Stories about: Devices

Robot-enhanced neurosurgery for nimbler seizure mapping

implanting electrodes for seizure monitoring, with robotic assistance
Scellig Stone and Joseph Madsen in surgery with the robot.

Head shaved, a little boy rests on the operating table, deep under anesthesia. His parents have brought him to Boston Children’s Hospital in hopes of determining the cause of his seizures. Now, neurosurgeons Scellig Stone, MD, PhD, Joseph Madsen, MD, and their colleagues in the Epilepsy Center are performing a procedure designed to monitor seizure activity in the 3-year-old’s brain.

But as the team members crowd around the table, they’re not alone. With the push of a button, a large robotic arm rotates and lowers right next to the boy’s head, helping the physicians pinpoint the precise location to drill. “This is a real game-changer,” murmurs one of the clinicians observing the surgery. “It’s going to transform the way we practice.”

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Training neurosurgeons in a rare hydrocephalus procedure, with a little help from Hollywood

ETV trainer

A 4-year-old has a progressively enlarging head and loss of developmental milestones: a clear case of hydrocephalus. He undergoes a minimally invasive endoscopic third ventriculostomy (ETV) to drain off the trapped cerebrospinal fluid.

This requires puncturing the floor of the brain’s third ventricle (fluid-filled cavity) with an endoscope — while avoiding a lethal tear in the basilar artery, which lies perilously close.

There are no good neurosurgical training models for this rare and scary operation.

“We semi-blindly poke a hole through the ventricle floor,” says Benjamin Warf, MD, director of Neonatal and Congenital Anomaly Neurosurgery at Boston Children’s Hospital. “To make the technique safer and to be able to train more people, it would be very helpful to make that hole in a way that’s less anxiety-provoking.”

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Predicting influenza outbreaks faster with a digitally-empowered wearable device

Influenza viruses. Outbreaks can be predicted using digital health tools like Thermia.The Thermia online health educational tool, developed at Boston Children’s Hospital, has enabled one-month-faster prediction of seasonal influenza outbreaks in China, via its digital integration with a commercially-available wearable thermometer. The findings appear in a new study published in the American Journal of Public Health.

 “The fact that we were able to predict influenza outbreaks faster than China’s national surveillance programs really shows the capacity for everyday, wearable digital health devices to track the spread of disease at the population level,” says the study’s lead author Yulin Hswen, who is a research fellow in Boston Children’s Computational Epidemiology Group and a doctoral candidate at the Harvard T. H. Chan School of Public Health.

China has 620 million mobile internet users who can theoretically access the standalone Thermia application from any computer, smartphone or even the Amazon Alexa assistant.

Although the Boston Children’s team has previously demonstrated that social media can be used to track disease, this is the first time they’ve shown that outbreaks can be predicted through an integrated wearable device and online tool.

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Preparing patients and families to manage ventricular assist devices

Beth Hawkins ventricular assist devices

Children in severe heart failure sometimes have a ventricular assist device (VAD) implanted in their chest. VADs are electrically-powered heart pumps that can tide children over while they wait for a heart transplant. They can also be implanted long term if a child is ineligible for transplant, or simply buy children time to recover their own heart function.

Because problems with VADs can be life-threatening, families need extensive training in managing the device and its external controller at home. Nurse practitioner Beth Hawkins RN, MSN, FNP-C, and her colleagues in the Boston Children’s VAD Program begin the training at the child’s hospital bedside while they are still in the cardiac ICU. But despite lectures, demos and practice opportunities, the prospect of maintaining a VAD remains terrifying for many parents and children.

“A lot of families feel their child is attached to a ticking time bomb that could go off at any time,” says Hawkins. “Many say taking a child home on a VAD feels like having a newborn baby again.”

Hawkins realized that families needed more support.

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GALLERY: Custom-built ‘trainers’ help clinicians master procedures

medical mannequins manikins trainers medical simulation
Andrew Hosmer (left) and Noah Schulz at the bench, building parts for medical trainers.

Walking into the SIMPeds Engineering Studio, a few blocks from Boston Children’s Hospital, the first thing you notice is body parts — high-fidelity replicas of human anatomy in various sizes. Some are in a glass display case, while others are laid out in various states of assembly, from a lone finger to the complete abdominal cavity of a newborn, packed with diminutive organs. Six newborn-sized, hollow duodenums, cast in rubber over a plastic mold, hang ready near a workbench.

