Cardiologist Dr. Brian Courtney earned a degree in engineering before attending medical school. He is currently also the director of the Medventions program at Sunnybrook. (Photograph by Kevin Van Paassen)
Last fall, a small group of scientists, clinicians and engineers – complete strangers to one another – spent four months together at Sunnybrook, all to solve a pressing medical problem. First they watched cardiologists perform heart procedures and talked to nurses, interventionists and technicians about the challenges they face in their work. Then they headed to a room down the hall to brainstorm.
The team – Ramtin Ardeshiri, Lindsey Di Bartolomeo, Ryan Tennant and Dr. Wael Abuzeid – wanted to address a conundrum that has long plagued cardiologists: how to better image and fix blocked blood vessels. If they could collectively devise a solution to make these life-saving procedures safer and more effective, it would result in improved patient outcomes and perhaps even save hospitals money.
The hard work paid off. Not only did the team build a prototype for a device that can get around hard blockages in blood vessels, they are now in the process of obtaining a patent.
These aspiring medical-technology (medtech) professionals were the first group to take part in the new hospital-based education program called Medventions. Launched by the Schulich Heart Program at Sunnybrook, Medventions gives multidisciplinary teams – undergraduate and graduate student interns as well as clinical fellows – the ability to work closely with expert academic and industry advisors who teach them how to create and commercialize innovative life-changing technology that directly answers clinical needs.
Sunnybrook has long been at the forefront of medical innovation and revolutionizing health care. Yet, according to Dr. Brian Courtney, director of Medventions, during this past decade – as health-care funding has been increasingly challenged – more emphasis has been placed on building Canada’s medtech industry from within the hospital’s own walls.
“We have great research in Canada,” says Dr. Courtney, also a cardiologist at Sunnybrook who earned his engineering degree before attending medical school. “We have a lot of people who are very knowledgeable and are world leaders on the scientific front. We have busy physicians who do high procedural volumes and fairly complex cases. And yet, when we go and use devices, they’re often sourced from elsewhere, not from [Canada]. Because a good chunk of our future depends on health-care technology, we have to participate more actively in developing and bringing new technologies to the market.”
From tongue depressors to hip implants, Canada has long depended on using medical devices from other places. According to Statistics Canada, in 2016 Canada imported $8.6-billion in medical devices while exporting $3.1-billion – a trade gap of $5.5-billion.
Developing more medtech innovations in our own backyard, however, could mean turning Canada into a world market leader in a rapidly growing and lucrative sector, expected to reach an estimated $342.9-billion (U.S.) globally by 2021, according to industry research data.
Encouraging an entrepreneurial culture at Sunnybrook to become a research and commercialization hub in Canada makes sense. Not only does Sunnybrook serve a large patient population, it also offers access to preclinical and clinical evaluation infrastructure – outstanding scientists, wellequipped labs, medical experts, financial support, patient participants, information systems and regulatory pathways.
On the top floor at Sunnybrook, there’s even a laboratory for developing medical devices and a machine shop where researchers can build prototypes in-house.
This vision has attracted donors who share Sunnybrook’s ambition to accelerate discovery and commercialization. Their support covers stipends for interns, prototype and equipment costs, networking and educational activities.
“At Sunnybrook, we are working to change the Canadian hospital environment with our vision of ‘inventing the future of health care.’ We need to move toward a culture with a stronger focus on how we can improve the patient experience and outcomes while making more effective use of finite health-care resources through innovation,” explains Graham Wright, research director of the Schulich Heart Research Program.
As a result of the technologies that have been developed at Sunnybrook – ranging from substances that soften plaque buildup in arteries to a worldfirst helmet-like device that uses focused ultrasound to non-invasively treat areas of the brain that were previously unreachable – more patients could eventually benefit from these kinds of targeted, less invasive treatments.
Dr. Courtney’s own research has led to the creation of an ultrasound catheter that takes pictures inside blood vessels and heart chambers – a device now approved in Canada and the U.S.
“What do patients want? They want minimal impact on their lives, ultimately. They want to get out of the hospital as fast as possible and they want to get better,” says Dr. Courtney. “So, would you prefer an open heart surgery or would you prefer a thin wire snaked up through your vessel, so you get out the next day, as opposed to seven or eight days later?”
Inventors in training
Medventions is taking medical innovation even further by developing not just the technology, but also addressing Canada’s skills gap by providing the necessary training – a boot camp for inventors. After all, new technologies can’t reach the patient’s bedside unless there are trained inventors with the skills to bring them to market.
Immersive training is key. Because the program has medtech engineers and students with other skillsets working closely with doctors, nurses and technicians, they’re able to get a true sense of the challenges medical professionals face.
For instance, Medventions team members can see with their own eyes the challenges playing out during actual procedures instead of simply visiting the hospital, sitting down with a cardiologist and asking, “What are your challenges?”
“Without that engagement, without that kind of shoulder-to- shoulder way of looking at the problems, discussing and going back and forth, it’s really hard to get to the core of the trouble,” says Wright.
The program isn’t prescriptive either. While team members are given some general suggestions, guidelines and a research area – whether it is in musculoskeletal, orthopaedics, vascular surgery or an area of cardiology – it’s ultimately up to them to decide what to focus their problem-solving skills on.
“We don’t want the Medventions team to come in and say to them, ‘This is what you’re going to work on. Here’s the project and just implement it,’” says Dr. Courtney. “We want them to identify the need and a number of solutions.”
Having students from different professions looking at problems is a boon for the doctors as well.
By working with the Medventions team, health-care professionals, who are typically immersed in their day-to-day work, become more familiar with the innovation and commercialization process. They also begin to see their problem areas through a different lens – challenges that can be solved.
Ultimately, building Canada’s medtech industry takes time. Developing an innovative new medical device or technology and bringing it to market – whether it’s a new catheter, stent, balloon, pacemaker, heart valve, hip implant or a piece of ultrasound equipment – requires patience and determination.
The eureka moment is just the beginning, but the Medventions program prepares innovators for the reality.
“It’s a marathon, not a sprint,” notes Wright. “Everybody understands that it takes time to make this all work. You can’t just come in and have an hour’s interview and come out with an idea. It’s something that takes years overall.”