CAMBRIDGE — Hospitals preparing for a possible Ebola case have been training nurses and doctors to don protective gear so that they can safely interact with infected patients.
But what if instead of putting themselves at risk each time an alarm went off, health-care workers could monitor vital signs from a remote location? What if instead of taking precious minutes to “gown up,” they could help a patient in distress by making rapid adjustments to drugs or fluids from afar?
Those deceptively simple questions were the focus of a three-day hackathon at a Massachusetts General Hospital laboratory that focused on technology to make sensors, pumps, and beeping monitors work together better.
The urgency of the Ebola crisis spurred this unusual cooperation between government regulators, companies, and academics to work together to engineer solutions. On Thursday, companies and academic scientists demonstrated some of the technologies that are now being connected in novel ways — in some cases, achieving in a few days things people have talked about doing for years.
On paper, many of these innovations will sound obvious, even mundane. But for years, barriers that range from regulatory hurdles to liability concerns have stood in the way of medical devices that can be operated remotely the way people typically expect from consumer devices. That means development of sensors that can easily share and provide data to one another and drug pumps that automatically shut down if there are signs the patient is getting sicker has largely stalled.
“Medical devices today don’t have remote controls,” said Dr. Julian Goldman, an anesthesiologist at MGH who began to focus last month on the question of how smarter, better-connected devices could help with Ebola treatment. “You can’t buy a television today without a remote control, and you can’t buy a medical device with a remote control.”
In response to a call from a White House official, Goldman and his collaborators from medical device companies large and small began to brainstorm and engineer solutions that could help with monitoring quarantined people’s temperatures or making the intensive care unit safer and more efficient for both health care providers and patients.
For example, they showed the ability to display vital signs taken from one device on a screen that displays a patient’s disease trajectory like a weather map. That may seem a run-of-the-mill in a world where we expect to be able to plug a bunch of digital devices into the same laptop, but in the medical device world that kind of interoperability is rare.
In one demonstration at the Cambridge lab, researchers from behind a blue partition were able to dial up and down the rate at which a ventilator provided air, slowing and speeding the breaths taken by a faux patient. They showed that a monitor that detects a patient’s breaths growing more shallow could shut off a pump providing pain medication that might endanger the patient’s health.
“It’s one step beyond actually not going into the room,” said Dr. Jenny Freeman, chief executive of Respiratory Motion, a company that makes the monitor that was linked to the pump made by another company, Smiths Medical. “It allows therapies as well as diagnostics to be performed. . . . We thought it was going to take six months or year, and in two days here we were able to connect these two things and we’ll be able to bring that out for patient care.”
The researchers think the potential is vast; the ability to collect and integrate lots of clinical data from different devices might open up diseases such as Ebola to new kinds of study from teams all around the world. Perhaps physicians would be able to identify patterns in the course of an infection that are only obvious when looking at the cases of many patients side by side, for example.
Mary Logan, president and chief executive of the Association for the Advancement of Medical Instrumentation, an organization that sets standards for medical devices, compares the advances to the early days of electronic banking. In the 1980s, instead of ATMs, people traveling abroad used traveler’s checks. In the 1990s, ATMs became more common but only worked on specific cards and specific banks.
Today, people expect as a matter of course to be able to withdraw money at pretty much any ATM in the world.
“That is exactly what’s going to happen with interoperability in health care,” Logan said.