Healthcare Technology Hub

DigiBreast3D

The rising incidence of breast cancer has created an increased demand for breast reconstruction. However the UK National Mastectomy and Reconstruction audit showed that that one in ten mastectomy patients and one in six reconstruction patients required additional surgery.

Surgeons rely on a standard set of manual measurements to plan the reconstruction and choose the breast implant, but this approach does not allow an accurate reconstruction of the breast shape and asymmetries can easily arise after surgery.

As such, Derby Hospitals NHS Foundation Trust wanted to establish the feasibility and accuracy of using Microsoft’s Kinect depth cameras for imaging the breast region in three dimensions.

Dr Jonathan Wheat and Dr Simon Choppin worked collaboratively with the trust to develop the DigiBreast3D system. DigiBreast 3D uses Microsoft Kinect to allow simple, inexpensive, 3D surface imaging of the breast region for pre-operative planning, post-operative evaluation of surgical outcome and comparison of different breast reconstruction surgical techniques.

DigiBreast3D is a value for money, easy to use innovation with demonstrated acceptable accuracy. The system can be used across the NHS and there are no special requirements for use or training – 3D scans can be taken by anyone with basic computer training.

The technology will enable surgeons to improve quality and patient satisfaction by optimising surgical outcomes in breast cancer patients undergoing reconstruction surgery.

Image: creative_tools

Compact Breath-actuated Dry Powder Inhale

Need

According to figures from asthma charity Asthma UK, 1 in 11 adults and 1 in 12 children are currently receiving treatment for asthma in the UK. Asthma is a relatively common, yet potentially fatal long-term condition, leading to an emergency hospital admission every 7 minutes in the UK. Worryingly however, 75% of these admissions are preventable.

Resources/research

Funded by the Arts & Humanities Research Council, former Hallam researcher Mark Fisher’s Industrial Design MA focused on reducing the number of potentially preventable, asthma related emergency hospital admissions. The catalyst for development was the voice of the individual and Mark was fortunate enough to work with a range of design partners living with asthma as well as a team of medical professionals from Sheffield Teaching Hospitals. These first hand insights allowed him to develop a deep understanding of how asthma medication might be re-considered to fit more realistically around people’s lives.

Solution

Mark identified an opportunity for a more convenient, less-stigmatising reliever inhaler to provide ‘just enough’ medication in a compact, intuitive and attractive package. Respiratory clinicians and other people living with asthma have advocated the dry powder device designed in response to this 18-month project. In partnership with Sheffield Hallam University, Mark has filed a UK patent application to protect his novel drug delivery method and we are encouraged to have received the initial examination report with minimal citations. We are currently discussing the concept with various medical product manufacturers, hoping to negotiate a licensing deal to make the product a commercial reality.

The device is a compact and easily transportable breath-actuated DPI, which is simple to use, delivering a pre-metered dose of powdered medication. The inhaler contains five shots stored in the sealed unit and is automatically recharged after each use. This, combined with breath actuation, simplifies the process for the individual, resulting in a more effective inhaler that also reduces problems due to poor user technique. The novel drug delivery method is suited to long-term conditions treatable with powdered medication or the delivery of vaccinations or analgesic drugs and fits well with the changing climate for convenient drug dispensing.

“We’re always telling people you must take your inhaler wherever you go and I mean, if you’re going out to a nightclub or off on your mountain bike and this was always attached to your bunch of keys you wouldn’t have any bother would you? I mean the number of people who say – when I hadn’t got my inhaler I had a bad attack. You’ve got something there that hasn’t been done before and there’s a reason for it so therefore I think that’s good. To be able to say to my patients ‘oh do you know about this?’ would be great.”
Clare Daniel, Asthma Nurse Specialist

Bone mineral density assessment

Need/research

Bone mineral density (BMD) is a measure of bone health used as an indicator of osteoporosis and fracture risk. Osteoporosis is a condition where BMD is abnormally low, weakening the bone and making it more susceptible to fractures [1].

