World First: 3D-Printed Tibia Successfully Inserted Into Man’s Leg During Surgery

First published September 10, 2017

A team of Australian surgeons have successfully implanted a 3D-printed tibia into a 27-year-old man’s leg.

Photo courtesy of The Age.

The Princess Alexandra Hospital in Brisbane, Australia, collaborated with the Queensland University of Technology with the design of the original polymer and “scaffold,” and with the printing technology in Singapore.*

The young father had suffered a life-threatening osteomyelitis, and faced above-knee amputation as the alternative.

It’s going to be fascinating following the journey of this man’s recovery, and hearing more and more stories of others successfully receiving 3D-printed bone and tissue. Both metropolitan and regional locations will soon be able to have these resources on hand (a 3D-printed tibia is pictured from Mackay Base Hospital’s 3D-printer here).

For more information, head to The Age and the ABC News.

*We’d love to credit the site in Singapore where the printing for this surgery took place!

Breaking The Boundaries You’ve Set Yourself: Thoughts and Events To Inspire Your Tech Journey

First published May 28, 2017

How do you learn about tech as an outsider?

For awhile, before The Medical Startup became an idea, I was toying with creating something in tech.

I was a full-time doctor in a Melbourne hospital, spending all my spare time studying for fellowship.

When you’re at that stage in your career, you’re usually facing another four to six years of focusing on fellowship full-time.

I was surrounded by peers who were working towards the same goal.

It was all we knew at that time. We’d forgotten what life was like pre-training, it was deemed a “waste” if you paused for breath, and it took a long, long time to learn to breathe above water again.

So it seemed impossible.

But when you start to act towards those “strange” goals, the world opens up beyond anything you’d imagine. 

Attending events and online webinars helped tremendously. I was surrounded by others who were teaching themselves, too.

I started learning how to adapt to new environments, even more new than running a Code Blue at 3am.

I started learning the lingo of life outside of medicine.

And the love of learning I have for medicine sustained me through this journey, too.

So here’s a thought for the next time you’re thinking, “I can’t do this” or “It’s impossible, I have no background in this area.”

Think laterally about what you’re telling yourself.

Is it really impossible?

 You’re not just a doctor.

You’re a woman in tech.

You’re not just a nurse.

You’re a father of three.

You’re not just a clinician who sees patients one by one at scheduled appointments at your clinic.

You’re facilitating their wellness beyond their current condition. How they are at home, at work, at the shops and their daily lives.

You have to stop thinking of yourself as a single job description. 

Otherwise, when you’re stuck, how will you remember who you are again?

Think about those who have the courage to uproot countries and settle in a new culture, starting from scratch with their careers again. Often, their degrees aren’t recognised at their new home.

Or think of those who graduate from one degree, then use their determination and self-belief (even when it’s down) to apply to study post-graduate medicine or another degree.

Don’t underestimate yourself.

We’re all learning, after all.

And that shiny, suited person speaking up on the big stage? They had to start somewhere, too. 

This is literally just a random post after reflecting on recent events and conversations. You have to normalise curiosity and your hunger for knowledge. 

Thinking about it, there are a ton of events coming up around the world that may help you along your journey; I’ll list them below. Perhaps you’ll find some of them useful, too.

A couple are med tech, but most are actually more general and will help you learn the vibe and get comfortable in the tech and entrepreneurship worlds, too.

Who knows what new friends you’ll make, and what skills and knowledge you’ll bring back to your usual lives? You’ll almost certainly realise that you already know more about tech than you thought you did.

Be inspired.

Let me know in the Comments or by email if you have been or end up going to any, and how you enjoyed it/what you took away from it. I’m also speaking at an AMA leadership event tomorrow, aimed at junior doctors but hopefully useful for others, too.

Below:

• “The Sunrise Conference” by Blackbird Ventures in Sydney. One of Australia’s most renowned tech venture capital firms. (Last year it was streamed online; here are a couple of tips we took from some of the talks.)

• The Melbourne Accelerator Program Launch Party 2017. Last year, two Melbourne digital health startups founded by doctors were part of the program. Nebula Health and CNSDose have both benefited hugely from MAP, with Nebula now partnering with hospitals and surgeons, and CNSDose breaking ground as part of Texas Medical Center’s Innovation program.

