Stanford Biodesign trainees have developed new medical devices and diagnostics that have been used to help care for more than 1.5 million patients so far.
August 1, 2018 - By Stacey McCutcheon
Medical technologies invented by fellows and students over the past 18 years at the Stanford Byers Center for Biodesign have been used in the care of more than 1.5 million patients, leaders of the center say.
The center teaches a process for solving problems in health care through technology innovation.
“The successful translation of these technologies into patient care reflects Stanford Biodesign’s focus on solving real-world problems, as well as the determination of our trainees to not only develop solutions but bring them to the market,” said Paul Yock, MD, the center’s founder and director. “Health care is an extremely challenging field for innovation because there are many different stakeholders — from doctors to patients to regulators to insurers — who have a say in whether a new technology is adopted.”
To help aspiring health care innovators succeed, Stanford Biodesign teaches a need-driven innovation process that involves interdisciplinary collaboration, project-based learning and hands-on mentoring from experts across Silicon Valley. In the yearlong Biodesign Innovation Fellowship, for example, the fellows spend a full six weeks in hospitals, clinics and other environments observing the delivery of care to identify unaddressed problems that could benefit from technology-based solutions. After determining which problems represent the most compelling opportunities, the teams use everything they learn over the course of the year to develop solutions.
The innovators who contributed to the 1.5 million-plus patient milestone have addressed a wide range of problems, from surgical infections to prostate disease to heart arrhythmia and essential tremor. But they all have one thing in common: a story about a patient encounter that inspired them to try and make things better. Following are a few of those stories.
Rush Bartlett: End-of-life planning
In their first week of clinical immersion, biomedical engineer Rush Bartlett, PhD, MBA, and the other members of his 2012-13 fellowship team — Stanford pulmonologist Ryan Van Wert, MD, and electrical engineer Frank Wang, PhD — sat down with an emergency physician at Stanford Hospital. They asked him to describe the worst part of his job. The physician replied almost immediately: “Giving CPR to a 90-year old woman, breaking her ribs and then finding out later that was not what she or her family wanted.”
After learning that this scenario repeated almost weekly, the team decided to investigate further. Explained Bartlett, “We learned that, while advance care directives are common, far too often this information isn’t readily available to the care team, especially in emergency situations. The advance care directive is filed away with an attorney or taped to the patient’s refrigerator. What was missing was a way for doctors to rapidly access the patient’s directive in a crisis if they are unable to personally communicate their wishes.”
The team solved this issue by directly linking advance care directives and other critical end-of-life information to electronic medical records, and by making it available to health care providers across the care continuum. Information about the team’s experience and project is available online.
Fletcher Wilson: Deep vein failure
A 2009-10 fellowship team that included mechanical engineer Fletcher Wilson was motivated to develop a better solution for treating deep vein valve failure after meeting a robust, physically active man debilitated by repeated venous leg ulcers that manifested as open wounds.
“They tried everything to help him,” said Wilson, who had a background in medical device development. “Unfortunately, the blood clot he’d experienced years ago had destroyed the vein valves throughout his thigh. On his most recent clinic visit, he was told that compression therapy was the best option available to control the swelling and pain. I caught him in the hall as his face turned red, unable to hold back tears. ‘Tight socks?’ he asked in frustration. ‘That’s the best they can prescribe for me?’ That’s when I committed myself to solving this problem.”
The technology Wilson and his team invented represents the first minimally invasive approach to deep vein valve failure. The solution allows physicians to create new vein valves for patients who are unable to efficiently pump blood from their legs back to their heart.
Bronwyn Harris: Childhood asthma
Bronwyn Harris, MD, a pediatric cardiologist, was a fellow in 2014-15. Her experience caring for children with asthma, both as a doctor and as a mother, inspired her to help caregivers manage this frustrating disease. “Pediatric asthma is a chronic disease with no good measures of control,” she said. “It’s hard to tell how a child is doing, and what might trigger a flare-up. The unpredictability of the condition leaves parents feeling as though asthma is controlling their lives.”
Harris’ team developed a system that uses environmental data and outputs from sleep sensors to detect changes in asthma control, identify potential triggers and provide insights to families and their physicians that enable more comprehensive management of the disease. The results so far have been promising.
As an example of what drives her to keep advancing the technology, Harris told the story of a 9-year-old boy she met during a clinical study: “He was having an asthma exacerbation roughly once a month. In the prior year, his flare-ups were so severe that he had been to the emergency room twice and was hospitalized once. But by the third month of using our service, he was symptom-free, and his mother felt more knowledgeable and empowered to manage his asthma.”
A need-driven approach
Yock, an interventional cardiologist and renowned medical device innovator, founded Stanford Biodesign in 2000 as part of both the School of Medicine and the School of Engineering. The center’s focus on deeply understanding the need first, rather than starting with an idea for a new technology, has become a model for health technology training programs around the world. Recognizing this contribution, the National Academy of Engineering awarded Yock the 2018 Bernard M. Gordon Prize for Innovation in Technology Education.
To date, 47 companies have been founded by the center’s trainees based on technologies they initiated during their training. Other alumni have gone on to drive innovation initiatives within larger medical-technology companies, launch innovation training programs at other universities, or pursue technology innovation within their clinical practice. Information about the center is available online.
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