Although osteoporosis is more common in adults, it also occurs in children. Osteoporosis during childhood may be due to an underlying medical condition such as osteogenesis imperfecta (OI) [2]. The most common method of evaluating BMD is dual energy x-ray absorptiometry (DEXA) [1].

BMD derived from DEXA is based on a two-dimensional area, thus not considering bone’s volume. This affects the accuracy of DEXA-derived BMD [3]. The growth of bone in children is not uniform in three dimensions. Changes in bone size over time may cause errors in measuring BMD in children with DEXA, leading to misdiagnosis [4]. In order to improve accuracy, radiologists consider patient’s individual physiological parameters; such as age, gender, height, weight and ethnicity, when evaluating DEXA results. Some studies have been performed to obtain normative values for BMD measured by DEXA. These are included in most current normative data sets provided by DEXA machine manufacturers. Limitations in the availability of these normative data constrain DEXA’s applicability for some children [3].

An abnormally high occurrence of bone fractures in children may be a sign of child abuse. The diagnosis of child abuse involves excluding abnormal BMD. Assessing the underlying cause of fractures as being mistreatment or osteopaenia is quite important legally as well as for prescribing medications.

Solution

We are currently developing novel analysis techniques combined with advanced digital signal processing as an alternative to DEXA for assessing BMD. It is a non-invasive, rapid and cost effective method of investigating physical properties of materials, including their densities.

The work involves design of a suitable BMD assessment system based on a novel method of analysis. This will provide a structural diagnostic approach that allows physical properties to be investigated. The system is being evaluated in clinical settings and is being developed for BMD assessment and may also be adapted for bone fracture screening. We aim to commercialise the resulting system.

References

1. Havrda, J. B. : ‘Pediatric bone densitometry’, Radiologic Technology., 2012, 84, (2), pp. 155–73
2. Bishop, N. : ‘Characterising and treating osteogenesis imperfecta’, Early human development., 2010, 86, (11), pp. 743-746
3. Binkovitz, L. A., and Henwood, M. J. : ‘Pediatric DXA: Technique and interpretation’, Pediatr radiol., 2007, 37, (1), pp. 21–31
4. Bachrach, L. K. : ‘Dual energy x-ray absorptiometry (DEXA) measurements of bone density and body composition: Promise and pitfalls’, J pediatr endocrinol metab., 2000, 13, pp. 983–988

Wearable Medical Monitoring

Need
There was a need in the healthcare market to improve the system for diagnosing diabetic foot disorders. Our challenge was to design the physical parts of a wearable device to measure plantar pressure inside the shoe, to more accurately assess areas in risk of ulceration in diabetic patients with neuropathy.

Solution
Lab4Living were approached by Tomorrow Options to work with them to develop WalkinSense, a wearable system that provides quantitative and qualitative information regarding a user’s dynamic plantar pressure and gait. WalkinSense provides more accurate assessment of people with diabetic foot disorders.

The product is safe, easy to put on and take off, and comfortable for patients to wear for prolonged periods. Simple to operate by healthcare practitioners, it provides clear and robust data to support diagnosis and can be applied in areas including: orthopaedics, neurology, cardiology, podiatry, rehabilitation and sport.

Design Futures was invited to work on the design of a second product, ‘MovinSense‘ – a device to help hospital staff to manage patients in beds to minimize or eliminate bedsores.

Resources/research
We took a user-centred approach to understanding the requirements for both patients and healthcare professionals, developing models and prototypes which informed the design process. This involved ergonomic studies and identifying how professionals, such as doctors and podiatrists, would work with the device and use the data it produced.

Design Futures‘ experience with designing moulded products was important in assessing manufacturing viability. Developmental work was carried out extensively using 3D CAD with supporting physical models and rapid prototypes to test and prove key elements of the design.

Head-Up

Need
Our challenge was to create a new product that provides head support for people with neck muscle weakness, particularly those with Motor Neurone Disease (MND), that allows the wearer to use and maintain their remaining function for as long as possible.

