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DE GRUYTER Current Directio ns in Biom ed ical Engine ering 2020;6 (3): 20203154 Holger Fritzsche*, Axel Boese, Michael Friebe How do we need to adapt Biomedical Engineering Education for the Health 4.0 challenges? Proposal for novel HealthTechnology teaching focused on applied Innovation Generation Abstract: Novel challenges and developments require 1. Introduction adaptations on skill set, content, and associated education. A biomedical engineer will require a broad range of skills — Modern Medicine is evolving fast. But the education lacks which to a large extent are currently not taught — in the behind the new and needed developments. The following coming years to meet the development needs of future needs should be included in training innovation oriented healthcare: intensive interdisciplinary team work, advanced biomedical engineers: communication skills, team management and coaching (1) Since technology is the driving force to improve diagnosis capabilities, advanced project management, learn how to and therapy there is also a growing need for professionals learn, visionary and forward looking thinking, understanding that specialize in bridging the gap between traditional and of health economics, entrepreneurship and leadership. But a new technology driven medicine. above all empathy towards the clinical user and patients is (2) This needs to be combined with effective tasks needed as well as a basic understanding of the current and management within a customer focused and economic future clinical workflows that can globally vary. An context. innovation process for a healthcare related product or service (3) Innovation generation and subsequent professional will likely only create value through the consideration and translation from bench to bedside should be introduced at implementation of several of these points. Even though German universities. While basic research is of course techniques for the development of innovation and enhancing needed, applied - and possibly - disruptive development creativity in individuals are widely discussed, there are focusing on improving treatment quality and patient relatively few reports on the practice of mainstreaming experience, while reducing delivery costs significantly creativity in an organizational setting. We report on the setup will become more and more important. of our Graduate School “Technology Innovation in Therapy The current medical technology engineering courses are and Imaging (T²I²)” that has implemented a structured post designed to impart knowledge from the natural sciences in the graduate program and focuses on interdisciplinary and technical context. Innovation, creation and implementation, application-oriented innovation generation education. The including some economic understanding and entrepreneurial educational process starts with the observation and training are rarely part of the curriculum, nor are identification of clinical needs and an in-depth understanding interdisciplinary or application focused approaches within a of the problem and subsequently covers all steps necessary to clinical setting. Structured innovation generation, translational transfer prototypes into viable solutions and further into concepts understanding local and regional needs, as well as implementing valuable products. knowledge of manufacturing and management processes are likely as important as technological depth for successful Keywords: Biomedical engineering education, product and service implementation. Innovation generation, clinical translation, Biodesign, The important cooperation between clinical users, engineers, Healthcare challenges, 21st Century Skills, economists, and politicians is becoming increasingly difficult due to the fragmented value chains but the core of an https://doi.org/10.1515/cdbme-2020-3154 innovation process solving unmet clinical needs and creating valuable products and services. ______ *Corresponding author: Holger Fritzsche: Otto-von-Guericke- Universität, Leipziger Str. 44, Magdeburg, Germany, e-mail: email@example.com Axel Boese, Michael Friebe: Otto-von-Guericke-Universität, Leipziger Str. 44, Magdeburg, Germany Open Access. © 2020 Holger Fritzsche et al., published by De Gruyter. This work is licensed under the Creative Commons Attribution 4.0 License. Challenges for Bioengineering Education — 2 and therapies. As personalized medicine is practiced more 2. Challenges and requirements widely, a number of challenges arise. The current approaches for Future Medical to intellectual property rights, reimbursement policies, patient privacy and confidentiality as well as regulatory oversight will Technologies have to be redefined and restructured to accommodate the changes personalized medicine will bring to healthcare. [3, 6] European healthcare technologies are in worldwide demand Genetic data obtained from next-generation sequencing and a very successful export. To keep technological leadership requires computer-intensive data processing and adequate future healthcare related trends need to be understood and tools will be required to accelerate the adoption of considered as important input for the development of personalized medicine to further fields of medicine, which meaningful and affordable products. requires the interdisciplinary cooperation of experts from Understanding future needs means dealing with current specific fields of research, such as medicine, clinical oncology, scientific topics, market developments and needs, as well as biology, and artificial intelligence. upcoming social changes. For this, we differentiate between Digitalization disruptive trends and reactive trends. Disruption comes and The digital transformation stands for a global change of can be beneficial in reshaping healthcare. Reactive trends are economy and society, caused by the consistent penetration of emerging as a result of the disruptive trends and can be acted daily life with information and communication technologies. upon . Compared to the classical contents of engineering studies, competencies in a cross-sectional area are added that can be Challenge Need described as digital technical content. In 2025, up to 175 ZB of digital data will be produced daily (Healthcare is one out of four main industries beside Production, Media and Entertainment and Financial Services). 90 percent of the world's total data has been generated over the past two years.  