When you think about health care innovation hubs, does North Central West Virginia come to mind?
For David Goldberg, the CEO of Mon Health System, an independent community health system in that region, the answer is “absolutely.” Working with Dr. Tom McClellan, a plastic surgeon affiliated with Mon Health and also the founder of Intermed Labs, a West Virginia innovation lab and startup studio, Goldberg green-lighted a partnership between the health system and the lab. The arrangement created a pathway for Mon Health clinicians and staff to pursue technological innovations that have the potential to improve patient care and benefit the local community.
Mon Health System’s proactive approach to nurturing innovation earned the organization ECRI’s 2021 Health Devices Achievement Award. The annual award highlights organizations’ innovative efforts to improve patient safety, reduce costs or otherwise facilitate better strategic management of health technology. (ECRI is currently accepting applications for the 2022 award.)
“Mon Health’s efforts show that you don’t need to be at a large academic medical center or in a major urban market to take a leadership position in innovation,” explains David Jamison, ECRI’s executive director of selection and evaluation. “ECRI is proud to recognize health systems that continuously look for ways to better serve their communities.”
Mon Health System provides advanced care in a region that is distant from major urban academic centers and that is populated with diverse communities, including remote and economically disadvantaged ones. Both Goldberg and McClellan shared the vision that fostering innovation could not only improve care for their patients but could benefit the region in other ways; and they shared the belief that the goal was attainable for a small health system.
Their shared vision led to the establishment of Intermed Labs at Mon Health. Under the arrangement, Mon Health agreed to provide Intermed Labs with space that it had available on campus, as well as some financial support, and would become a minor partner that would “stay out of the way,” as Goldberg describes it. He considers it essential to let the doctors, clinicians, engineers and students do the work of innovation without undue interference.
In exchange, individuals affiliated with Mon Health System who have innovative ideas for improving patient outcomes would gain access to Intermed’s expertise and resources to help them turn the ideas into real-world solutions. The arrangement provides these individuals a place where the can tinker with their idea. They get access to lab space, specialized equipment and a team of individuals with relevant expertise to guide them in trying to take the idea to the next level.
For Goldberg, establishing the partnership “was a no-brainer.” Benefits he cites include that the arrangement could advance patient care; it could unlock the potential of local talent (and perhaps attract and retain talent); and it could be a source of pride, business development opportunities and economic benefit for the region. One of the exemplar projects for the partnership – the design and production of a 3D-printed prosthetic finger augmentation that was spearheaded by McClellan – illustrates how such benefits could be realized.
Many of Mon Health System’s patients work the kinds of manual labor jobs that are associated with distal ﬁnger amputation – the loss of a fingertip. Along with the loss of sensation, amputation of one or more ﬁngertips can create drastic functional deﬁcits. As a plastic/reconstructive surgeon in West Virginia, McClellan saw the opportunity to address a need in the region.
McClellan explains that current options for functional ﬁnger prostheses can be cost-prohibitive; the prostheses are often created in isolated specialized centers, and they generally require additional reﬁnement after fabrication. For economically disadvantaged patients or those living in remote regions – or for pediatric patients, who are still growing – the cost, time and travel factors can be significant obstacles.
When treating one such patient, McClellan had the idea to involve the patient in the process of designing a custom-fitted prosthetic finger augmentation that could be 3D printed. Doctor and patient worked with the engineers, designers and programmers at Intermed Labs to design a 3D-printed finger augmentation that: (1) would restore an adequate level of function to the patient, (2) could be sized and ordered from the patient’s home, (3) would require no postproduction reﬁnement, and thus could be shipped directly to the patient, and (4) was inexpensive (could be sold for about $50).
The result of the collaboration is now a marketable product: Fingy 3D (see photo). McClellan notes that the ﬁnger augmentation is designed for patients with amputation at the distal interphalangeal (DIP) joint. The design uses a single, ﬂexible joint that consists of two pins molded directly into the medial and lateral aspects of the prosthesis immediately after 3D printing. High-grade nylon material is used during the fabrication process to achieve low cost while maintaining comfort and durability.
From the patient’s perspective, the sizing and ordering process can be completed entirely from home. As McClellan explains: Patients simply use their phone to take a picture of their hand resting on an 8½ × 11-inch sheet of paper (for scale), and upload the image through a web app. Custom-designed scanning software obtains the measurements needed, which are then fed into a proprietary digital sizing model. Computer-aided design (CAD) software is used to adjust the devices for speciﬁc ﬁtting points. Once the custom design is prepared, it is sent to a 3D printing service that fulfills the order and ships the finished product directly to the patient in a matter of days. The beta version is currently available at www.Fingy3D.com.
With the resulting product, McClellan reports that patients experience signiﬁcant return of function with quality range of motion and improved anatomical grasping of objects. He adds that additional materials, user interface improvements and new designs to address more proximal amputations are in the works.
To read more about this project, visit www.ecri.org/health-devices-award-winners. If you have a project you’d like considered for the 2022 award, visit https://www.ecri.org/health-devices-achievement-award and tell ECRI about it. The award competition is a great way to gain recognition for the work you do to improve patient safety, reduce costs, or otherwise facilitate better strategic management of health technology. (Applicants must subscribe to one of ECRI’s programs or services.) You can also contact ECRI by telephone at 610-825-6000, ext. 5891, or by email at firstname.lastname@example.org.
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