Solution
Current neck support provision for people with neck weakness varies hugely, from the soft ‘beanie’ and foam collars to stiffer, immobilising collars and specialist products such as the ‘Headmaster’. There are problems with all versions, as they provide support by pushing the head up from under the jaw, which has an impact on basic functions, such as eating.

This innovative, multi-disciplinary project was initially proposed by DeNDRoN (Dementia and Neurodegenerative Diseases Research Network) and the Clinical Studies Group for Motor Neurone Disease. With support from patients and carers, they approached D4D (Devices for Dignity) with the view that current neck collars are inadequate in terms of function, comfort and cosmesis.

Resources/research
Designers from Lab4Living combined research methods from design, healthcare and engineering, such as the Neck Assessment Tool engineering simulation. The design team and healthcare professionals took part in comfort assessments, which gave them the opportunity to wear for themselves the collars that are currently offered to MND patients.

The Head-Up project was supported by the Motor Neurone Disease Association as well as MND patients and carers, who worked in a collaborative process to help us understand their needs and to co-create solutions. The project engaged clinical neurologists, MND nurse specialists, occupational therapists, physiotherapists and orthotists, as well as industrial designers and engineers from across the University.

Funding
Lab4Living successfully bid for i4i (Invention for Innovation) research funding from the National Institute for Health Research with partners from D4D and Sheffield Institute for Translational Neuroscience.

The Infusion Pump

Need
The original syringe pump was developed over 30 years ago and effectively delivers continuous infusions of medicines to manage disease symptoms and side effects such as pain, nausea and vomiting. However, research suggests that syringe pumps can be stigmatising and limiting to a patient’s quality of life, due to their size and how they are carried. This project was to develop a new, mobile infusion pump that improves lives by being easier to transport and carry around, as well as simpler to set up.

Solution
Our mobile infusion pump concept encourages patient mobility, confidence and independence. It’s a small, handheld device that fits in a pocket or a bag and allows patients to live as normal a life as possible, for as long as possible.

Resources/research
The infusion pump concept was developed as part of an MDes Product Design degree by research assistant Rebecca Partridge.

Funding
Lab4Living have applied for funding to evaluate and develop the concept with patients based at Sheffield Teaching Hospitals.

Medical Connectors

Need
Colour has traditionally been the main distinguishing factor for healthcare staff using medical connectors and setting up equipment. However, in dimly lit conditions such as an intensive care unit, this can be difficult. Plugging the wrong connector into the wrong device can have serious consequences.

Solution
This research project set out to develop medical connectors to be used safely by health professionals in all conditions, including low light. It has led to the design and manufacture of specific products that have a direct impact on patient safety.

Resources/research
This project was led by Lab4Living’s Design Director Professor Paul Chamberlain in collaboration with the human factors group at the University of Leeds.

Our research established the ease of differentiating small shapes (appropriate for use as medical connectors) under three conditions: visual cues only, haptic cues only and both visual and haptic cues.

Experimental research looked at how cutaneous senses could be used to inform the design of devices that rely on this sense. It offered an increased understanding of the characteristics of exterior shape that are more and less easy to detect via the cutaneous senses.

Funding
This study was funded by the Department of Health’s Health Technology Device Agency. We have since worked with a commercial partner, which has led to the design and manufacture of products.

Everysense

Need
Everysense is a customisable version of the successful tac-tile sounds system. Tac-tile offers a holistic interactive environment for educational, therapeutic and recreational use by people with special needs including autism, dementia, and behaviour problems. The Everysense project set out to empower users through the ability to customise interfaces and activities.

Solution
The customisable nature of Everysense products is designed to increase engagement by giving control to the user. More than 20 products – including software control and user interfaces – have been developed as part of the ‘Everysense System’ for ROMPA – a regional Small Medium Enterprise (SME) which supplies a wide range of multi-sensory equipment and services for all ages and ability levels. The Everysense System was installed in 10 special needs centres in a number of countries, and has created jobs and increased turnover for ROMPA.