These big data and the explosion of digital data will lead to infrastructure and application changes. In addition to IT- related content, this area also includes more extensive aspects such as the understanding of new, digitally induced business models, data security and protection, and social implications (e.g. technology assessment), this offers opportunities for a 1. Disruptive trends as future challenge resulting in reactive remote health system, but places high demands on data trends- as need for educational focus [1 - 4] management and security. [3, 7] Patient empowerment Aging society Focuses primarily on people who receive health care services In the next 20 years, 2040, the German population of ages of - people with physical and mental health needs. Fast 65-79 and 80+ is expected to have an increase up to 24% and communication, better education and the involvement of the 79%, respectively. Up to 30% of the population would be wider public (citizens) in local planning and priority setting retired from the working life . Especially, the increase of are important to get health across all policies and move away 80+ agers requires more healthcare resources which can be from societies that actively market unhealthy lifestyles . supported by daily life’s diagnostic tools and devices. Early Networks and information systems help patients to make their detection of health problems will be the most relevant impact decisions - making the healthcare sector more transparent from factor of successful treatment. This will affect the entire care diagnosis to therapy. There is clearly a significant overlap with sector. There is a need for smart diagnostic devices and tools health needs and services: which are connected to a whole care network with local care - Better understanding their condition. services, hospitals, medical offices and pharmacies. - Participating in making decisions about their care. Personalization - Being supported to better self-manage their health Personalized medicine, uses diagnostic testing for selecting and treatment. appropriate and optimal therapies based on the context of a - Feeling confident to ask questions and challenge patient’s genetic content or other molecular or cellular professionals and organizations. analysis. Personalized medicine may provide better diagnoses with earlier intervention and more efficient drug development Challenges for Bioengineering Education — 3 - Having the chance to join networks or groups of trend. However, there is a lot of inefficiency in healthcare, up other patients in similar circumstances. to 20 percent of healthcare expenditure could be saved Exponential technologies (OECD) without quality loss. Starting points for savings Exponential technologies describe new, mostly digital, would include less unnecessary double examinations, technologies that are experiencing exponential growth. These avoidance of unnecessary operations and a more reserved use include Sensors, 3D Printing, Virtual Reality, Drones, of antibiotics. Many treatments that are carried out in hospital Artificial Intelligence, Blockchain etc... These developments today could also be carried out on an outpatient basis. are based on Moore's Law, which states, exponential growth 2.1 Face these needs towards based on the example of integrated circuits. This development postgraduate education is the basis for the digital revolution we are currently experiencing. Every industry and every business will be We have to react adequately to the challenges and to build an affected by the consequences of this digital revolution. interdisciplinary exchange in education - to enable the creation Exponential technologies offer innovative companies great of creative and innovative clinic engineers who are not only potential in terms of cost and time savings. interdisciplinary but interprofessional. There is a need to impart an exponential mindset to all Disruptive trends will come with political, economic and innovative and future-oriented executives and decision- social changes. But they also provide great opportunities to makers in order to jointly define extraordinary goals. serve the sectors with new innovative ideas and establish not Exponential technologies could lead to a dramatic change in only new tools and equipment, but also services and business the way that healthcare is delivered. Currently almost all of the models. The trends not only generate costs but also have a national healthcare systems treat sick patients rather than to significant impact on cost savings - with better process design prevent people from becoming patients. (e.g. through digitalization). This requires a basic Climate changes understanding of processes, decisions and impacts and More clearly than ever before, the United Nations Climate increased need for innovative solutions with global focus. Council (UN) warned in its World Climate Report (2019) of Healthcare 4.0 is heading for a reduction of inpatient the consequences of the greenhouse effect. The controversy treatments and increased outsourcing of specialized clinical over climate change will also affect the healthcare system in services. With higher quality and efficiency and a vertical future. The effects of anthropogenic climate change are integration between providers who offering various services, already taking root in nature and society. Existing climate from preventive models to acute- care and after- care projections prove a future strengthening of already solutions. recognizable climate impacts. The Biomedical Engineering education as we know them Primary level of affection: The Human. today will need to change to cope with these issues or adapt to Increasing temperatures can lead to a change in the spread and become driving forces of innovation. Engineering students and activity of pathogens, particularly diseases transmitted by ticks early stage researchers need collaborative and problem- and mosquitoes. Food-borne and water-mediated infections solving skills to perform in teams of high diversity. With the can increase the incidence of diarrhea. Heat waves put an aim of translational research - to create new therapies, medical enormous strain on the organism of old and ill people as well procedures, or diagnostics to act on the disruptive trends and as children. Also the increase of allergies, e. g. through new handle the reactive trends. immigrant plant species is possible . Secondary level of affection: The Healthcare sector. The markets are closely linked to production, storage and 3. The Graduate Program