4 colleges partner on devices to improve patient care
By Dawn Goodlove
The nurse tried twice to find a vein in the right forearm of the 84-year-old patient, who was severely dehydrated. His vessels were so fragile, however, that advancing the IV catheter tore through the vein wall, sending blood into the surrounding tissue. The nurse left the room to find the nurse manager while the man stared at his arm.
On the third try, this time in his other arm, the nurse manager succeeded in piercing the skin and advancing the needle just far enough before retracting it while slowly and steadily threading the outer sheath of the peripheral IV catheter, establishing a channel to quickly infuse fluids into his system.
Starting an IV to provide intravenous access is one of the most basic yet challenging procedures. It is a skill that can be difficult for medical professionals to maintain without years of practice and is further complicated by the often poor venous access of the elderly, IV drug abusers, and patients receiving chemotherapy. A survey of 100 University of Iowa Hospitals and Clinics nurses found that a patient is typically stuck 2.4 times before a peripheral IV is successfully inserted.
One nurse had an idea that could make the task less painful for everyone.
“In many settings, there’s no time for us to struggle with getting fast access. There has to be a better way, or some device that could improve the success rate and eliminate unnecessary pokes to the patient,” says Robert Anderson, a registered nurse in the medical intensive care unit of UI Hospitals and Clinics.
“I wanted to come up with some sort of modified Seldinger technique, which is commonly used for placement of central lines and PICC lines, using a guide-wire system.”
Anderson proposed his idea to the Iowa Medical Innovation Group (IMIG), an interdisciplinary program that pairs UI students with medical professionals who identify a need for a medical device. Soon a team of students in business, engineering, law, and medicine was helping him design, patent, and commercialize what would eventually be known as the Segmented Stabilization System. A company in China is licensed to bring the technology to the marketplace.
“A nurse or a doctor at the bedside can conceptualize something in their head, but translating that picture in my head into a realistic technology is something that I could have never done without IMIG,” Anderson says.
If necessity is the mother of invention, IMIG is the family that nurtures the idea. Although IMIG’s main goal is to introduce students to all aspects of medical device development, the ultimate outcome would be a product worthy of a patent, a place on the market, and practical application in clinical care.
Room for improvement
On a cardiac surgery fellowship during the summer between his first and second years of medical school, Tyler Rasmussen (’16 MD/PhD) noticed the daily frustrations providers encountered with medical devices and technology. He took notes, as did classmate Tom Waterbury (’12 MD) during his own summer research fellowship, and when they returned to classes at the UI Carver College of Medicine they had 50 items on their combined to-do list.
“We had ideas of things we wanted to improve upon, but we knew we couldn’t do it alone,” Rasmussen says. They approached David Hensley, executive director of the UI’s John Pappajohn Entrepreneurial Center (JPEC), who rounded up UI law students to investigate prior patents, engineering students to design the devices Rasmussen and Waterbury wanted to create, and business students to determine their marketability. For two years, a handful of students from the four colleges chose projects from the list Rasmussen and Waterbury started.
Since 2011, a request for problems has gone out to the UI medical community each spring, generating up to a couple of dozen responses from doctors, nurses, resident physicians, and others who encounter clinical situations that could benefit from better devices or technologies. Then faculty and administrators from four UI colleges review the submissions, eliminating problems too technically demanding to solve in a year. IMIG has evolved into a yearlong program offered for course credit that organizes students into teams, each typically containing two students in the full-time MBA program, two law students, two medical students, and three to four seniors in biomedical engineering.
“The overall goal is to learn how to think like an innovator and have that cross-college dialogue with people who think differently from you, so that whatever is your next step—whether it’s patent law or residency—you think like that for the rest of your life,” Rasmussen says.
IMIG assignments start over the summer when students complete initial needs assessments on the problems submitted to determine if solutions already exist or a potential device already has a patent. Then UI faculty consult with the UI Research Foundation to develop a finalized list from which students choose their projects.