Resources/research
The tac-tile system was developed by Lab4Living’s Design Director Professor Paul Chamberlain and a project team working in collaboration with special needs experts and software programmers. As a by-product of this project, Paul Chamberlain’s multi-disciplinary connections in the field have led to the publication of a series of expert papers sent by ROMPA to their professional clients. Commercial production has followed directly from this research.

Funding
This industrial collaboration has led to significant knowledge transfer, and further research and development with ROMPA. A new initiative developing sensory environments was launched in 2007, together with several major international organisations and companies, including Philips, Macmillan Cancer trust, Arup and Nightingale Associates.
Everysense provides a great example of design research as a significant driver in supporting and reconstructing post-industrial regions.

Future Bathroom

Need
Our challenge was to design products that all bathroom users find acceptable, while meeting the specific needs of older and disabled people. Lab4Living’s Future Bathroom project set out to develop appropriate methodologies to better understand the needs of older people using bathrooms, and to use these findings to inform design responses.

Solution
Our study adopted creative strategies in designing bathroom furniture. We developed spaces that would have the flexibility to evolve, grow and reflect the changing needs of individuals and their families as they age.
We created a range of innovative and desirable bathroom prototypes, including furniture and assistive technologies. The prototypes showed sensitivity to the problems of living with disability, with designs that do not stigmatise, are capable of manufacture, and which demonstrate the principles we developed.

Resources/research
Future Bathroom involved academics, researchers and designers from the Art and Design Research Centre and the Centre for Health and Social Care Research working with health professionals, end users and their family carers.

We developed a robust methodology for fostering co-design dialogue between designers, researchers and older people (aged 50+) with chronic age-related health conditions, such as arthritis, osteoporosis, stroke and macular degeneration. Training older people to be researchers helped to overcome the sensitivities that can be involved when talking about personal activities and helped us develop a ‘creative community’ between the stakeholders.

Funding
The three-year, £400k project was funded by the Engineering and Physical Sciences Research Council and supported by the bathroom manufacturer Ideal Standard.

The Foundation for Assistive Technology (FAST) produce an annual parliamentary report about R&D in Assistive Technology. The Future Bathroom project had a significant mention on page 28 of the 2011 report. You can download a PDF of the report from gov.uk and read a Future Bathroom case study on the FAST website.

SMART Rehabilitation

Need
Research (UK Stroke Audit, DoH, 2006) showed that there was limited availability of specialist rehabilitation units, therapist staff and time, and community-based therapy. This project examined the scope, effectiveness and appropriateness of systems to support home-based rehabilitation for older people and their carers.

Solution
Our project set out to explore how technology might be used to facilitate active in-home rehabilitation for people following stroke.

We attached orientation sensors to a user’s wrist and upper arm using clothing resembling sportswear. The user moved their arm when asked to by a therapist, and the sensors tracked the movement, which was recorded and displayed on a computer or TV screen.

The decision-support interface was tailored in a way that gave the user meaningful feedback about their progress. The therapists prescribing the rehabilitative interventions were able to obtain feedback about the user’s progress at another location, such as a hospital or primary care setting.

Resources/research
The project, entitled ‘SMART rehabilitation: technological applications for use in the home with stroke patients’ was a joint project between Sheffield Hallam University’s Lab4 Living and Centre for Health and Social Care Research, the universities of Bath, Essex and Ulster and the Stroke Association.

Users, carers and clinical stroke therapists were an integral part of the project, from an initial scoping of need through to the testing of new iterations of the SMART system as it developed.

Funding
The SMART project is funded under the EQUAL (extending quality of life of older and disabled people) initiative of the UK Engineering and Physical Sciences Research Council, which has encouraged a wide range of research including:

• design of the built environment to encourage safe and enjoyable use by older people
• inclusive products which can be used by everyone including older people
• technological applications in the home to maintain independence in later life.

Tactile Map

Need
Visually impaired people can be dependent on sighted people to acquire the information they need to navigate rooms, buildings and cities. This project set out to create an affordable and easy-to-use tactile system to enable blind and partially sighted people to navigate indoor spaces independently.

