A transportation engineer travels to the medical school
If you want to get the attention of an engineer, all you need to say is, “I think this could work better…” John Hourdos, a transportation engineer by training, embraces that engineering mindset. When confronted by something that is not working, he says, “Let’s fix it!”
“How did I get involved in this seemingly far-flung project developing medical sensors?” echoed Hourdos. “Well, it started four years ago with the mobile ECMO project.” That project involved building a mobile unit that could provide extracorporeal membrane oxygenation (ECMO) to patients experiencing cardiac arrest, reducing time to treatment and increasing survival.
Hourdos was originally asked to collaborate in a small way, solving a typical transportation problem: Determine the best places to position a fleet of these specially equipped emergency ECMO vehicles to get the best coverage and quickest response times throughout the city. “So, that is how,” said Hourdos, “I first got involved with the medical school, and specifically, with emergency operations.”
However, Hourdos was able to make an even greater contribution to the ECMO project by applying his IT expertise, which he applies daily in the Minnesota Traffic Observatory (MTO). There he uses multiple cameras, real-time video monitoring, and connects disparate technologies for communication and data collection. After the original programming resources pulled out of the ECMO project, Hourdos enlisted Dr. Ioannis Nompelis, a colleague from the Department of Aerospace Engineering and Mechanics. Together they were able to design a practical mobile telemedicine system for the new mobile response unit.
“The mobile unit was a great advancement in attending to cardiac arrest patients, and the story was picked up by the news and got some media attention. The project was also successful in terms of academic collaboration,” said Hourdos.
An engineering mindset
As Director of the Minnesota Transportation Observatory (MTO), Hourdos deals with a lot of information and communication technologies (ICT) including real-time video, remote sensors, cameras, and big data. He was somewhat surprised to find that the medical team seemed to be limited in their ability to interface remotely with medical equipment and personnel.
“People like me, who deal with a lot of advanced technologies, we cannot fathom having equipment that does not talk to each other. But that was part of their reality,” observed Hourdos. “As an engineer, it seemed to me like working with a coal fireplace, so to speak, instead of central heating. My engineering mind said, ‘Let’s improve this; let’s connect this!’”
The experience of working in a very different field open Hourdos’ eyes to some unique challenges of working in medical areas. One hurdle Hourdos found was that, in the medical field, everything—even upgrading a little bit of software—needs to go through FDA approval. They have the technology, but legitimate restrictions for approval, privacy, and safety can delay implementation. Medical researchers face additional regulations and privacy concerns when working with human patients, medical records, and communicating about both of those.
Over the course of the ECMO project, Hourdos had a lot of discussions with Dr. Demetri Yannopoulos, Center for Resuscitation Medicine, and other people in the medical school about the needs for emergency medical operations. “We discussed how things could be improved through the technologies that I was bringing in,” said Hourdos.
One of the issues discussed was a need to monitor patients while they are waiting within the hospital in the emergency room (ER). “People at the medical school showed me data, indicating that thousands of people die each year while in the ER waiting room.” As Hourdos is a motorcycle rider, this data stuck in his mind. “I have visited the ER many times,” recalled Hourdos, “every time it involved several hours of waiting.”
Although patients are triaged as they arrive, that assessment only captures their condition at that moment. If their condition is not life threatening at that moment, they might be sent back to the waiting room. But conditions can progress as they wait. Even though the patients are in the hospital, they are not being monitored for the condition that brought them there. Continuous monitoring could be very beneficial.
Yannopoulos explained to him how important it is to monitor blood chemistry in the case of a cardiac arrest. It could save someone’s life. Yannopoulos emphasized what a big gap exists because hospitals do not have that ability now.
Again, Hourdos’ engineering mind prodded him, “Surely, we could make this better!” However, he knew he was not the person to consider the medical solution. “I’m very comfortable with technology, but considering a new kind of medical sensor was out of my expertise. Yet, that problem stayed in the back of my mind.”
