Spring 2003
15.963 Medical Innovations
Professors Gabriel R. Bitran, Martha Gray, and Tom Brady
Class Day/Time: Mondays and Wednesdays, 4:30-6:00pm
Location: E51-145
Units: 9 units (graduate (G) level)
Grading: The class will use A-F grading
I. Course Overview
This course will explore the application of technology to medicine, and also
will consider such related issues as the commercialization of innovation,
the economics of the healthcare industry, and the product design & development
process. The goal of 15.963 is to provide opportunities for graduate students
and others to identify projects that combine elements of engineering, management,
and medicine. A secondary purpose will be to assemble multi-disciplinary
student teams with the aim of gaining new insights and approaches to medical
hurdles that may not occur with a more narrow focus. The course is jointly
offered by the MIT Sloan School of Management, the Mechanical Engineering
and Electrical Engineering departments, and the Center for Integration
of Medicine and Innovative Technology (CIMIT)
The class format will include topical lectures as well as ‘hands-on’ applied project work. Physicians in various specialties affiliated with one of the Partners HealthCare System hospitals (i.e., either Massachusetts General Hospital or Brigham and Women’s Hospital) will describe their medical work, with an emphasis on the hurdles that limit optimal patient care. Six (6) or 7 clinical topics will be presented over the course of the semester. Each will describe a theme in Medical Innovation and will be moderated by a physician from one of the Partners HealthCare System.
The medical hurdles will be assigned as project work to a team of students. The team will be encouraged to spend time with the physician as they work toward a solution. The team will then be asked to respond within a specified time period (typically 4-5 weeks) with a presentation on proposed solutions to these problems. The physician will critique the response and moderate the classroom discussion. Afterwards, the student teams will prepare a report containing a written summary of their findings.
Instructors
Prof. Gabriel R. Bitran - e-mail: gbitran@mit.edu - Room E52-455 - ext: x3-2652
Prof. Martha Gray- e-mail: mgray@mit.edu - Room 25-519 - ext: x8-8974
Prof. Tom Brady- e-mail: -tom@nmr.mgh.harvard.edu - Room 100 CRP, MGH
ext: 726-8313
Course Materials
Students will be provided with handouts and preparation materials 1 week prior to the relevant class session. These materials will also be posted on the 15.963 SloanSpace site.
Grading
Students will be evaluated by the following criteria:
* Class participation 20%Due Date
* In-class Team Presentation 20%
* Final Project Report 60%
Class Participation
Students must be prepared for class and participate in the class discussions.
Evaluation of student participation will be based heavily on the quality of a
student’s comments and their relevance to the topic under consideration.
Help
The instructors will be available for discussion outside class hours. You should feel free to call and arrange meetings.
II. In-Class Activities: Physician Class Visits and Student Team Presentations
The centerpiece of the course will be the student team project, which will be done in conjunction with practicing physicians. As noted in the course overview above, physicians from various medical specialties will visit the class to make presentations about their work. They will emphasize the hurdles (technological and otherwise) that limit optimal patient care. These hurdles will be assigned as a homework project to a team of 4-6 students. The team will spend time with the physician and jointly work toward a solution. The student team will be asked to respond within a specified time period (typically 4-5 weeks) with an in-class presentation on proposed solutions to these problems. The physician will critique the response in class, and moderate the classroom discussion.
III. Final Written Report
The final component of the student team project will be the written report.
After the student team completes its in-class presentation, it will prepare
a report containing a written summary of their findings. This report should
be approximately 3,000 words (about 10 double-spaced pages using margins
of a least one inch and a font size of 12-point).
Projects are to be done in teams of 4-6 students. Please contact one of the instructors if you have difficulty finding a group.