• General Assembly, a tech education company running coding bootcamps, one-day workshops and even two-hour events across their centres in Australia, Asia, the US and UK. Visit generalassemb.ly to find your nearest centre and see what’s available. I’ve found their events very helpful.

• HIC, Australia’s premier health informatics (digital health) conference, run by HISA, the Health Informatics Society of Australia. It’ll be in Brisbane in August, and I’ll be presenting as part of the UX (User Experience) workshop, along with others interested in digital health. I really recommend joining HISA, HiNZ, HIMSS (including their APAC branch), COACH (Canada) or other organisations as a way to get access to valuable resources, networks and skills for eHealth.

• COACH, Canada’s annual health informatics event early June.

• HIMSS Asia-Pacific Summit, in Singapore in September. (As a member of HiNZ, you also get full automatic membership to HIMSS Asia-Pacific.)

• HiNZ, which we wrote about last year; it’ll be in Rotorua this year.

• The Global Ideas events in Melbourne, inspiring global health innovators with skills including tech and human-centred design thinking. (Read about founder Dr Lloyd Nash’s journey here.)

• Vogue Codes, an Australian event running in Sydney and Melbourne in August aiming to inspire more women to take up careers in STEM. Speakers include the founders of ClassPass and Shoes of Prey as well as female members of Australia’s startup and tech communities. Being a woman in STEM who loves fashion and the arts, (even if I don’t look the part!), this event really speaks to me, knowing that although society places us into simplistic career boxes (“Medicine!” “Science!” “Engineer!” “Designer!”), we’re much more than just a “science person” or “arty person” 100% of the time.

• Vivid Sydney’s Ideas program, coming up this week.

• Girl Geek Academy, an Australian organisation aiming to educate 1 million girls and women in tech by 2025. It also has events in the US.

Singapore Stanford Biodesign Paid Fellowship Open for Applications

First published April 17, 2017

If you’ve ever wanted to experience medical innovation in Asia, this opportunity is for you.

The Singapore Stanford Biodesign Fellowship gives clinicians, engineers, developers, designers, and other aspiring healthcare innovators the opportunity to be immersed in a healthcare innovation project for a year. A unique program that unites diverse career pathways, the SSB Fellowship comprises five months at Stanford in America; immersion and project rollout in a Singaporean hospital; and a three-week clinical immersion in another Asian hospital outside of Singapore. Similar to the original Stanford Biodesign Fellowship, a stipend is included for the program’s duration.

Members of the Singapore-Stanford Biodesign Fellowship team. Pic courtesy of SSB.

The clinical theme for the year is selected by SSB’s Board members, challenging participants to develop valuable experience in areas outside their usual training. New ideas are stimulated when an orthopaedic trainee is given an obstetrics focus for the program; similarly, we believe strongly in thinking outside the box to generate better medical solutions.

Some of the program’s previous fellows have gone on to commercialise their projects and been listed on Forbes’ “30 under 30.” There is an option to extend the program for a further period of time after the initial year.

Entries close 2nd May 2017. Preference is given to Singaporean citizens and permanent residents; however, it’s worth a shot if you’re passionate about healthcare and medical technology in Asia. For more information, please visit ssbiodesign.org.

To hear about other programs and opportunities, sign up for our mailing list. 

Job Listing: Australian Medical Startup Looking For Doctor

First published February 20, 2017

Surgical doctor Chandrashan Perera’s startup Nebula has recently been funded after its success in the Melbourne Accelerator Program last year. They’re now looking for another doctor to join their team in a paid non-clinical role.

Nebula’s tech solutions aim to help medicine by improving patient engagement with doctors; improving patients’ understanding of their conditions, and helping busy doctors spend more time looking after patients while collecting data for research.

Ideal Requirements:

• Medical background (junior doctor is suitable, preferably with a surgical interest or background)

• Amazing people skills including being able to meet with hospital directors, surgeons, insurance companies and so forth

• Ability to travel frequently throughout Australia

• Ability to present well at conferences and head up research projects, plus create medical and educational content

This is a varied role that will give you a taste of the startup life, whether you’re wanting a break from studies and fellowship training, or whether you’re deciding to leave clinical medicine fulltime in future to work on healthcare technology solutions. The skills you’d gain would be invaluable for your CV and resume, and would help build networks across the world for better patient care.

