciplines together, especially the involvement of engineers, we advance the field of cell and tissue engineering.
T. Are there specific difficulties in Europe?
DB. Engineers are problem solvers who bring new technologies into a format that make them applicable as medical diagnostics or therapeutics. We certainly need more engineers trained in medical applications and more centres to educate bioengineers with a specific understanding of medical problems.
4 jobs that combine medicine and engineering
A fast-growing field, biomedical engineering develops such medical products as joint replacements, robotic surgical instruments and rehabilitation devices. Biomedical engineers also manage equipment and processes in hospitals. Europe’s 350,000 biomedical engineers are primarily in the UK, Germany and France.
Usually educated to the PhD level, medical scientists work in universities, pharmaceutical companies and hospitals, conducting experiments to increase understanding of human health and diseases. They also develop and improve drugs, treatments and other related products.
Clinical data scientist
Combining an aptitude for statistics and computer science with experience in healthcare, clinical data scientists manage the technologies used in clinical studies, while also being able to interpret data.
Medical VR designer
With cutting-edge knowledge of virtual-reality software and an understanding of deep medical concepts, medical VR designers explore the benefits that this technology can bring to a medical setting – from improving teaching by experiencing surgical operations remotely to speeding up recovery after a stroke.
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