IV. Class Schedule, Spring ’03 Term
SESSION #1 Wednesday, February 5
COURSE INTRODUCTION AND OVERVIEW, PROFESSOR GABRIEL BITRAN
SESSION #2 Monday, February 10
LECTURE: ECONOMICS OF HEALTHCARE, PROFESSOR ERNST BERNT
Required Readings (to be distributed and read prior to the class session):
“Pharmaceuticals in U.S. Healthcare: Determinants of Quantity and Price”
“Promotion of Prescription Drugs to Consumers”
SESSION #3 Wednesday, February 12
Lecture: Healthcare Industry Overview, Ellen Zane, Partners Healthcare
Required Readings (to be distributed and read prior to the class session)
From Health Affairs, January/February 2002 (Volume 21; Number 1):
“The Changing Face of Managed Care”
“Defined Contribution Health Insurance Products: Development & Prospects”
“Employer-Sponsored health Insurance: Pressing Problems, Incremental
Changes”
“Trends: Inflation Spurs Health Spending in 2002”
“Trends: Workers and Their Health Plans: Free to Choose”
“Trends: Trends in Health Insurance Coverage: A look at Early 2001 Data”
From the Massachusetts Business Roundtable Report, December 2002.
“Why Care? Massachusetts Health Care: On the Brink”
From the First Consulting Group’s Report for the California HealthCare Foundation, September 2002
“Achieving Tangible IT Benefits in Small Physician Practices”
(continued)
From Health Care News, October 2001
“US Trails Other English Speaking Countries in Use of Electronic Medical Records and
Electronic Prescribing”
NOTE: THERE WILL BE NO CLASS HELD DURING THE WEEK OF FEBRUARY 17 DUE TO THE PRESIDENT’S DAY HOLIDAY AND MAKEUP SCHEDULING CONSTRAINTS.
SESSION #4 Monday, February 24
Lecture: Medical Innovation Case Study, Lita Nelsen, MIT Technology Licensing Office
Handouts/Required Readings will be distributed prior to the class session
SESSION #5 Wednesday, February 26
Physician Presentation, Dr Joseph Vacanti, Massachusetts General Hospital (MGH)
Handouts/Required Readings (to be distributed prior to the class session):
Vacanti, J.P. and Langer, R. “Tissue engineering: the design and fabrication of living replacement
devices for surgical reconstruction and transplantation”
Vacanti, J.P. and Langer, R. “Tissue engineering”
Vacanti, J.P. “Beyond Transplantation”
Deadline for Student Team Response Presentation: April 14
Abstract: The Challenges of Regenerative Medicine (Joseph P. Vacanti, M.D. Director, Laboratory for Tissue Engineering and Organ Fabrication, MGH)
The field of tissue engineering is now intersecting with the emerging science of stem cell biology to produce new approaches in regenerative medicine. Approaches, results, and new avenues will be reviewed and discussed.
SESSION #6 Monday, March 3
Physician Presentation, Dr. Donald S. Baim, Brigham and Women’s Hospital (BWH)
Required Reading (to be distributed prior to the class session)
Baim, Donald S. “New Devices for Coronary Intervention” Physician's Day
Deadline for Student Team Response Presentation: April 16
Abstract: Challenges In Interventional Cardiology (Don Baim MD, Interventional Cardiology, BWH)
Angioplasty, the intravascular treatment of coronary artery disease, is now a common procedure. We will review how some problems (abrupt closure, inability to dilate calcified lesions, restenosis) are well on the way to solution, but how others (crossing chronic total occlusions, and treating degenerated saphenous vein grafts) remain problematic.
SESSION #7 Wednesday, March 5
Lecture: Entrepreneurship and Healthcare, Professor Fiona Murray
Handouts/Required Readings will be distributed prior to the class session
SESSION #8 Monday, March 10
Physician Presentation, Dr. Vivek Reddy, Massachusetts General Hospital (MGH)
Handouts/Required Readings will be distributed prior to the class session
Deadline for Student Team Response Presentation: April 21
Abstract: Ventricular Arrhythmia (Vivek Reddy, MD, Cardiac Arrhythmia Service, MGH)
The approach to catheter ablation of life-threatening ventricular tachycardia has undergone a paradigm shift. Studies have revealed that determining the location and extent of the scarred myocardium is key to identifying the pathological circuits that cause these tachycardias. This is typically performed by manipulating a catheter within the cardiac chambers to delineate the endocardial (inside) boundaries of the scar. Evolving strategies: 1) use of a non-surgical sub-xyphoid approach for catheter mapping and ablation of the epicardial (outside) surface of the heart, and 2) use of cardiac MR imaging to aid in the mapping and ablation of ventricular tachycardia.