If you think you or your friend would be suitable, please contact chandra (at) nebulahealth.com.

How Can We Be Leaders Through Healthcare Technology? Day 3 of HiNZ and the New Zealand Nursing Informatics Conference

First published November 7, 2016

This week, we’ve been inspired by the many speakers who have made career leaps: from clinician  to academic; from clinician to ICT (Information and Communications Technology) specialist; and even from accountancy to the public service in healthcare. Here are some of their insights from Day 3 of HiNZ, and the concurrent New Zealand Nursing Informatics Conference:

1) Videos of nature scenes played via app, with or without music, can help reduce pain perception and level of anxiety in the perioperative period. Professor of Nursing, Margaret Hansen of the University of San Francisco,  was inspired to investigate the power of visualisation in dealing with pain, after experiencing a severe illness herself. Her feasibility study, performed as a randomised controlled trial, has shown these promising effects, and will lead to further study- perhaps even in Virtual Reality!

Prof Margaret Hansen of USF demonstrates one of the app’s Nature videos at the NZ Nursing Informatics Conference 2016. Pic: The Medical Startup

2) “We need to collaborate with our international colleagues,” said Lucy A. Westbrooke, who is the New Zealand ambassador for the International Medical Informatics Association – Nursing Informatics (IMIA – NI). From her diverse career in nursing, leading to executive and chairperson positions in New Zealand health informatics and telehealth, she described some of the various international meetings and opportunities helping to achieve this goal.

3) “You don’t design systems for the most technologically agile; it has to be for the users,” Dr Simon Kos, Chief Medical Officer of Microsoft advised. Having experienced healthcare both as a clinician and as a software engineer, Dr Kos gave insights into the future of medical education with virtual reality through Hololens. 

Dr Simon Kos, Chief Medical Officer of Microsoft at HiNZ 2016. Pic: The Medical Startup

4) Finally, NZ Ministry of Health Director General Chai Chuah posed the question: What kind of leader are you (in healthcare)? “Today’s global leaders understand and lead the art and science of disruptive change,” he said, acknowledging the combination of both art and science in medicine, technology and healthcare.

Leadership isn’t always about being the first to present an idea, or the first to use a new technology. Leadership can occur at an individual level. As an example, guiding a patient to a tech solution enabled by a District Health Board (DHB), such as A.Prof Robyn Whittaker has done with her project with Waitemata DHB. Her research findings from a messaging reminder service for behaviour change showed that patients benefited from this service. Or coordinating an entire Australian Territory’s telehealth services, as Michelle McGuirk does in the Northern Territory; or encouraging a patient to keep an app-based symptom journal.

A/Prof Robyn Whittaker, Medical Doctor and Digital Health lead at Waitemata DHB presents her Behaviour Change Messaging project findings. Pic: The Medical Startup

You can view sessions from 2016 and 2015 at HiNZ.org.nz with membership. Catch up on Day 1 and Day 2 highlights as well.

We thank HiNZ for providing media access to the conferences and opening our eyes up to these incredible experiences.  

The Virtual Ward Round Is Here: Highlights from Day 2 HiNZ, Successes and Failures in Telehealth, and the Global Telehealth conferences

First published November 2, 2016

We’ve been very inspired from the talks and positive atmosphere at HiNZ, SFT and the Global Telehealth conferences this week. New Zealand is a country that deserves a lot more credit for their innovation in medicine and global healthcare. Here are some of today’s highlights:

1) Virtual Ward Rounds and Consults help patients and clinicians alike feel supported and at ease with care. Dr Eddie Tan, nephrologist from Waikato Hospital, spoke about the “hub and spokes” model of care that Waikato Hospital and its satellite rural hospitals and clinics run. With hundreds of kilometres between sites, Dr Tan and his colleagues are on planes at least every fortnight for clinics that may last just a few hours before returning back to Waikato. This is problematic when rural patient emergencies develop; however, Telemedicine with videoconferencing to the satellite clinics has helped the Renal team conduct assessments, minus the hours and dollars spent on travel (and minus hours of patient/family stress). It has also prevented unnecessary hospital presentations, and brought critical patients to hospital sooner.

