Health Care Problem Solving | Harvard Medical School

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Sim Kahlon is an skilled well being care innovator with a pc engineering diploma and an MBA in finance. When he grew to become one of many first contributors in Harvard’s new HealthTech Fellowship program final fall, nonetheless, he quickly realized he was embarking on an academic expertise not like something he’d beforehand encountered. 

As a member of a four-person crew of interdisciplinary fellows enrolled in an intensive, two-month immersion within the Division of Cardiac Surgical procedure at Massachusetts Normal Hospital, that realization hit dwelling when he noticed a coronary heart transplant surgical procedure firsthand. 

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Kahlon was amazed at one level to see a affected person’s physique with an empty chest—no coronary heart inside. The surgeons’ potential to physiologically help the affected person as they waited for a brand new coronary heart to reach, he felt, was a testomony to fashionable drugs.

To attenuate the potential for delays upon receiving a donor coronary heart, the surgical protocol is to help a affected person on a synthetic heart-lung bypass machine till the donor coronary heart turns into accessible.

“They might be ready for the donor coronary heart to reach so they might rapidly choose up the guts and put it within the physique,” Kahlon mentioned.

Though the surgical procedure is extremely coordinated, Kahlon mentioned time appeared to crawl whereas the affected person remained fully reliant on the synthetic help methods, all of the whereas underneath fixed surveillance. The expertise was an epiphany of types for Kahlon.

“Simply to ponder the miracles of science, and the way essential the necessity is for innovation … to maintain pursuing, to maintain pushing to develop, to ensure there are innovations occurring on a regular basis. As a result of with no coronary heart bypass machine, this could not have been potential,” he mentioned.  

Observing the surgical procedure provoked different questions for Kahlon, who questioned the place the donor coronary heart was coming from and what would occur if it was delayed.

“All these questions are going via my thoughts,” he mentioned. “And I’m considering, ‘What occurs if the donor coronary heart that’s on the best way meets with an accident … and this individual is mendacity on the desk with no coronary heart?”

For Kahlon and his colleagues in this system—Bahar Rahsepar, Harvey Chin, and Manny Fanarjian— this system’s medical immersion experiences, corresponding to this one, had been designed to immediate simply that sort of considering.

Figuring out a necessity

The ten-month fellowship program, a collaborative effort between Harvard Medical Faculty, the Harvard John A. Paulson Faculty of Engineering and Utilized Sciences, and Harvard Enterprise Faculty, embeds contributors at Harvard-affiliated hospitals with the objective of getting the fellows establish and characterize unmet well being care wants via direct statement.

Screening these wants based mostly on components together with medical impression and potential market, the fellows then brainstorm and iterate novel options. The goal is to develop the talents to steer well being care innovation, rework challenges into viable enterprise alternatives, and in the end, enhance well being look after all.

“We hope to spur innovation with our medical companions in addition to inside our medical companions,” mentioned Paola Abello, director of innovation on the HMS Middle for Main Care who oversees this system.

The fellows started their work by conducting in-person observations for eight weeks. From that effort, they recognized greater than 370 well being care issues for about 20 illness states, Abello mentioned. They then narrowed their listing all the way down to the 5 they had been most fascinated by pursuing.

“The purpose is to grasp what the true want is, proper? Since you may have a extremely fabulous answer, however if you happen to’re not addressing the proper drawback, it’s not going to take you very far,” mentioned Abello.

 

Though the HealthTech Fellowship program falls inside the HMS Therapeutics Initiative, proper now its focus is on bettering well being care supply relatively than drug discovery, particularly specializing in potential enhancements in digital well being and medical expertise. They utilized the biodesign innovation framework to establish issues that want options, touchdown on a challenge they imagine may handle an actual want.   

“They’re engaged on congestive coronary heart failure, and the way sufferers can extra effectively monitor their medicines and fluid ranges from dwelling,” Abello mentioned. “The lack of sufferers with congestive coronary heart failure to watch these items is a large motive why many find yourself again within the hospital.”

“We’ve talked to most likely over 50 consultants up to now. And everyone’s agreed that it is a drawback that must be solved,” mentioned Chin, one of many 4 fellows.

