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Mind the Gap: Connecting Clinicians and Engineers at Duke

Creating an environment where the clinical, engineering and business fields can collaborate for further research and commercialization possibilities

From the 2018 DukEngineer Magazine

Historically, there has been an immense divide between clinicians and engineers. Failure to adequately communicate about clinical needs and functional engineering requirements has slowed the development and commercialization of medical technologies, resulting in patients not receiving breakthrough medical treatments, which potentially worsens their outcomes. Duke is looking to cross that chasm.

Through strong interdisciplinary facilitation, Duke's School of Medicine, the Pratt School of Engineering, and the Duke Innovation & Entrepreneurship Initiative are creating an environment at the university where the clinical, engineering and business fields can collaborate for further research and commercialization possibilities. Each group represents a unique phase of the technology development and commercialization process, which allows for the generation of interdepartmental competencies across the university.

Ideation—Innovation & Entrepreneurship

Geoff GinsburgHow is a clinical need identified? Who do you design the solution for? What are the unique features that the solution must contain? Before development of a medical innovation can even be considered, these and similar questions need to be thoroughly vetted and understood.

That is the goal of the Innovation and Entrepreneurship (I&E) course Biodesign, taught by Professor Joe Knight. The course places value on the direct observation of clinical interactions by design teams to search for clinical gaps in the implementation of medical practice. Through the course, students learn how to identify clinical needs, determine critical functional requirements for the solution and generate value propositions to develop the solution.

Communication—MEDx

Bringing the correct functional groups together is critical to a medical innovation's success, and MEDx is working to secure those relationships. Founded in 2015, MEDx is an initiative through the Duke School of Medicine and the Pratt School of Engineering with the goal of fueling medical and engineering collaborations. By facilitating dialogue between the two groups, MEDx hopes that partnerships can be established that would have otherwise been missed, and new medical innovations can flourish as a result.

This year, MEDx has hosted a myriad of events helping to accomplish this goal. For example, in October, MEDx hosted the Kaganov Symposium, an event to raise awareness of the immense need for new solutions in the field of pulmonary medicine and build collaborations amongst the research and clinical communities. The symposium hosted experts across the fields of medicine and engineering, including faculty from both the School of Medicine and the Pratt School of Engineering, and some of the leading patient advocates in lung disease. The winners of three new research grants to teams of engineers and clinicians were also announced at the event. The symposium was one of the first events of a recent $3 million gift from Alan and Carol Kaganov to improve pulmonary disease outcomes by fostering new collaborations across engineering and medicine at Duke.

MEDx has also sponsored numerous workshops and seminar series designed to educate the Duke network, highlighting the research of fellow Duke labs, teaching entrepreneurship and regulatory skills, and awarding recognition for individuals who have served as examples for the benefits of the clinician-engineer interaction.

Duke University Hospital front entrance

Development—Biomedical Engineering

Duke's Biomedical Engineering Department (BME) has been at the forefront of medical innovations across the world for years; the department has continued to adapt to the rapidly changing field through a variety of new course offerings designed to create engineers who are not only technically sound, but also clinically competent and business savvy.

Through BME's design course offerings, students are exposed to unique applications of their engineering skillset that challenge their innovative and technical abilities. Some of the options across both the undergraduate and graduate design courses include Devices for People with Disabilities, Biomedical and Clinical Design, Medical Device Design, and Intercontinental Engineering Design.

Another interdisciplinary course new to the BME department this year is Biomedical Product Development, taught by Peter Johnson, MD. Johnson, a plastic surgeon by trade, has had years of experience as a CEO and investor in several medical device companies.

"The class was created to foster a diverse group of product development talents, while simultaneously weaving them together to form a whole."

"The class was created to foster a diverse group of product development talents, while simultaneously weaving them together to form a whole," said Johnson.

The course has no technical components, but rather teaches the students how to start and run a medical device company. Teams, comprising students in marketing, finance, R&D, regulatory, and others, fulfill the roles of each functional group within a medical device company, with the class culminating in a full application to the FDA for a medical device as the final project. Johnson focuses heavily on the value of all three components—medicine, engineering and business—in order to succeed in a medical device venture. "Unmet clinical need is the number-one determining factor whether a medical device will succeed," said Johnson. "And you have to get clinician feedback to determine if this need is being met."

This idea of interdisciplinary education is being adapted through these course designs to generate more well-rounded engineers who understand the implications of their technologies outside of their traditional technical roles.

Johnson commented on the necessity of this multidisciplinary interaction, saying "Creating a medical product that is actually needed and simultaneously profitable is like a five-tumbler lock. You may be able to get through four of the tumblers, but if you can't get that last one, the door will not open."

Erik Anderson is a master's student studying engineering management with a focus in biomedical engineering.

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