Solution
TacMap™ is a novel and simple piece of graphical software that produces tactile maps. The maps enable visually impaired people to acquire information about how a building, an individual floor or a room is laid out before visiting. TacMap™ can represent a wide range of buildings and venues such as hotels, museums, theatres, universities, schools, bus and train stations, transport hubs, sports and leisure complexes or workplaces.

The tactile language developed by the researchers comprises of a palette of symbols and textures representing entrances, exits, fire exits, directions of door openings, receptions/information points, toilets, stairs, access ramps, and evacuation points. Most of this information is usually acquired by an individual asking the help of a sighted person. Many current visual signs and symbols cannot be interpreted clearly through touch. The research team, working with blind users, have developed new symbols to add to the icon-based language.

Our graphical software makes it possible to produce accessible information at a reasonable cost. Once created on screen, the maps are produced on reactive paper. After printing, the paper is heat processed to produce the tactile surface.

TacMap™ is a simple, unique system that produces effective and intelligible tactile maps. Public buildings can now be equipped with effective, useful and detailed maps to support blind visitors, guests or clients and satisfy the duties under the Disability Discrimination Act.

Resources/research
TacMap™ was developed over three years by Patricia Dieng and Lab4Living’s Design Director Professor Paul Chamberlain of the University’s Art and Design Research Centre, in collaboration with Zychem Ltd and the Sheffield Royal Society for the Blind (SRSB).

The research team carried out substantial user trials with extremely positive outcomes. The trials were supported by Zychem Ltd, the SRSB and Sheffield City Council who provided the space for one of the trials to take place.

Funding
The project was funded by the strategic investment fund from Sheffield Hallam University for the first 18 months of development. We are now in the process of undertaking further research and development in response to positive outcomes for the project.

Paddling the Dragon

Need
To find ways to raise awareness of the health and wellbeing benefits of exercise, and to encourage people to take part in fun, novel and accessible activities to improve their fitness.

Solution
The Paddling the Dragon project saw the installation of a dragon boat simulator in Sheffield’s Winter Gardens during National Science and Engineering Week. It grew from research led by Dr Helen Crank of the Centre for Sport and Exercise Science within the Faculty of Health and Wellbeing

Dragon boat racing has become a global movement, for its positive effect on health and well-being, and for raising public awareness to the benefits of regular physical activity. It’s based on research by Prof Don McKenzie who explored the positive effects of dragon boat paddling on cancer sufferers and survivors.

In this project, a wooden dragon boat prow was combined with Wii technology to create a simulation of paddling a dragon boat. With a river scene played on simulation video to the front and the side, the project recreated the experience of paddling a boat along a river.

One member of each team of five banged a drum in the prow to set a time, as the other four members paddled the boat. Wii remotes in the paddles recorded their speed and their synchronicity as a team. Speed and time were displayed on the front screen.

Dr Jon Wheat, a senior research fellow in the University’s Health and Wellbeing faculty said: “The idea is that the more in time they paddle as a team, the quicker they will go as opposed to each individual paddling as fast as they can.”

Resources/research
Researchers from the University compiled data about the positive benefits of team sport and exercise. More than 250 people took part, between the ages of 3 and 92.

The University team included representatives from the Centre for Sports Engineering Research, Centre for Health and Social Care Research, and artists and designers from the Art and Design Research Centre in the Faculty of Arts, Computing, Engineering and Sciences.

Funding
Part of the Engineering for Life initiative, the simulator was developed and built by a multidisciplinary team from Sheffield Hallam University in partnership with the voluntary organisation Paddlers for Life.

Aiming to foster innovative collaborations that will enhance people’s lives, Engineering for Life is creating a network of passionate researchers who have the ability to push the boundaries of interdisciplinary working. In particular, it will address problems related to rehabilitation and assisted living (through sport, physical activity and medicine) and sustainability. The initiative offers the opportunity to gain funding towards 10 of the best projects derived from these collaborations.

Engineering for Life is funded by the Engineering and Physical Sciences Research Council under the ‘Bridging the Gaps’ initiative.