Rochester Medicine

Looking for Trouble

Jan. 31, 2014

The School of Medicine & Dentistry is collaborating with the Hajim School of Engineering and Applied Sciences to open the Center for Medical Technology Innovation (CMTI). The new center is forging connections between bio­engineering students, health care professionals, and the medical technology industry. The goal is to identify problems -- and develop solutions.

Assistant Professor Ankur Chandra, M.D., RPVI, is a problem solver. When he needed an inexpensive way to generate three-dimensional models for teaching, he and students in his vascular bioengineering lab built their own 3D printer. Instead of using ink, the device draws in a polymer cord and then spits it out again in very thin layers. The layers accumulate to form solid objects. The “homemade” printer cost thousands less than commercial printers and it makes its own replacement parts. (They’re biodegradable, of course.)

But that doesn’t necessarily mean Chandra is the biggest problem solver in his family. His mother might also be in the running.

She sat with him in the kitchen one morning, right after he earned his undergraduate degree, and thoughtfully listened as he described his dilemma. Chandra was the proud owner of a baccalaureate in Biomedical Engineering, but he had no idea what to do with it. He had amassed a slew of engineering skills, but he knew almost nothing about health care.

“I had all these ways to solve problems, but I didn’t know what the problems were,” he recalls.

His mother helped convince him to enroll in medical school so he could look for the problems. He put on a white coat and began studying medicine at Case Western Reserve University. He eventually became a vascular surgeon, all the while hoping his new path would someday merge with the old. It has.

House of Problems, House of Solutions

Chandra has been named clinical director of the UR’s new Center for Medical Technology Innovation (CMTI). Here, biomedical engineering students are working side by side with surgeons. Students are confronting real-world medical problems in the operating room, and trying to engineer real-world answers back in the lab. They are making important contacts in the medical device industry and learning about entrepreneurship. At the end of their aca­demic experience, the most ingenious could conceivably top off their degrees with patent royalties or a promising startup company.

The School of Medicine and Dentistry and the Hajim School of Engineering and Applied Sciences are collaborating on CMTI. It takes about five minutes to walk between the two schools.

“We’re here in this big house of problems,” says Chandra from his office in the medical center, “and just across the street is a big house of solutions in search of problems.”

A few years ago, Chandra began trying to bridge the two houses in response to what he considers a disturbing trend. As clinical use of medical technology is expanding, so is the divide between physicians using medical devices and engineers making them. Gone are the days when surgeons, like the late Arthur B. Vorhees, Jr., could dash out of the operating room, grab a swatch of fabric in the lab, and stitch up a synthetic artery to save a patient’s life. Devices are becoming increasingly complex, highly engineered, and subject to a daunting and expensive approval process. They are built inside large corporations by people who rarely, if ever, step into a hospital. Critical, yet potentially highly scrutinized, consultation between physicians and device manufacturers is facing mounting scrutiny amidst growing public mistrust.

“We need to figure out ways to successfully interface clinicians and engineers,” says Chandra.

The center is dedicated to that task, designing programs and courses for undergraduate and graduate students. It is forging connections with businesses, high-tech organizations, and entrepreneurs. It is tapping into the expertise of the Simon Graduate School of Business and UR’s Office of Technology Transfer. And, as Chandra once did at Case Western, CMTI students are going into the medical center in search of problems.

Bringing Ideas to Life

Spencer Klubben (MS ’14) knows how to spot a problem in the operating room.

“Sometimes it’s just grunts, or cursing, or something like that, and other times it’s pretty straightforward. The doctor or nurse will say to me, ‘Look, this does not work.’”

Klubben is among the first students to enroll in CMTI’s Medical Technology Innovation masters program. His undergraduate degree is in Biomedical Engineering. Just days after starting his masters’ in July, however, Klubben found himself standing in Strong Memorial’s operating room for 13 hours straight. He and a partner spent the rest of the summer observing colorectal surgeries and brainstorming a list of 100 problems. Other students were watching cardiovascular and orthopaedic procedures. With steady input from clinicians, nurses and surgical staff, students discovered poorly designed tools, voids in technology, and room for procedural automation that could reduce the risk for human error.

“URMC is a treasure trove of ideas,” says Greg Gdowski, Ph.D., executive director of CMTI and associate professor in Biomedical Engineering. “There are 1,400 clinicians, all of whom likely have novel ideas based on what they do in their practices.”

Working in pairs, the students are narrowing down their ideas and choosing projects to prototype. They are consulting with entrepreneurs and visiting high tech incubators. They will soon begin hammering out the engineering, business, legal, and regulatory details associated with each innovation. Eventually, some students could create intellectual property for the University — even if it’s after the year-long program ends.

“It’s very possible I’ll want to keep working on whatever device I decide on, to see how far I can take it,” says Klubben. "It’s also possible I’ll go to a company and say ‘Hey, you should license this device from the UR — and then hire me.’”

Not an Entry-Level Engineer

“The students who go through this process will have something on their resumes that others don’t,” says Amy Lerner, Ph.D., academic director of CMTI and associate professor in Biomedical Engineering.

By working intensely with partnering companies, CMTI students will benefit more than they would from a typical internship. They will gain extensive insight into specific product lines, including the manufacturing process, the surrounding business environment, regulatory issues, and physician reimbursement policies. They might form concrete ideas about improving or expanding a product line. If they have a question about how products are used, they will know doctors whom they can call for an answer.

“You put all that together, and our graduates aren’t entry-level engineers when they leave,” Gdowski says with a smile. “Companies like experience.”

The center is capturing the attention of businesses like Idea Boxx. The Rochester-area startup is exploring ways to bring antiquated medical devices and processes into the 21st century. Founder Richard Aab says he’s excited about cultivating a partnership with CMTI. He hopes to engage students in defining procedures to validate the benefits and actual uses of products.

“It really gets them out of the purely academic environment to apply what they are learning, while at the same time helping us build an economic engine that will benefit the entire community,” says Aab, who is a member of the UR board of trustees and URMC board. “Ultimately, the most important result will be improved outcome and safety for patients.”