Innovation today in medicine and health care is deeply rooted in the creative genius of engineers. The introduction — and subsequent improvement — of innovations related to electronic patient records, powerful electromedical equipment and devices and minimally invasive technologies represents the tip of the iceberg; it calls attention to the you-haven’t-seen- anything-yet aspect found in the innovation revolution that is underway in health care.
This revolution has commercialized technologies across the innovation spectrum. Examples in health care involve telemedicine and e-health services along with advances that are coupled with applied innovations related to self-care in the home, sophisticated new sensors that communicate with each other and new ways to provide effective (and affordable) health care for all persons — whether young or old, rich or poor, residing in industrialized cities or in villages inside developing countries.
Evidence of biomedical engineering is found everywhere in the innovation revolution underway in health care. Hospitals are full of connected devices; the instruments and machines in use have been designed and manufactured by engineers working in collaboration with doctors, nurses, biochemists, physicists, microbiologists and technicians. Additional examples range from the pumps that administer drugs to patients and instruments that monitor heart rates to scanners that produce detailed three-dimensional images of internal body parts. Biomedical engineering is also at the root of devices that monitor the heart, replacements for body parts damaged by disease or injury and systems that produce synthetic blood vessels.
The pace of innovation in health care continues to accelerate, yet tremendous challenges lie ahead. Next-generation prototypes found in both university labs and the drawing boards at industry-leading companies reflect the creative genius of biomedical engineers imaginatively developing problem-solving devices for today and tomorrow.
Biomedical engineering is challenged to apply diagnostic procedures and therapies to noninvasive or minimally invasive procedures. Doing so is a big deal and represents an enormous market opportunity: Less invasive techniques and devices will lead to more comfortable recoveries for patients as well as faster rehabilitation periods and shorter hospital stays — all of which lead to reduced healthcare costs and, hopefully, improved quality of health care along with increased effectiveness.
Fundamental disruptive changes to industries result when mature technologies are replaced by newer, innovative ones. For example, when digital cameras replaced traditional film photography or the disruption of paper-based newspapers by Internet news. The technology is often discovered 10-20 years before disruptive change occurs; during this “refinement” period, the technology is improved and often combined with other innovative technologies before marketplace disruption happens.
Biomedical innovation is no exception, as old medical devices continue to be replaced by innovative ones. As lifechanging ideas are commercialized at a rapid pace, new disruptive technologies are emerging — all of which transforms health care. New vaccines are undergoing tests today, which, if clinically successful, could cure Alzheimer’s disease, curb smoking and prevent malaria. The stakes are the highest in the pharmaceutical industry, where therapeutic vaccines and cell therapy are advancing rapidly using new technology platforms. These innovations are happening at a time when pharmaceutical companies are restructuring their business models to improve R&D efficiency while also questioning the efficacy of the process, investment and time spent bringing new drugs to market.
A look at the future of emergency care
The time is fast approaching when a 911 call to emergency services will bring a new kind of ambulance to the patient. The ambulance will be “wired” to the Internet of Things and contain equipment to assess a patient’s medical status more quickly and with greater accuracy. Using scanners and computer diagnoses, the EMTs will be able to properly and efficiently treat patients during transport and produce a smooth “hand off” upon arriving at the hospital.
Once at the hospital, advanced scanners will take clear, realistic pictures of patients’ bodies. These images will be supplemented by information provided from laboratory tests using automated equipment; treatments will be determined by computers and will follow evidencebased medical protocols. This allows for real-time, detailed cost-benefit analysis of proposed procedures, yet patients will certainly criticize — as is the case today — the inhumane treatment insurance companies are accused of when proposed treatments are denied based on cost considerations.
Alas, these advances result in fewer human “touches” between health care professionals and patients. Internal and external sensors are able to continuously measure patient responsiveness to treatment — even though the people who engage the sensors and care for patients will not be medically licensed. Instead, they will be highly skilled technicians adept at performing the specific procedures that accompany specialized diagnostic and therapeutic devices.
The commonplace smartphone will play a central role in delivering medical care; doctors, nurses, equipment technicians and other medical staff will have access to clinical data and health records via smartphones.
Local Innovator: Exactech
Innovation applied is occurring at a rapid and accelerating pace. Gainesville-based Exactech is a solid example of biomedical innovation applied. The publicly traded company was founded in 1985 and operates today, as it did at its founding, with the goal of improving the quality of life for individuals. Exactech achieves this by commercializing innovative ideas, producing high-quality products, educating the marketplace as well as its own employees and exercising a deep commitment to service.
One of Exactech’s core values is innovation, a key concept that is instrumental to the company’s shortand long-term success. In speaking with Ryan Loftus, engineering manager at the company, I liked his perspective on innovation. I asked Ryan how Exactech handles disruptive innovation; he said, “The best way to mitigate the risk of a disruptive technology is to be a part of it. Despite Exactech’s innovation success, we constantly invest in new ways to meet our goals and to fulfill our purpose. Being first is a big deal for Exactech, so whatever we do — and how we do it — reflects our drive to innovate and achieve operating excellence.”
Exactech’s global footprint means the company sees opportunities in the developing world, too. While healthcare advances quickly in the developed world, Exactech engineers must also address the mounting health-related issues found in third-world countries. Delivering medical care using long-distance telecommunications (telemedicine) provides an enormous potential to improve diagnosis and therapy while simultaneously increasing access to life-saving medicines and technologies. The mainstay of diagnosis will most likely remain X-ray and ultrasonic imaging — both of which are relatively inexpensive but require adaption to the local environment. The challenge for Exactech and other industryleading companies is to transform today’s technology into affordable in-field versions. Doing so results in greater ease of use by more people in third-world countries.
More from Ryan: “Patient-specific cutting guides are an example of a technology that appeared to be disruptive at the time of introduction. Significant portions of the market adopted this technology — a technology Exactech did not have direct experience with. Our response was not to jump at the chance of incrementally improving the technology. Instead, we first investigated how and why the technology helped patients. While the objective is a good one, this technology was not advanced enough to achieve its stated goal.”
As a testament to how far biomedical engineering has advanced since da Vinci, a group of surgeons at Montreal’s McGill University used the da Vinci robo-surgeon in 2010 to remove a patient’s prostate. Surgeons had been using robotic arms in surgery for many years prior, but the surgery with the da Vinci robo-surgeon was the world’s first surgery performed without direct implication of humans, with surgeons involved only in the process of controlling the robots. The use of autonomous robo-surgeon equipment is widespread today, and its usage will most likely continue to accelerate at a rapid pace.
It is undeniable how far biomedical engineering has come since the time of Leonardo da Vinci. Da Vinci was ahead of his time with his detailed drawings of skeletons and the human form. His forward-thinking approach led him to study the flight mechanics of birds, and his creativity contributed to the application of engineering in almost every branch of medicine — so much so that medicine today is deeply dependent on the work and support of biomedical engineers whose work reflects da Vinci’s legacy of problemsolving innovation.
Society benefits from today’s biomedical engineers’ pursuit of simple solutions for sophisticated problems. By doing so, biomedical engineers design and build the devices, equipment, therapies and treatments that bring profound change to the world.