Once the projects are selected—four or five, depending on the number of IMIG teams—each team meets with the practitioner who identified the problem and then typically tours the clinical or surgical area where this “mentor” works. With a better understanding of the solution needed, students start the process of creating a novel medical device: conducting intellectual property reviews, developing and testing prototypes, and creating business plans for marketing their devices. Teams report on their progress in monthly presentations to faculty and the other teams, and students hear from guest lecturers who are successful technology entrepreneurs, investors, and business experts from around the Midwest.
Each team receives $5,000 from JPEC to cover the cost of materials for their prototypes, access to databases, and other expenses. A generous gift of $50,000 from William A. Steele (’85 MD), a retired dermatologist in Florida, has helped to fund several projects that could potentially improve patient care.
From concept to clinic
Ellen Gardner was a senior in biomedical engineering when she joined a team developing an intravascular oximeter, which would be a minimally invasive way to measure blood oxygen levels in critically ill hypo-perfused patients, using a fiber optic probe inserted into an existing arterial catheter. This is another idea from Anderson, the UI Hospitals and Clinics nurse, who wanted an oximeter that would provide a more accurate reading for critically ill patients than the devices that clip onto a patient’s fingertip, toe, ear, nose, or forehead.
“I was trying to decide my career path at the time: Did I want to go to medical school or go into industry after graduation? So I thought working with medical students would be a good opportunity to help me figure out what I wanted to do after graduation,” Gardner says.
Her team completed a prototype by the end of the IMIG year but wanted to continue the project. By then, Anderson had launched BloodWorks, LLC, a small medical device development company, so Gardner and other IMIG team members joined the company. Her role is to investigate prior patents and help choose materials to build devices.
“IMIG helped me decide I didn’t love the computer industry side of the project, so I wanted to continue my education in medical school,” says Gardner, who is completing her first year in the UI Carver College of Medicine. “I like contact with patients, where you can see firsthand that devices really do help someone. I knew after that year that I wanted more patient contact.”
Since IMIG launched seven years ago, interdisciplinary teams have nurtured 23 projects toward development and commercialization. Of course, not all devices earn patents and find their way to the clinic. IMIG co-founder Rasmussen wanted to redesign the commonly used Foley catheter to decrease the risk of urinary tract infections. But the project was abandoned when business students determined the redesigned device would cost significantly more than the current model, reducing the new device’s marketability.
“There’s a very large interdisciplinary educational component to IMIG,” Hensley says. “Students will develop an understanding of the medical innovation process—including ideation, prototype development, intellectual property, and commercialization strategy.
“Beyond education, our hope is that teams will bring a successful product to market that will be utilized by health care providers to improve care, make money for the students and the university, and create economic impact,” Hensley says. “We believe IMIG is a model that can be the catalyst for future student innovation across the campus.”
Curious minds launch IMIG
By Dawn Goodlove
Sometimes it just takes fresh eyes on a problem.
Tyler Rasmussen (’16 MD/PhD) and Tom Waterbury (’12 MD) were first-year students in the University of Iowa Carver College of Medicine when they hatched the idea for the interdisciplinary Iowa Medical Innovation Group (IMIG).
“We saw physicians and other providers routinely working around obstacles to patient care without the time or resources to improve upon them,” Waterbury says. “As young medical students, I think we felt a responsibility to not only learn current techniques in the delivery of care but also to work to advance the way we deliver care in the future for our patients and fellow providers.”
Today, Waterbury is a first-year cardiology fellow at Mayo Clinic. Rasmussen is finishing the dual-degree Medical Scientist Training Program at the UI—earning an MD and a PhD—and preparing to start his residency in internal medicine at UI Hospitals and Clinics. And IMIG is now a program offered for course credit through four UI colleges each year and involving 40 to 50 students who gain a working knowledge of all phases of medical device and medical technology development.
“I don’t think Tom or I pictured this when we dreamed up the idea seven years ago,” Rasmussen says. “Every year we are adding people to the army of innovators, and hopefully it becomes the culture here at Iowa that everybody in the hospital has that innovative spirit. I think we can deliver better health care and be better providers with that spirit in mind.”
Neither is directly involved with IMIG currently, but each still takes note of problems in patient care that beg for solutions.
“I keep a running list of clinical needs encountered in a variety of medical settings and have proposed potential solutions to the venture program at Mayo,” Waterbury says.