IIH Overview Presentation
IIH Overview Presentation
IIH Overview Presentation
1
IIH
Global
Health
Device
Development
Model
2
IIH
Opportunity
Sectors
Vaccines
Tech
for
disabilities
Mom
and
baby
health
Diagnostics
Therapy
enhancements
Surgical
tools
Personalized
medical
devices
Chronic
conditions
Appropriate
Lab
Instrumentation
Information
Systems
3
HLab
IIH
network
of
HLabs
are
an
important
part
of
our
ability
to
produce
world-‐
class
medical
technologies
for
developing
world
countries.
Our
access
to
rapid
prototyping
facilities,
micro-‐machining,
biomedical
labs,
software
development
clusters
combined
with
the
talented
developers
who
run
them
make
HLabs
the
new
Menlo
Park
for
Global
Health.
MIT
Essential
prototyping
facilities
3
Machine
Shops,
3-‐D
Printers,
Laser
cutters,
Machine
Shops,
Electronics,
Mobile
technology
Outsource:
partners,
competitions,
classes
Karachi
Informatics,
mobile
technology,
software
Managua
Laboratory
testing
and
diagnostic
co-‐development
2009
D-‐Lab
Health
impact
4
By
the
numbers
2
Years
Old
12
collaborative
country
sites
Peru,
Pakistan,
Nicaragua,
Guatemala,
India,
Ghana,
Nepal,
Honduras,
Tanzania,
Venezuela,
Ethiopia,
Uganda
20+
PIs
working
across
7
fields
22
active
technology
projects
3
ongoing
field
trials
5
A
Global
Collaboration
Footprint
6
80-‐90%
of
all
medical
equipment
in
developing
countries
are
secondhand
80%
fail
in
the
first
6
months.
How
We
Measure
the
Impact
Viability
of
our
Solutions
Appropriate technology often requires a nuanced approach to design that
combines simple solutions, elegant technologies and robust engineering to make
technologies survive the rigors of the field. This often produces a highly tailored
approach to each solution that is difficult to standardize across sectors and
across individuals.
We have taken steps to identify the most important tensions that exist in
appropriate biomedical technologies seen through the design lens. By mapping
RESOURCE INVESTMENT and IMPACT along a X-Y spectrum, we can anticipate
how appropriate our solution is against conventional approaches. We call this the
Impact
Global Health Innovation Compass.
Resource Investment
8
The
Global
Health
Innovation
Compass
Affordable/
High Impact Expensive/
High Impact
Impact
Investment
&
Resources
Affordable/ Expensive/
Low Appropriate Impact Low Appropriate Impact
9
The
Global
Health
Innovation
Compass
Affordable/
High Impact Expensive/
High Impact
Affordable/ Expensive/
Low Appropriate Impact Low Appropriate Impact
A
Focus
on
Applied
Technology
to
get
Products
to
Patients
IIH provides researchers at MIT and
other institutions to work on applied
technology projects that have a real
impact in the field. This requires a
comprehensive look at the solution.
The picture illustrates the value-chain
of a microfluidic diagnostic product
compared to the academic
publishing opportunities.
11
From
Prototype
to
the
Field
IIH
SafeTrial
Through
the
IIH@
MIT
SafeTrial
program,
we
have
the
opportunity
to
conduct
clinical
and
engineering
field
trials
in
Tanzania,
Nicaragua
and
Pakistan
for
member
technologies.
The
IIH
SafeTrial
program
allows
the
technology
to
be
tested
at
a
very
low
cost
compared
to
traditional
testing
facilities
under
the
direction
of
experienced
public
health
professionals.
This
is
an
important
distinction
between
IIH
and
other
global
health
centers.
Our
ability
to
rapidly
prototype
concepts,
take
them
to
the
field
for
data
acquisition,
and
iterate
provides
a
pathway
in
which
we
can
show
early
results,
adoption
information,
and
market
feasibility.
This
gets
our
designs
closer
to
commercialization
that
our
counterparts
in
other
institutions.