These aren’t your usual medical mannequins.

In the adjoining InventorSpace, three 3D printers stand ready to fabricate additional custom parts. Some will be used by surgeons to rehearse an upcoming complex operation. Others are used for general training and preparedness purposes.

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Can virtual reality headsets save vision in people with lazy eye?

Luminopia amblyopia virtual reality
IDHA’s Matt Murphy tries out Luminopia’s VR headset with Dean Travers (photo: Greb Weintraub)

Three to five percent of the population has amblyopia, a.k.a. lazy eye, in which a healthy eye never “learns” to see because isn’t used. This usually happens because of a focusing problem or subtle misalignment of that eye. The brain learns to ignore input from that eye, and unless this is noticed early, it weakens and can slowly go blind.

“When I can diagnose amblyopia early enough, I can treat it with an eye patch or eye drops to block the ‘good’ eye,” says David Hunter, MD, PhD, chief of ophthalmology at Boston Children’s Hospital. “This gives the eye with amblyopia time to catch up.”

Unfortunately, eye patching doesn’t work well at older ages, and kids hate the socially stigmatizing patches, which often need to be worn for more than a year. As Dean Travers, cofounder of Luminopia, put it at Boston Children’s Hospital’s Innovators’ Showcase last week, “Being a pirate isn’t cool for very long.”

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2017 Innovators’ Showcase spotlights healthcare decision support

2017 Innovator's Showcase Boston Children's Hospital

Healthcare innovations will be on display next week — April 12 — at Boston Children’s Hospital’s Innovation & Digital Health Accelerator’s annual showcase. The event, from 3:30 to 5:30 p.m., will be kicked off by a discussion on clinical decision support with Doug Perrin, a bioengineer/computer scientist in Cardiac Surgery at Boston Children’s and Garry Steil, who is developing a glucose control technology for diabetes patients at the hospital.

Exhibits, demos and mingling will take place in the Patient Entertainment Center off the main hospital lobby (300 Longwood Avenue, Boston).

Among the roughly 20 apps, ventures and technologies on display:

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Developing a startup: bringing your healthcare innovation to market

a digital health startup

Sixth and last in an on-going series of Innovator’s Roadmap posts from Boston Children’s Hospital’s Innovation & Digital Health Accelerator (IDHA). Matt Murphy is Innovation Lead at IDHA.

We recently provided guidelines for selecting a platform and developing a Minimal Viable Product to take your digital health innovation beyond the prototype stage and create meaningful iterations. Once a Minimum Viable Product has been developed, numerous commercialization pathways are available, such as licensing an innovation to an existing company. But for many innovators, the best path may involve forming a startup company.

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7 digital health tips: Selecting a platform and developing a minimal viable product

digital health

Fifth in an ongoing series of Innovator’s Roadmap posts from Boston Children’s Hospital’s Innovation & Digital Health Accelerator (IDHA). Matt Murphy is Innovation Lead at IDHA.

We recently provided guidelines for developing prototypes of digital health products incorporating user-centered design and feedback from multiple sources. Let’s assume you’ve gone through multiple cycles of design updates, informed by your project goals and requirements, regulatory considerations and your long-term business or clinical strategy. Now, it’s time to select a technology platform and begin developing a fully functioning prototype of your innovation — your minimum viable product (MVP).

Below are some technical and tactical considerations to ensure your innovation’s long-term success and sustainability.

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A guide to market sizing for healthcare innovators

market sizing healthcare innovation

Second in a series of Innovator’s Roadmap posts from Boston Children’s Hospital’s Innovation & Digital Health Accelerator (IDHA). Matt Murphy is Innovation Lead at IDHA.

We recently published some helpful tips on how to create a business model that accelerates and operationalizes a healthcare innovation. But a business model — and the unique value proposition you’ll offer to your users or customers — cannot exist on its own. It must serve a specific market or population.

Who are your users? And how many potential users would your product serve? Market sizing will enable you to answer these questions and others as you determine the financial opportunity and economic sustainability of your innovation.

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