Monday, November 1, 2004

Med Tech

Biomed Rounds: CIMIT wages revolution on pair of medical fronts

By Dyke Hendrickson

CIMIT is going to war.

Actually, the Center for Integration of Medicine and Innovative Technology has been working closely with the U.S. Department of Defense for a half-dozen years.

But organization leaders say they are accelerating efforts to bring medical innovation to the battlefield in Iraq and venues touched by terrorism.

"Our funding is allocated through the Department of Defense," said Dr. John Parrish, director of the Cambridge-based organization, who spoke at the group's recent annual meeting, "and the DoD is responsible both for the health of our soldiers and military dependents.

"The threat of terrorism blurs the distinction between civilian and military needs for new technology. CIMIT can be part of creating innovations that improve diagnosis, treatment and, ultimately, patient outcome."

Its mission is to improve patient care by facilitating collaboration of scientists, engineers and clinicians to develop innovative technology, emphasizing minimally invasive diagnosis and therapy.

CIMIT receives $10 to $12 million annually from the DoD.

The organization employs only 10, but it calls on the expertise of scores of brilliant physicians, researchers and engineers to get things done even as they hold full-time positions in local institutions.

Parrish, who founded the organization eight years ago, is himself is an example of this industrial-strength moonlighting.

His multi-faceted day job is as chair of the department of dermatology at Harvard Medical School, chief of the dermatology service at Massachusetts General Hospital, and professor of health science and technology at MIT.

In addition, he conducts and directs research in photobiology, biological effects of lasers and cutaneous biology.

CIMIT focuses on a verity that is familiar to everyone from learned doctor to frightened patient: the health care system in the United States is broken.

So CIMIT researchers act on an ad hoc basis to provide solutions to what they would consider solvable problems. Some of its most recent undertakings are focused on military concerns.

One current project is developing miniature personalized sensors and monitors than can be used to evaluate fallen soldiers.

And it is pursuing technology to develop improved replacement prosthetics for arms and legs, a need that has increased since the start of the Iraq war.

Its researchers are also working on detector technology to screen the environment for dangerous biological agents.

CIMIT researchers say that most of their projects will serve civilian needs as well as those of the military.

"We are concerned about bioterrorism in the war theater," said Dr. Michael Callahan, a CIMIT physician and researcher with ties to Boston University. "But more use will come in civilian medical centers.

"We've seen how fast airborne disease can spread, and most casualties are in populated urban centers."

One of the organization's most successful projects has been the Operating Room of the Future.

Developed in concert with Massachusetts General Hospital, this project has enabled managers to bring numerous reforms to the operating room.

Advancements include getting wires off the floor, integrating sensors and monitoring systems, implementing touch-screen monitors and introducing bar coding to facilitate the use of hardware and drug-delivery systems.

None of these technologies is revolutionary. The achievement is to get the appropriate parties to sign off on the project and actually implement the technology.

In the case of the operating room, the CIMIT team has risen above the barriers and deployed the technology at Mass General.

"Technology in operating rooms is often from the '50s, '60s or '70s," Parrish said. "But to actually make the changes is difficult.

"Bringing change to medicine is a frustrating task that overwhelms some people. But we recruit team members who can collaborate, cooperate and overcome barriers in rapid time."

Parrish said CIMIT will now be looking to "enlist a critical mass of the best and the brightest" from the Department of Defense, Department of State and academic institutions to continue to develop tools and implement them in the field.