SESSION #9 Wednesday, March 12
Physician Presentation, Dr. R. Rox Anderson, Massachusetts General Hospital (MGH)
Handouts/Required Readings will be distributed prior to the class session
Deadline for Student Team Response Presentation: April 23
Abstract: Non-invasive Ideas For Destroying/Removing Fat (Rox Anderson, MD, Dermatology Service and Director, MGH Laser Center)
SESSION #10 Monday, March 17
Physician Presentation, Dr. Jennifer White, Massachusetts General Hospital (MGH)
Handouts/Required Readings will be distributed prior to the class session
Deadline for Student Team Response Presentation: April 28
Abstract: Endoscopic And Robotic Coronary Surgery (Jennifer White, MD, ???, MGH)
Novel endoscopic techniques, robotics, and new ways to join tissues are being explored to create minimally invasive methods for coronary artery surgery. The ultimate goal is to perform close chest procedures on the beating heart to minimize the trauma to the patient and maximize the benefits of surgery.
NOTE: DUE TO SLOAN SPRING BREAK, NO CLASS WILL BE HELD ON WEDESDAY, MARCH 19. THE FIRST CLASS SESSION AFTER THE BREAK WILL BE MONDAY, MARCH 31.
SESSION #11 Monday, March 31
Physician Presentation, Dr. Lee Schwamm, Massachusetts General Hospital (MGH)
Handouts/Required Readings will be distributed prior to the class session
Deadline for Student Team Response Presentation: April 30
Abstract: Complex Physiologic Signals (Lee Schwamm MD, Dept. of Neurology, MGH),
Cerebral blood flow is very difficult to measure at the bedside. Surrogate measures have been developed but their relationship to the actual CBF is quite variable. Two measures will be discussed. Oxygen saturation in the blood draining the brain relies on the laws of mass balance to estimate changes in CBF. Doppler ultrasound uses estimates of blood flow velocity to assess cerebrovascular resistance. Examples of these waveforms will be presented and the strategies for better data extraction will be discussed. In addition, the relationship between intracranial and transvenous pressures will be explored
NOTE: NO CLASS WILL BE HELD ON WEDNESDAY, APRIL 2
SESSION #12 Monday, April 7
Physician Presentation, dr. Dan Shannon, Massachusetts General Hospital (MGH)
Handouts/Required Readings will be distributed prior to the class session
Deadline for Student Team Response Presentation: May 5
Abstract: Challenges in Pediatrics (Dan Shannon, MD, ???, MGH)
SESSION #13 Monday, April 14
STUDENT TEAM Presentation. Topic: Challenges of Regenerative Medicine
Physician Presentation, Dr Joseph Vacanti, Massachusetts General Hospital (MGH)
SESSION #14 Wednesday, April 16
STUDENT TEAM Presentation. Topic: Challenges in Interventional Cardiology
pHYSICIAN MODERATOR: Dr. Don Baim, Brigham and Women’s Hospital (BWH)
SESSION #15 Monday, April 21
STUDENT TEAM Presentation. Topic: Ventricular Arrhythmia
PHYSICIAN MODERATOR: Dr. Vivek Reddy, MGH
SESSION #16 Wednesday, April 23
STUDENT TEAM Presentation. Topic: Non-invasive Ideas For Destroying/Removing Fat
PHYSICIAN MODERATOR: Dr. Rox Anderson, MGH
SESSION #17 Monday, April 28
STUDENT TEAM Presentation. Topic: Endoscopic And Robotic Coronary Surgery
PHYSICIAN MODERATOR: Dr. Jennifer White, MGH
SESSION #18 Wednesday, April 30
STUDENT TEAM Presentation. Topic: Complex Physiologic Signals
PHYSICIAN MODERATOR: Dr. Lee Schwamm, MGH
SESSION #19 Monday, May 5
STUDENT TEAM Presentation. Topic: Challenges in Pediatrics
PHYSICIAN MODERATOR: dr. Dan Shannon, MGH