Dr Eddie Tan, kidney specialist at Waikato Hospital NZ discussing Telehealth in Renal failure. Pic: The Medical Startup

Dr Tan’s colleague, Waikato District Health Board (DHB) renal nurse Jenny presented her research paper on how palliative care decisions were made easier with telehealth’s videoconferencing capabilities. This meant that difficult and time-critical family and patient conversations could be had in the comfort of the patient’s home, without wasting precious time in the potential final days of life arranging hours or even days of transport for the same consultation.

Dialysis ward rounds also help Dr Tan assess end-stage renal patients who may deteriorate very rapidly and become fluid overloaded.

Similarly, Rehabilitation ward rounds by telemedicine has helped patients in a rehabilitation ward feel happy and secure with their care. Registered Nurse and PhD candidate Sophie Gerrits’ research has so far found that rehab patients and staff at Thames Hospital, Waikato DHB New Zealand, are happy with the consults, and the elderly patients have adapted well to the new technology. The Ward Registrar goes from bed to bed with a telecart, and the Rehabilitation Physician or Geriatrician video-calls weekly in from the tertiary hospital, in addition to their usual weekly face-to-face visit.

Staff appreciated having a second chance during the week to ask questions and raise issues that had arisen in the days since the last visit. The main issue to overcome was “patient jitters” at not knowing what to expect from a video consult and what was expected of them. This reinforces the need to counsel patients prior to a consult; that they can speak, behave and ask questions just as they would if the clinician was in the room with them.

2) Telestroke Improves Door-to-Needle Time in New Zealand

Yesterday, Dr Chris Bladin of the Victorian Telestroke Program discussed the very promising findings from the Victorian Telestroke Program research in rural hospitals, with hopes to expand to other Australian hospitals. Today, New Zealand Neurologist Dr Anna Ranta showed that since Telestroke has piloted from 3rd June in the Capital and Coast DHB, door-to-needle median time has reduced from 80 minutes down to 54. With cerebral ischaemia being a critical matter of seconds, this is a significant early finding, and along with other positive outcomes, will hopefully help push for a Telestroke rollout in other DHBs.

1,100 delegates attending HiNZ this week. HiNZ Awards Dinner at Shed10, Auckland, sponsored by Microsoft. Pic: The Medical Startup

3) The finalists for the Sysmex Award for Health Informatics at the University of Auckland have promising ideas for mobile health applications. The winner, Daniel Surkalim, was announced tonight at the HiNZ Awards dinner. By creating visually appealing, simplistic views of patient data, his project, GRID(Graphical Relational Integrated Database) will help solve the clinician bugbear of “too much data, not enough sense” that occurs in many existing EMRs (electronic medical records). The other finalists deserve commendation for their work; Frances Toohey with Dr.Doctor for clinicians and patients to track eReferrals, and Kyle Frank’s MedScript to facilitate e-prescribing solutions for patients and doctors.

4) Tele-ophthalmology in India aims to cut waiting lists for a population short of ophthalmologists. Dr Sheila John of Chennai, India has done extensive work with diabetic retinopathy and machine learning, and inspired us with her dream to help rural villages be screened for diabetic retinopathy accurately and safely without a long waiting period for an eye specialist. Dr John quotes 60 million people in India as suffering from diabetes, with nearly 20% experiencing diabetic retinopathy, a cause of blindness if left untreated.

Speakers from four different nations closing the Global Telehealth conference today; L-R: Global Telehealth co-chair Dr Kendall Ho of Canada; Dr Karen Day of NZ; Dr Laticha Walters, South Africa; and Dr Sheila John, India. Pic: The Medical Startup

With four events running this week, it’s impossible to catch all sessions at once. Watch the conference on demand, even after this week, with a Virtual Ticket, including one year’s worth of membership with HiNZand HIMSS Asia-Pacific, among other benefits. We thank HiNZ for providing media access to the conferences and truly enjoyed the experience.  