T²I² delivery. Here, new low-emission and environmentally friendly approaches are sought. Based on this, adaptation The T²I² intends to foster the coming generation of health strategies and measures can be developed and implemented. engineers to efficiently develop medical technology and These increase the resilience of the environment and society ensure that this technology is a marketable resource. A to current and future climate impacts. Increasing damage and structured education program with an interdisciplinary costs of climate change are reduced . approach in the disciplines of Medicine, Technology and Costs Economics is provided. Currently 13 international Ph.D. Germany affords one of the most expensive health systems in students (from Egypt, Mexico, Nepal, India, Iran, Taiwan and the world. Last year, for the first time, more than one billion Germany) are in that structured doctoral program for euros were spent daily (376 billion in 2019) . Ascending innovation generation, technology transfer and business Challenges for Bioengineering Education — 4 implementation of medical technologies. The participants 4. Discussion and Potential have to successfully attend at least 300 hours of lecture or Clinical Impact lecture equivalent study over a 36- to 48-month period. They work on topics and projects in the main area of medical imaging, minimally invasive therapy, image guided surgeries The aim of the graduate school is to bridge the gap between and catheter technologies. Soft skill development is a core medicine and technology for products and services that have a challenge and objective. Close contact to clinical users, direct clearly identified need. Students need to work more intimately involvement of industry and application oriented research with the medical users to gain a better understanding of their projects, an international exchange and regular further training needs. This result in identifying much more useful equipment are core components. The graduate school, while engineering for the healthcare professionals. T²I² will also focus on the oriented, is located and placed within the medical faculty of innovative and entrepreneurial aspect of healthcare and teach the Otto-von-Guericke-University in Magdeburg in order to students to make those innovations marketable. They will act create a close clinical relationship. The students are supervised local and think global including specific needs through jointly by a clinical and a technical professor. Additionally, a disruptive trends und healthcare 4.0. strong education focus is on the 21-century skills to approach New device and services should help patients and doctors, complex challenges, teaching competencies like critical create value and market share or at least return investment and thinking, creativity, communication and collaboration. should lower the overall cost of healthcare. Bioengineers must Furthermore, for individual and subject-specific education, an recognize these sometimes conflicting drivers for an external stay of at least 6 weeks is required at a partner innovation process. In this process, the open minded mind-set university with a similar research focus. For scientific literacy of the learners and especially the teachers play a crucial role. an early publication culture is cultivated. Then innovation can significantly improve health outcomes: Better procedures by – reduced procedure time, improved Table 1: Core competencies for the Ph.D. students in the procedure outcomes, reduced procedure/ device costs and Graduate School Technology Innovations in Therapy and Imaging fewer the people in the procedure room or efficient use of facilities, equipment and man power. Journal Publications (>3) Less hospitalization by – fast recovery, reduced re- hospitalization and a shift of patient care from clinic to home. Scientific literacy Improved patient satisfaction – back to daily life, homebased (Knowledge, Action, Conference Publications (>3) Review) recovery and improved health. Subject-Specific Further Training (>300 h) Author Statement Research funding: The author state no funding involved. OR- Observations Conflict of interest: Authors state no conflict of interest. Clinical literacy (Understanding Clinical Medical Co-Supervision Processes) References  Ducher, A., Mühle, U. (2019) The role of EIT Health in Training the European Health Interdisciplinary Groups Workforce. Health Management.org - The Journal, Volume 19, Issue 6. ISSN 1377-7629  Friebe, M. (2017) Exponential Technologies + Reverse Innovation = Solution for Future Healthcare Issues? What Does It Mean for University Education and Entrepreneurial Start-up Projects Opportunities? Open Journal of Business and Management  Friebe, M. (2020) Healthcare in need of innovation: exponential technology and biomedical Entrepreneurship/ entrepreneurship as solution providers. Proc. SPIE 113150T (16 March 2020); Business Modelling Invention Disclosures/ Patents https://doi.org/10.1117/12.2556776  Traub J., Ostler D., Feussner H., Friebe M. (2019) Globale Innovationen in der (Costs, financing, market) Medizintechnik – Interdisziplinäre Ausbildung an der Universität. In: Internationalisierung im Gesundheitswesen. Springer Gabler, Wiesbaden Industry driven projects  Bevölkerung Deutschlands bis 2060, Ergebnisse der 14. Koordinierten Bevölkerungsvorausberechnung (2019). Statistisches Bundesamt (Destatis)  Lu, Y., Goldstein, D. "Personalized Medicine 101: The Science". Personalized Medicine Research proposals (>3) Coalition. Retrieved 2014.  Prognose zum Volumen der jährlich generierten digitalen Datenmenge weltweit in den Management Skills Jahren 2018 und 2025 (2018). Statistisches Bundesamt (Destatis)  Smith M, Saunders R, Stuckhardt L, et al., editors. Best Care at Lower Cost: The Path to (communication, Master/ Bachelor Supervision Continuously Learning Health Care in America. Washington (DC): National Academies leadership, organization) Press (US); 2013  Baylis M. (2017). Potential impact of climate change on emerging vector-borne and other Conference / Summer School infections in the UK. Environmental health: a global access science source, 16 (Suppl 1), organization  Gesundheitsausgaben (2019). Statistisches Bundesamt (Destatis)
Current Directions in Biomedical Engineering – de Gruyter
Published: Sep 1, 2020
Keywords: Biomedical engineering education; Innovation generation; clinical translation; Biodesign; Healthcare challenges; 21st Century Skills
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