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How Clinical Technology will change healthcare

In spring 2020, the country was facing a potential lack of hospital ventilators for the huge numbers of Covid-19 patients. In response, Clinical Technology students designed an emergency device in the space of just three weeks. ’These students become 80% doctor and 80% engineer.’

Jaap Harlaar is  an engineer and Director of Studies for Clinical Technology.
Jaap Harlaar is an engineer and Director of Studies for Clinical Technology.

One is an engineer, and the other a doctor. Director of Studies Jaap Harlaar and co-founder Frank Willem Jansen are proud advocates of the Bachelor’s degree programme in Clinical Technology and the Master’s degree programme in Technical Medicine. The programmes are offered by TU Delft, Erasmus MC and LUMC; the first Master’s students graduated last September.

Non-existent problem

Although the Clinical Technology programme is relatively new, biomedical electrical engineer Harlaar had actually spent 30 years working as a clinical technologist before he was appointed Director of Studies in Delft three years ago. ‘At the Rehabilitation department of what was then the VUmc, I developed instruments to treat patients with walking problems. My office was literally next to the consulting room. I really wanted to be near and actually have contact with the physicians, because before you know it you’ve come up with a solution to a non-existent problem. Unfortunately, that happens a lot.’

This year, Harlaar was appointed professor of Clinical Biomechanics at Erasmus MC and the LUMC, in addition to his position in Delft. This makes him a ‘Medical Delta Professor’: a professor who is appointed to at least two of the five academic institutions from the province of Zuid-Holland that have come together with various businesses to form this partnership whose aim is to develop technological solutions for sustainable care.

Jansen, originally a gynaecologist, is chair of Medical Delta. ‘I’m involved in the surgical side of my field, specifically in Minimally Invasive Surgery (MIC), or keyhole surgery. This means you perform operations through a very small hole in the body.’ He is a professor at both LUMC and TU Delft and researches the patient-safe implementation of MIC methods and technologies.

Gynaecologist Frank Willem Jansen is one of the founders of the Clinical Technology programme.
Gynaecologist Frank Willem Jansen is one of the founders of the Clinical Technology programme.

Communicative engineers and creative doctors

Jansen was one of the founders of the Clinical Technology degree programme. ‘In the beginning, the idea was just to start a Bachelor’s degree programme that would prepare students for a Master’s degree programme in engineering or medicine. It wasn’t our plan to train engineers to be at a patient’s bedside.’ But this idea gradually started to change. Jansen: ‘Medicine is fairly conventional. And rightly so, because as a doctor you have to be prudent. But there are more and more technological developments and new opportunities. Take 3D printing and artificial intelligence, for example. To actually use those technologies in clinics, you need communicative engineers and creative doctors.’

Precisely the people who are being trained on the Clinical Technology degree programme, according to the two men. Harlaar, half joking: ‘Our students become 80% doctor and 80% engineer. So they’re exceptionally intelligent individuals.' Every year, 600 aspiring students apply for the 100 places available on the programme. On the medical side, they don’t cover psychiatry and pharmacology, but they do study anatomy and communication. 'They really have to understand patient vulnerability,’ Jansen emphasises.

Prostheses and ventilators

Consider the exoskeletons, prostheses and other aids that Harlaar has been working on throughout his career. ‘We want to make them smarter and smarter, so they’re optimally attuned to the residual capacity of the patient. You have to have an excellent understanding of what is going on clinically and know a lot about neurology, muscle physiology and how forces work. The products we make aren’t mass-produced, it’s all customisation. Just as each operation a surgeon performs is different.’

This spring, under Harlaar’s leadership, Clinical Technology students developed a solution to the impending shortage of ventilators due to the expected surge in Covid-19 patients in the space of just three weeks. They even made it on to the Dutch TV news programme NOS-journaal. ‘Many initiatives were launched to prevent a shortage, but these devices are quite complex. They do more than simply administer oxygen. The students used their clinical and technical knowledge to scale back the device to the absolute essentials. Fortunately, the much feared ‘wave’ never really transpired, but 80 ventilators were still produced, which the Ministry of Health, Welfare and Sport is holding on to.’

Scepticism, followed by a warm welcome

Some students do their internship with Jansen at the LUMC. ‘When they come to the ICU, they walk around in amazement. It’s full of technology. You can see that they’re good process thinkers. Traditional doctors tend to look for solutions straight away: surgery or medication. Engineers start by analysing the problem.’ How do doctors actually feel about this new group of professionals moving onto their patch? Jansen: ‘When I first brought students to the hospital, my colleagues were quite sceptical. “What are they doing here?” But now they actually approach the students and ask them for help.’

The first cohort of graduates from the Master’s programme are now entering the labour market. There are plenty of opportunities, but no made-to-measure vacancies. Jansen: ‘We’ve come up with a solution for that. We have created fellowships at the LUMC, whereby a clinical technician is appointed for two years on a cross-departmental project. They can then specialise, for example, in intensive monitoring for neonatology and cardiology, or in 3D printing for both orthopaedics and oral surgery. Our Executive Board pays for these fellowships, and I’m sure that after those two years the clinical technologist will have made themselves so indispensable that they’ll be able to stay.’

Text: Rianne Lindhout
This article was previously published in the December 2020 edition of the online LDE Universities magazine.

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