Mass High Tech: The Journal of New England Technology - November 7, 2005
http://masshightech.bizjournals.com/masshightech/stories/2005/11/07/story14.html

Rx for the OR: Mass. physicians tap experience and tech leaders to bring better medical solutions to market

Mass High Tech: The Journal of New England Technology - November 4, 2005

by Dyke Hendrickson

 

Dr. Julian Goldman has a technological prescription for treating a disorder in the nation's operating rooms, and he is consulting with IBM, Philips Medical and others to implement the cure.

His initiative is called the Plug-and-Play Interoperability Program (PnP), which is designed to organize data flow so that better decisions can be made in the OR.

"The operating room is a complex and sometimes hazardous environment," said Goldman. "We depend on a patchwork of systems to minimize hazards instead of using automated safety systems.

"Errors and mistakes can be cut down if we have coordinated systems that provide data that can be accessed by doctors, nurses, anesthesiologists and others to produce good medicine and good electronic medical records."

Goldman is an anesthesiologist at Massachusetts General Hospital. But he does more than knock people out during surgery. He is leading a team with the goal of attracting private industry into partnering to solve a problem in the OR: informational disarray.

He's also one of a growing number of Massachusetts physicians taking on the titles of "inventor" and "technology business partner." And it's a trend that is garnering serious interest from the leading hospitals where they work, as well as technology market leaders that can help deliver the solutions.

Goldman is a principal investigator for the Center for Integration of Medicine and Innovative Technology (CIMIT), an organization that provides research and commercial options to medical institutions and private industry. Its consortium members include the hospitals within Partners Healthcare, the Charles Stark Draper Laboratory and MIT.

Goldman's concern is that information systems don't always work together to benefit the patient. He tells the story of a patient who underwent surgery that required her lungs to stop functioning. At the end of the procedure, physicians didn't notice the oxygen had not been turned back on. The patient died.

"That death was a tragedy," said Goldman, who was recruited to Mass. General several years ago after graduate work at the University of Colorado and a stint in private industry. "We need a system that will coordinate systems, and provide interlocks so that each party in the OR knows exactly what the others are doing, and what the medical data is indicating."

Goldman does not have a physical product at this point. Instead, he is engaging top developers to work with him to develop a system that could be sold nationwide. His plan is to develop standards for interoperability, accumulate data from clinical results and then aid companies in developing a profit-based product.

"We're interested in this plan," said Chris Perrera, who heads IBM's Engineering and Technology Services group. "We'd like to be part of the team that develops it, and want to be involved when a product is produced."

The Plug 'n' Play is drawing interest from smaller companies as well.

"We're supporters of their technology," said Jeffrey Robbins, chief executive officer of LiveData Inc. a private integration company in Cambridge. "Our experience includes work with large corporations, and we'd like this to be developed to where companies like GE, Siemens and Philips would get involved. Of course, sometimes it's hard to get large vendors to agree on product standards but we feel the program can be attractive to many companies."

Proof of concept is no proof of profit Goldman is part of a growing trend, that of CIMIT physicians who see systemic problems and pursue solutions to be commercialized. Many physicians help to develop commercial medical devices, of course.

Dr. David Lederman made national headlines when he was chief executive of Abiomed Inc. in his effort to develop an artificial heart. Dr. Daniel Kopans at Mass. General is developing a new mammography device to detect breast cancer; Dr. Stephen Corn of Brigham & Women's Hospital and Harvard Medical School has launched a small company to commercialize a tool to monitor the breathing of at-risk hospital patients.

Physicians working through CIMIT, which is funded by public and private sources, appear to have a more focused approach. The organization identifies promising projects, and dispenses research money and staff support for its "practicing doctors."

Dr. Joseph Kvedar, for instance, is a Mass. General dermatologist developing tools for telemedicine or "untethered monitoring." His team is responsible for developing teleconsultations for doctors and patients in other countries.

Dr. Brett Bouma, a CIMIT investigator, has conducted clinical studies on new diagnosis techniques for the gastrointestinal tract and cardiac arteries.

Dr. Jay Schnitzer, of Mass. General and Harvard Medical School, has received a patent for a ventilator that lowers airway pressures for babies in trauma.

This version of the proof-of-concept model appears to be a response to a certain Catch-22 mentality in the creation of medical devices. Manufacturers are reluctant to develop medical devices because there is no certainty the industry will use them. For instance, if there are no industry standards and no approvals from the U.S. Food and Drug Administration, a private company would not want take the financial risk.

Conversely, health care providers didn't demand new tools because they couldn't envision the problems the technology would address.

"What we are doing is creating a foundation," said Goldman. "When we get the standards, approvals and technology, private industry will follow because it is a very big market."