Treating an infectious disease like the Ebola virus is fraught with dangers for both victims and their caretakers. Ebola’s fatality rate can reach 70 percent and an errant drop of blood, vomit or other bodily fluid can turn a nurse or a doctor into a patient.
That’s why engineers and technologists started looking for ways that would allow hospital staff to limit their exposure to the virus when treating the sick.
“If you look at the intensive care unit environment, there is danger to health care workers just entering the room,” says Dr. Julian M. Goldman, MD, an anesthesiologist at Massachusetts General Hospital’s Department of Anesthesia, Critical Care and Pain Medicine, and the medical director of Partners Biomedical Engineering. “Ventilators currently require a worker to come in to adjust them, and the same goes for infusion pumps. That means personnel are exposed to danger while they also have to take valuable time to be properly outfitted in protective gear.”
Scanning electron micrograph of Ebola virus budding from the surface of a VERO cell (African green monkey kidney epithelial cell line). Top image: Colorized scanning electron micrograph of filamentous Ebola virus particles (green) attached to and budding from a chronically infected VERO E6 cell (blue) (25,000x magnification). Images credit: NIAID
In October, Goldman, who also heads MGH’s Medical Device Plug-and-Play program (it’s seeking to develop an interoperability platform that can connect different hospital devices) received a call from a White House official. Medical personnel safety is a national issue and the Obama administration is working on a better national strategy to address infectious disease, including looking for ways to improve treatment and diminish transmission risk to health care workers.
Goldman decided to hold a “hack-a-thon” seminar at his hospital where researchers, engineers and representatives from industry, the government, regulatory agencies such as the FDA, and other organizations could participate in a challenge aimed at protecting health care workers from Ebola and improving patient outcomes.
Technologists from companies like GE Healthcare, Qualcomm, Intel and others brought ideas and equipment to Boston in early November. Over the course of three days, in response to the challenge, they devised software code, modified existing medical devices, and presented hospital robots. (GE Foundation is also supporting efforts to fight Ebola at the source, in rural villages in Liberia and Sierra Leone.)
Some figured out how to take data from patient monitors and analyze them to see if a patient’s condition is improving or worsening. Others retooled ventilators and drug pumps so a doctor or nurse could monitor and adjust the devices from outside the room, a major deviation for devices that are normally blocked from two-way communication for safety concerns.
“Many companies had never worked together, and in three days they had working, interoperating prototypes,” Goldman says. “They were surprised at how much they could work together to make new things when their technologists got together in the same room.”
Dr. Goldman, center above the mannequin, at the hack-a-thon. Image credit: Massachusetts General Hospital
The participants said that the work done over the three days could outline the future of technologies used inside the intensive care unit.
Mike Foulis, the anesthesia products manager for GE Healthcare, says his company’s therapeutic devices are currently walled off from the outside world for security purposes.
The reality of how devices and protocols are evolving, he says, means they will need to investigate expanding access to hospital networks for remote control and data analysis.
Goldman says this future is the Medical Internet of Things, where connected machines and instruments talk to each other and Big Data analytics could make health care much more effective and efficient.
At the end of the hack-a-thon, GE Healthcare showed a standard ventilator that had been reworked to be monitored and adjusted remotely through a cable and display that could be positioned outside a patient’s room.
“We took one of our existing devices, connected one of our test tools to it, and developed a makeshift remote control,” says Tim Knor, a lead software engineer at GE Healthcare who took part in the Boston event.
“This was a demonstration prototype was developed solely in response to this hack-a-thon challenge, of course, and not how we’d actually implement any potential solution,” Knor says. “But we proved that it may be achievable.”
Says Knor: “I’ve never done something like this—interacting with different companies and seeing what they’re figuring out to fix the problem.”