12
Field
Organizations
for
Technology
Testing
and
Implementation
Nicaragua (H-Lab Managua, MIT IIH) Pakistan (H-Lab Karachi, MIT IIH)
13
Field
Organizations
for
Technology
Testing
and
Implementation
Cambodia (Cambodian Health Committee): Indonesia
(International Organization of Migration):
Siem-Riep Provincial Hospital
Phnom Penh (2 sites: KSFH & Calmette) Cut Nyak Dhien Hospital
Takeo Provincial Hospital
Community Clinics (Puskesmases)
Svay Rieng Provincial Hospital
14
Field
Organizations
for
Technology
Testing
and
Implementation
Ethiopia (Global Health Committee):
Addis Ababa
15
IIH
Representative
Technologies
16
Drug
Delivery
Aerovax
The Aerovax System was designed as a go-anywhere inhalable drug and vaccine delivery technology designed for mass immunization of
remote populations.
Diagnostics
S.N.A.P
Simple
Nucleic
Acid
Processing
A field deployable DNA collection device. An IIH H-Lab team worked on a field deployable solution for Boston University researcher’s
bench-based microfluidic sample collection tool that is now under further development by researchers MIT, Boston University, and
designers in California and Ethiopia.
18
Diagnostics
Patients who do not take their medications
cost the American healthcare system $290 billion
XoutTB
a year in increased medical spending.
--- New England Healthcare Institute, August 2009
19
Diagnostics
Patients who do not take their medications
cost the American healthcare system $290 billion
XoutTB
a year in increased medical spending.
--- New England Healthcare Institute, August 2009
20
Diagnostics
Microfluidic
System
for
Monitoring
Sepsis
at
the
Point-‐of-‐Care
21
Diagnostics
Microfluidic
System
for
Monitoring
Sepsis
at
the
Point-‐of-‐Care
Jose Trevejo, MD, PhD, BIDMC and Preshious Rearden, PhD, Draper
Need and ImpactTuberculosis (TB) remains a major public health problem worldwide with
approximately 8 million new cases and >2 million deaths per yearMajor obstacle is the lack of
point-of-care diagnostics for TB with high sensitivityNo real-time, reliable, inexpensive,
portable detection deviceSolution and InnovationDevelop real-time volatile analysis system
(breath analyzer) for TB detectionLeverage and apply novel differential mobility spectrometer
that has a highly sensitive, portable gas sensors for detection at very low
concentrationsWorld Healthcare Organization (WHO) supported ongoing clinical trials for TB
• Need and ImpactSepsis is a systemic response to an infection that can be bacterial, viral,
fungal or parasitic in origin and its diagnosis is based on patient’s history and
presentationCurrent standard of care for sepsis require blood cultures that can take days to
completeCurrent FDA approved “rapid tests” have reasonable sensitivity and specificity, but not
the causative organism
23
Maternal
and
Infant
Health
Car
Parts
Incubator
Dr. Kristian Olson is the Program Leader for CIMIT’s Global Health Initiative and chief
architect of the Car Parts Incubator project.
Need and ImpactEach year over 4 million infants worldwide die within a month of birth due to
pre-maturity, low birth weight and infectionConventional incubators designed for industrialized
markets can cost over $30,00095% of donated medical equipment ends up broken within five
years and unused due to lack of local training and repair Solution and InnovationBuild a low-
cost, higher performing, safer and effective neonatal isolette for low-resource, rural
settingsDesign and leverage readily locally available automotive partsDevelop and train to be
operated, repaired and maintained with local human resource capacity
24
Cell-‐phone
Based
Vibrotactile
Balance
Visual
Central
Nervous
System
h"p://www.sensory-‐systems.ethz.ch
Ves=bular
h"p://www.infovisual.info/
Vibrotac=le
Electrotac=le
Auditory
h"p://www.profeet.co.uk
25
Cell-‐phone
Based
Vibrotactile
Balance
Body motion is sensed and displayed to the user via vibrotactile cues to the torso
Connect via
Headphone Jack
External Tactors
(Samsung)
Samsung smart phone
iPhone features Balance trainer with smart phone
- Tri-axial accelerometer - Support ubiquitous balance training device
- Interface tactor driving hardware with 32 pin
- Visual display and Touch screen
connector
- Internal data storage
- Provide winCE operating system that enables to
- SDK development kit build embedded application software
26
Portable
Biofeedback
System
Battery
Tactor
(Samsung)
MCU
Main objectives
- Improve human motor function in patient populations with
sensory and/or motor deficits
- Support multiple patients via wireless or web-based manner
- Provide clinical or motor learning tasks in physical therapy or 6X5X3.5 cm
sports training
27
Global
Health
Design
Research
Noninvasive
dehydration
detection
Approximates
fluid
loss
on
the
order
of
1-‐2%
dehydration
by
assessing
radial
pulse
before
and
after
supine
to
standing
transition
Cell
phone
based
maternal
health
diagnostic
platform
Cell
phone
based
patient
symptom
recognition
and
referral
system
28
Portable
Obstetrics
Exam
Table
http://current.com/items/89197959/12yr_old_boy_circumcised_with_rusty_knife.htm
31Tran
Brian Holcomb, Alex Klonick, Michael Swift, and Michael
Fall
2009
Design
Projects
32
IIH
Design
Strategies
33
How
do
we
get
there?