Doctors Want To Be Innovative, But They Don’t Know How

First published June 20, 2016

Since embarking on this journey, I’ve been fortunate to explore innovation in medicine and learn what makes a medical entrepreneur, by talking to people first-hand outside of hospitals and clinical environments.

From working full-time in hospitals, I know first-hand what it’s like to want to create change, but not know how to. The constraints of protocols, hierarchies, specialty college milestones, and expectations of supervisors- not to mention full-time rosters- they all exist for safety and for high-quality medical training. I value my time in that world like nothing else. It made me into the doctor and person I am today.

Yet, I had to forcibly step away in order to figure out my odd journey.

Looking up at the possibilities. Gaudi built his vision, which millions enjoy today. Credit: The Medical Startup

Medicine is a long road, signposted by those milestones I mentioned earlier. You graduate from med school. You start Internship. You score your first Resident job in the field you want to enter. You gain entry into the specialty college of your choice. You survive your first day as a Registrar. You pass your college exams. You become an Advanced Trainee. Then you’re a Fellow.

Then, one day, you finish that, and you’re finally a Consultant. (What many in the public refer to as a “specialist” or, in the case of General Practitioners, Fellows of the RACGP– fully qualified and accredited family doctors.)

It is odd if you step away.

Will people point you out for daring to be different? – Grand Canyon. Photo: The Medical Startup

It is odd if you take a break. (Okay, maternity/paternity leave, marriage, other life events, they obviously do happen.) In the recent past, not even five years ago, it may have been more acceptable to take a break for a year. But with the ferocity of job competition amongst junior and senior doctors alike in Australia, the walls are closing in on flexibility.

And now, taking a step away from training; even for just a few months; even by remaining employed but putting off an exam for a year; even if you just need a 6 month “half-gap” of a year, because you’ve not had a proper study break since you were 5 years old – even if – sorry to hear –  a tragic life event has shaken your world – it can be seen as detrimental to a person’s chance of being rehired.

And when you’re surrounded by colleagues and well-meaning friends who don’t understand, and who actually say that those who take a break, even to work on a startup, are “unambitious” or “unmotivated” – is it any wonder, then, why doctors feel isolated and stay under the radar when they come up with an idea?

And, even if a hospital or clinic is supportive (and they usually are; unfortunately, it tends to be particular influential individuals who aren’t) – you have to go a step higher, and try explain to colleges that you’re still doing valuable work in healthcare, by working on your startup- it just doesn’t fit their definition of training.

And this is why doctors find it hard to Innovate.

Leaping through the clouds- daring to dream. Photo: The Medical Startup

How can you innovate when you are feeling weighed down by all these pressures?

How can you innovate where your environment is slow to respond to change, and, despite best intentions, has trouble understanding the few (or many) employees who want to do more, but can’t articulate their feelings?

How can you innovate when you risk being penalised or even kicked out of a specialty college that you’ve worked so hard to enter?

How can the medical profession realise that a step away doesn’t equate a permanent career change, and that it is vital for the future of healthcare for motivated health professionals to gain experience building something outside of their day-to-day work environments in order to bring optimal change for their patients and colleagues? 

Entrepreneurship doesn’t suit everyone. This is not a comment on forcing everybody to become entrepreneurial. It’s about creating the supportive ecosystem for those who are motivated and capable of change, to create that good change.

We should connect our different ways of thinking, and allow ourselves to shine. Credit: The Medical Startup

Many Australian hospitals have rotations in Clinical Redesign and Innovation, or other similarly-named Medical Resident positions. A junior doctor has the opportunity, usually for 10-12 weeks (the standard duration for hospital rotations) to work on innovating within the hospital system. They are usually assigned a senior Supervisor and observe, advise, discuss, formulate, and strategise solutions and carry out these solutions during these ten weeks.

Projects are varied. They can improve the efficiency of completing discharge letters sent to the GP when patients go home. They can improve the allocations of night shift duty. They can create more structured Handover meetings at the start of each shift, so the staff finishing can “hand over” outstanding tasks and patient updates to incoming team members. These roles give junior doctors the opportunity to innovate. However, very few of these roles exist, and to be honest, I am not sure of the demand for doctors who want to rotate in these roles over Cardiology, Nephrology or other critical specialties that count towards training and clinical care. (Feel free to let me know.)