A doctor with a grasp’s diploma in biomedical informatics, Chin has began two well being tech firms that make use of synthetic intelligence to resolve issues

“I believe as a doctor, you all the time really feel like issues might be higher,” he mentioned. “If you end up in med faculty, you be taught a number of medical information. You memorize, … you be taught concerning the cutting-edge scientific outcomes, however there’s a lacking piece between new innovation and really making an impression on the affected person aspect.”

Important analysis funding can go into growing options for issues that in the end will not be adopted by the well being care system or physicians, Chin mentioned. The answer is just not one thing folks actually need or want

“My predominant motivation is studying about how to consider the enterprise aspect of drugs extra structurally,” he mentioned.

A greater approach

Fellowship participant Manny Fanarjian is a doctor and a biomedical engineer who did his residency in inner drugs.

“I can’t inform you the variety of occasions you run right into a hurdle or an inefficiency or a spot in the best way that care is delivered,” he mentioned. “And also you simply suppose to your self, ‘There’s received to be a greater approach to do that.’”

The fellowship supplied Fanarjian with centered time to consider these sorts of well being care issues and a possibility to attempt to remedy not less than considered one of them.

For instance, Fanarjian mentioned, silos in well being care methods create difficulties when a affected person will get an MRI at a hospital in a single well being care system after which will get transferred to a different hospital in a distinct system. Suppliers may not have entry to the earlier imaging, or they discover that lab outcomes and data get shared in an inefficient approach—or under no circumstances. Typically, the imaging scan simply will get repeated within the new hospital, he mentioned.  

“And that is available in at a price to the system and a nuisance to the sufferers, and probably, , extra radiation publicity, relying on what sort of scan it’s,” he mentioned, including that “your entire [health care] system is just not in-built a patient-centric approach.”

“Sufferers who’ve a number of continual comorbidities, they actually plan their lives round their medical care. And it would not serve them that nicely,” Fanarjian mentioned.

Fanarjian mentioned there are instruments that permit blood strain monitoring from a affected person’s dwelling, and even dialysis might be performed from dwelling now. However extra work wants to enter discovering and scaling extra options. The fellowship supplied him with additional experience.

“There’s a number of expertise that I realized that I simply did not have earlier than, round patent writing and a few product design, stakeholder interviews and market analysis, and pitching to buyers. These are all issues which can be actually vital in growing new applied sciences that I simply didn’t have entry to earlier than,” he mentioned.

Photo of the HealthTech fellows inside MGH
The fellows at MGH.  From left, Chin, Rahsepar, Kahlon and Fanarjian.  Picture: Courtesy S. Kahlon

One other profit to this system was working intently with the three different fellows who all have a various vary of experiences in well being care, drugs, and science. His colleague, fellow Bahar Rahsepar, for instance, has a PhD in biomedical engineering.

Rahsepar’s work has concerned neural engineering—how recollections may be modulated in relation to emphasize issues. Primarily centered on primary science analysis, she was fascinated by studying extra about translation, that’s, easy methods to take her discoveries from bench to bedside.  

“Completely different methods that could possibly be employed in translating primary science analysis into precise impactful outcomes for sufferers. That is the broad class of what I’m fascinated by,” she mentioned.

For the fellows group, she mentioned, one of many key questions was ‘What’s the impression for sufferers?’

‘It’s like, if you happen to remedy this, would there be time saved? Would high quality of life be improved for sufferers? All of these questions come into consideration,” Rahsepar mentioned.

The coronavirus pandemic, she added, additionally performed a task within the group’s final determination to focus on enhancements to congestive coronary heart failure care. Because the pandemic led to a wider use of telemedicine, the probabilities surrounding dwelling monitoring and care grew to become extra obvious.

Abello mentioned this primary fellows pilot group has already sparked business curiosity, particularly amongst buyers within the enterprise capital neighborhood, she mentioned.

“In the event that they’re in a position to launch and develop a product for congestive coronary heart failure sufferers, that’s an enormous neighborhood of sufferers that shall be served,” she mentioned.

The truth is, Abello mentioned, it was an entrepreneur who supplied the preliminary funding to help the fellowship program which, at this level, is totally supported by philanthropy.

“[Investors] see this as a possibility to domesticate a pipeline of actually sturdy expertise that may keep in Boston,” she mentioned. “However with the intention to develop this program, we have to proceed getting help to have the ability to educate these future entrepreneurs and innovators.”

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