Design
Strategies
Hybridization
Vintage Technologies + Smart Design/Tech
= New Solutions
Taking the improvisation and engineering
solutions
Bottom up observation
Be trendsetting, not trendy
Context shifting
Distributed Systems
Crowdsourcing
34
A
little
of
the
old,
a
little
of
the
new
35
Hybridization
Hybridization
+
Context
Shifting
Vintage
Technologies
+
Smart
Design
Improvisation
Design
microfluidics
Microfluidics
Solar
Windows Mobile
Neonatal
J2MEE
Tuberculosis
Pulse Ox
40
Our
Community
By
the
Numbers
Nursing;
6%
Public
Health;
4%
Biomedical
Engineering;
6%
Physicians;
27%
Biomedical
Research;
6%
Business; 14%
Electrical
Engineering;
9%
41
IIH
Global
Health
Technology:
Healthcare
Challenges
Our
Research
Direction
Collaboration
Opportunities
42
IIH
Global
Health
Technology:
Healthcare
Challenges
Our
Research
Direction
Collaboration
Opportunities
43
The
Next
Challenges
in
Global
Health
Technology
Oncology
Diabetes
Diagnostics
Imaging
Solutions
Telemedicine
Medical
Simulation
Rehabilitation
and
Personalized
Orthodics
44
Oncology
|
Challenges
Cancer
now
kills
more
people
in
developing
countries
than
HIV,
TB
and
malaria
combined.
Key
Drivers:
Longer
life
expectancy
-‐-‐
cancer
risks
rises
as
one
ages
Adoption
of
modern
lifestyles
(smoking,
drinking,
sedentary
lifestyles
couples
with
diets
high
in
fast
and
sugar)
Lack
of
early
detection
for
cancers
related
to
infection,
such
as
human
papillomavirus
(HPV),
which
is
linked
to
cervical
and
colourectal
tumours
45
Oncology
|
Opportunities
There is a clear opportunity for applications for early diagnosis, treatment, and palliative care of cancer in the
developing world. In addition to research opportunities, the field is largely untapped as a business opportunity
since most cancer patients constitute the driving force, the working professional class, of developing world
economies. The lack of adequate treatments fosters regional medical tourism afforded only to the wealthy.
The
Programme
of
Action
for
Cancer
Therapy
is
rapidly
expanding
conventional
radiation
More
than
75%
of
cancer
patients
in
treatment
and
imaging
devices
to
select
pilot
sites
in
the
developing
world.
Radiotherapy
low
and
middle
income
countries
have
Development
of
smaller,
portable
radiotherapy
units
could
decentralize
access
to
radiotherapy
access
to
radiotherapy
treatment
and
make
it
available
in
more
remote
geographies.
Advances
such
as
ion-‐induced
nuclear
radiotherapy
could
prove
pivotal
is
combined
with
appropriate
technological
design
.
46
Diabetes
|
Challenges
WHO predicts that developing countries will bear the brunt of this epidemic in the
21st century, with 80% of all new cases of diabetes expected to appear in the
developing countries by 2025.
Diabetes is increasing faster in the world's developing economies than in developed
countries. Seven out of ten countries with the highest number of people living with
diabetes are in the developing world. With an estimated 35 million people with
diabetes, India has the world's largest diabetes population.