I’ve been really fortunate (and also worked hard!) to attend events where I get to meet people in the health tech space; and others who are medical entrepreneurs in non-medical fields; and I find, that non-medical people are, very graciously, applauding those of us who innovate. Those of us who choose to step away. This whole post has been stimulated by yet another Twitter comment by a non-medical entity encouraging more doctors to innovate. It’s fantastic that the non-medical community are eager to see more doctors and health professionals innovate. If they only knew how hard it was, and how much doctors risk by choosing to innovate, they might understand why there are, perhaps, fewer Australian doctors in the entrepreneurial spotlight than in other fields.

Dreaming big at Yosemite National Park. Photo: The Medical Startup

I’m going to shine this spotlight on inspiring health professionals who are doing great things with their time, to help normalise this situation, and to celebrate their wins as well as their journeys. And I challenge you, too, to be inspired, to value your time, and give your best to the world, no matter what field you’re in.

Do you agree? How can healthcare ecosystems and communities in general improve inclusion for health professionals to innovate, in and out of their workspaces? What cultural issues need to be addressed and how can they be fixed? Or do you think things are fine as they are? Feel free to comment below, or send us an email via our Contact page. 

Innovations for Aged Care and Senior Citizens at the Digital Health Show

First published April 19, 2016

The Digital Health Show Conference and Workshophad some standout projects aimed at improving the lives of the elderly and more vulnerable in our communities. Innovation for our ageing population will help integrate our society’s communities, improving wellbeing across all age groups. Here are some highlights:

1) A/Prof Valerie Gay and Dr Peter Leijdekkers of UTS showed how their community model, Le Bon Samaritain, links elderly residents in the community with “Good Samaritan” neighbours who are alerted via smartphone app if the resident is in distress, via a Red, Yellow and Green light system. Using “tech to empower communities,” this will help engage neighbours with often isolated members of the community. From our experiences working primarily with the elderly, we’ve seen many preventable hospital admissions occur during heatwaves, floods and falls, and feel that systems like these will help improve safety in our communities.

2) Philip Goebel, Physiotherapist and co-founder of Quanticare technologies, demonstrated the Footprints sensor, that attaches to a user’s walking frame and analyses gait during everyday use. The Internet of Things Innovation World Cup Winner at Barcelona, Philip created Footprints in response to the feeling that “our healthcare system is very reactive; focusing on fall detection, rather than indicator of cause.” Footprints uses an optical sensor which analyses gait via spatio-temporal gait metrics. The data generated can assist with prescribing mobility aids and falls risk management.

3) The ePAT (Pain Assessment Tool) for Dementia uses facial recognition software assess pain accurately in dementia sufferers, who often cannot verbalise their pain. Founded by Professor Jeff Hughes, former head of Pharmacy at Curtin University, he described how, by using the inbuilt cameras on smart devices, ePAT can assess facial pain cues at the point of pain onset, as well as non-facial pain cues. The benefits for dementia sufferers and their carers, will extend to more accurate pain management in hospitals and the community, and is being looked into with pre-verbal children.

4) Eureka Connection: A/Prof Helen Hasan, Information Systems specialist from the University of Wollongong, hosted a workshop discussing Eureka Connection’s vision for bringing computers and smart devices to senior citizens. Starting with the Illawarra region of New South Wales, Helen’s passion for bringing tech literacy to seniors through home visits, community centre stations and education was reflected in the videos of seniors who were awed at sending their first email, receiving their first Skype call, and joining their first Facebook community group during a seasonal flood. As the elderly are at more risk of injury and isolation, tech education to encourage connectivity and social integration helps their wellness and physical health. Giving advice on how to set up a computer or smart device; selecting the right device for their needs, making it user-friendly by, for example, enabling large text; and helping them to reload credit and find hotspots are just some of the things this ambitious project hopes to achieve.

What are your thoughts on these projects for seniors? Comment below.

The Medical Startup attended the Digital Health Show 2016 on a courtesy pass. See our other highlights from the Digital Health Show here.