InterSections
In the spring of 2022, Hourdos found an opportunity to bring up this question. Joseph Konstan, UMN’s Associate Dean for Research, hosted a seminar to introduce InterSections, a new research funding initiative by the College of Science and Engineering. The goal was to bring together resources from around the College to encourage intersectional, collaborative research. Konstan made space for people in various disciplines to come together to explain their problems
and their expertise, knowing that connections would be made.
For his part, Hourdos presented a couple of problems related to transportation and traffic analysis. “I described my problem and the data that we collected at the MTO. I spoke with several computer science people who work on analytics and artificial intelligence. We came up with a couple of proposals on these more traditional projects.”
“As I listened, I heard people who said, ‘We make flexible sensors that look like skin,’ and ‘We design anodes that can detect chemicals,’ and that rekindled the question in the back of my mind. I took Dean Konstan at his word; he asked us to come up with problems that other people in the college can solve. So, I explained that I had worked on a project with my connections in the medical school, and I explained the problem that they have right now about real-time monitoring of patients’ blood chemistry. I asked if someone would be interested in looking for a solution.
“Dr. Sarah Swisher from the Department of Electrical and Computer Engineering said she could develop a system that would be small enough, and she knew Dr. Andreas Stein from Chemistry who designed ion sensors but had never miniaturized them. A team was quickly formed adding Dr. Philippe Buhlmann also from Chemistry, and Dr. Arthur Erdman from Mechanical Engineering. When they got to talking about membranes that only specific types of ions can pass through and 3D printing things at the micro- and nano-levels with a special type of ink, I was out of my depth. It was a great instance of connecting expertise. I brought this medical need I had heard about to the engineers. Ideas began flowing; and now they are flying!”
Role of the Engineer
“As an engineer who worked with emergency response people through the four years of the ECMO project, and who was exposed to some of their limitations based on policy, legislation, finances, what I brought was a bit of understanding about the needs and challenges involved in developing remote technology that could support continuous monitoring of patients.
“We do have sensors that can measure a lot of things. So as an engineer, I think, well, yeah, that’s simple. But that is something that hasn’t been solved or applied yet in this medical application.”
The Current Project
“I don’t know where it’s going to go. Right now, we were working on two different avenues. One, to create a prototype of a continuously monitoring sensor so that doctors can do some experimentation. And secondly, working on creating such a device at the nano scale.
“We are still formulating the process. The goal is, basically, to use the seed funding from the college, and in one year demonstrate that it is feasible to manufacture a kind of nano-needle that can measure what we want, and to develop a micro-electronic that allows us to receive continuous measurements. We hope our progress will attract development funding, perhaps from NIH or from industry.”
Role of the MTO
“One thing we do here at the MTO is to make connections, and we do it for a lot of other people. Yes, we are a transportation laboratory, but look around, we are filled with technology. MTO has the ability to make connections between unrelated technologies.
“If you’re a good engineer—and we see ourselves as good engineers—you can see the simplicity of a tool and apply it to this or that. So, if you have a tool that can pull a wire, it could also pull a tooth. The way my engineering mind thinks: Tell me what your problem is, and I will think of a solution.
“This project (developing a new sensor for monitoring human bodies) is, agreeably, a new record of how far afield, in terms of expertise, we have ever applied that principle. But that was what I said when I joined the ECMO project and developed the virtual reality system for telemedicine. That was my record then; this project takes us further.
“If you are smart enough not to pigeonhole yourself, and you are willing to talk to people outside your own area, you can take advantage of the expertise that is around. That is the beauty of being at the University, a research institution, in a research lab with a lot of expertise around.”
“Personally, I think civil engineers may be least likely to pigeonhole. As civil engineers, our work involves providing civil infrastructure, protecting society—clean water to clean air to safe roads to buildings that don’t fall on your head in a tornado. Other fields may not have that wide spectrum “baked in,” as it were. But because our projects are so large and complex, we are forced to take a big-picture view.”
John Hourdos is committed to collaboration and a big-picture view. With those tools and an engineering mindset, he and the MTO are creating inspired and innovative engineering solutions for society.