Diabetes is a silent epidemic that claims as many lives each year as HIV/AIDS. In
2007, diabetes will cause 3.5 million deaths globally.
If present trends persist, by 2025 the majority of people with diabetes in the
developing countries will be in the 45-64 age group.
47
Diabetes
|
Opportunities
Diabetes is a multi-sided healthcare burden that offers many opportunities for impact. Although prevention is ideal, treatment
is needed for those who have already developed this chronic condition. We see opportunities in affordable management and
monitoring, insulin delivery systems, and secondary disease management (diabetic wound care, prosthesis, eye care).
48
Imaging
|
Challenges
According to the World Health Organization, two thirds
of the world's population has little or no access to
basic diagnostic X-ray services. Additionally, the
World Health Organization estimates that there is a
need for one diagnostic imaging system for every
50,000 people. Medical imaging services are needed
for the diagnosis and management of medical
conditions such as trauma, chest disease (including
tuberculosis), and abdominal ailments.
Despite decades of efforts aimed at addressing the
problem of limited access to diagnostic imaging, little
progress has been made. A key reason for this has
been the lack of coordination in efforts and funding for
sustainable deployment of the affordable technology
that exists. Infrastructure needs to be created to
include support for these critical components, while
utilizing more modern and advanced imaging
technology.
http://www.healthcareitnews.com/news/new-partnership-give-developing-countries-access-diagnostic-imaging-systems
World Health Imaging Alliance
Society for Imaging Informatics in Medicine
49
Imaging
|
Opportunities
There is a clear opportunity for applications for early diagnosis, treatment, and palliative care of cancer in the
developing world. In addition to research opportunities, the field is largely untapped as a business opportunity
since most cancer patients constitute the driving force, the working professional class, of developing world
economies. The lack of adequate treatments fosters regional medical tourism afforded only to the wealthy.
Specialty
practitioners
such
as
The
growing
availability
of
broadband
mobile
connections,
cached
data
links,
and
distributed
data
radiologists,
cardiologists
and
connectivity
provides
a
solid
platform
for
telemedical
consults.
IIH
companies
such
as
Diagnostic
Telemedicine
pathologists
are
largely
unavailable
ClickDiagnostics
and
Moca
Mobile
are
providing
important
telemedicine
services
to
bridge
the
gap
in
rural
areas
due
to
“internal
brain
between
rural
patients
and
knowledagable
specilaists
in
eye
care,
dermatology,
oncology,
and
drain”
maternal
health.
50
IIH
Global
Health
Technology:
Healthcare
Challenges
Our
Research
Direction
Collaboration
Opportunities
51
Click
Diagnostics
52
Cough
Tracker
53
RFID
Symptom/Disease
Navigator
54
Lab-‐in-‐a-‐Box
55
BioMagnetic
Diagnostics
56
Mobile
Health
|
Population
Counting
Signs of life
57
Mobile
Health
|
Population
Counting
58
Mobile
Health
|
Diagnostic
Accessories
59
Rural
Health
Informatics
Large health inequity seen in
Latin America
Rural poor are 5x more likely to
die before 60 than non-poor1
Financing of rural health systems has
decreased proportionally
62
IIH
is
an
Ecosystem
of
Collaboration
with
MIT
as
a
Host
Our
members
are
embedded
in
world
class
organizations
willing
to
collaborate
and
provide
field
insight
63
Collaboration
Opportunities
• D-‐Lab
sponsorship
• Support
MIT
students
and
• Engage
Samsung
engineers
opportunities
investigators
in
deploying,
and
designers
to
engage
IIH
• Academic
and
scholarly
designing,
and
testing
new
researchers
and
their
students
exchanges
medical
device
technologies
to
integrate
Samsung
• Conference
and
Lecture
for
global
health
technologies
into
current
and
opportunities
future
projects.
• Firmware
assistance
• Korean
fabrication
opportunities
Research
Academics
Fellowships
64
More
Information
Jose Gomez-Marquez
Program Director
[email protected]
617.674.7516
MIT
32 Carlton Street, Building e34
Cambridge, MA
65