By Estrella Z. Gallardo
Bannered by the theme, “Health Research and Industry 4.0”, the 37th year Anniversary of the Philippine Council for Health Research and Development of the Department of Science and Technology held the International Conference on Health Research and Industry 4.0, at the Philippine International Convention Center (PICC), Pasay City on March 15, 2019.
DOST Secretary Fortunato T. de la Peña said that in today’s fourth industrial revolution (FIRe), digital transformation will impact our way of doing things, thus, our anniversary theme, “Health Research and Industry 4.0” means that we are positioning ourselves to be FIRe ready. “Our Talakayang Heart beat will focus on PCHRD’s Biomedical Products and Engineering Program wherein there is merger of healthcare, technology and industry sector”, he said.
Secretary de la Peña talked about the following: Sixty years ago, In 1958, the first pacemaker was implanted to 43-year-old Arne Larsson by surgeon Ake Senningand and engineer Rune Elmqvist in Sweden.
The device helped regulate Mr. Larsson’s heartbeat and allowed him to get back to his work as an engineer. This small device extended his life for 43 more years before his death to skin cancer in 2001. He ended up outliving both Dr. Enquist, who died in 1996, and Dr. Senning, who died in 2000.
Similarly, I’m sure most of you are familiar with him, in 1999, then-52 year old English singer and pianist Sir Elton John was diagnosed with an irregular heartbeat and had a pacemaker fitted on him. Although pacemakers have come a long way from those made by Dr. Enquist and Senning, the premise is still the same, a small biomedical device was implanted in the chest to help prolong their life.
Today, at 71-years of age, he is still touring the world to perform his greatest hits.
He also talked about biomedical device. It is defined as any Instrument, apparatus, implement, machine or implant intended to be used for human beings.
And health technology is the application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures and systems developed to solve a health problem and improve quality of lives.
Ventilator: In our hospitals, particularly in Intensive Care Units, most of you will see a ventilator. It provides an ICU patient with oxygen when they are unable to breathe on their own.
Without ventilators, the human lungs will be not be able to breathe, resulting to respiratory failure.
A majority or 50% of ICU patients need a ventilator, and the ideal set-up is 1:1 ventilator ratio per patient.
The lack of affordable medical devices: But with the dream of having a ventilator available for every ICU bed, comes the reality of its high cost.
In many developing countries, like ours, majority of government tertiary hospitals only have 1 ventilator for every 10 ICU beds because current standard ventilators cost around three to five million pesos.
Moreover, we are highly dependent on biomedical device imports so prices will also increase because of the market chain and sales distributors.
Objectives of the BEHT Program: Which is why through the Biomedical Engineering and Health Technologies program, we address the need for affordable, safe, and reliable biomedical devices as stated in the National Unified Health Research Agenda.
This area not only aims to develop biomedical devices but also develop skills and support systems towards a Philippine Biomedical Device Industry.
What BEHT wants to create: Technologies that we develop should be at par with both regulatory and industry standards, more affordable than imported devices, easier to operate, accessible to and fit for the Filipinos, and innovative for it to compete even at the international market.
Priority Areas: Result of initial consultations with primary stakeholders identified four major priority areas in developing biomedical devices. Devices on these areas are doable and we have existing expertise locally to develop said devices.
Respiratory support: As mentioned earlier, these devices provide breathing support when
patients are unable to breathe on their own.
Devices for Rehabilitation Medicine: Devices used to provide assistance or improve a bodily
function during rehabilitation therapy.
Prosthesis: Any device that helps replace, correct, or support a body part or function of a body
Minimally-invasive surgical equipment: Equipment used to operate with less damage to the body than with open surgery.
ReliefVent: The project entitled, “Development and Technical and Clinical Safety and Performance Testing of a Philippine-made Volume-cycled Mechanical Ventilator”, is led by Dr. Abundio Balgos of the University of the Philippines.
With the goal of providing locally-available ventilators in the country, this project aims to design
an affordable but safe and reliable mechanical ventilator for respiratory failure support, benefiting intensive care units, primary health care units, patients with respiratory failure.
This is also one of the first collaborative efforts between UP Manila and De La Salle University.
Agapay and Tayo: Two rehabilitative devices were developed by the De La Salle University led by Dr. Nilo T. Bugtai.
Agapay: A Robotic Exoskeleton for Upper Extremity Rehabilitation and Tayo: Robotic
Rehabilitation for the Lower Extremity were both developed to address the need of limited
rehabilitation devices in the Philippines.
Traditional physical therapy is labor-intensive and highly repetitive work for the therapist.
Through these robotic systems, we will provide highly effective, improved or at par efficiency in
terms of rehabilitation therapy, at a lower cost.
Gait and Insole: The project on gait assessment system entitled, “Development and Comparison of Quantitative Gait Assessment Methods of Normal and Hemiplegic Gait using 3D Motion Capture and Wearable Inertial Sensors” will address the need for a reference database of normal Filipino gait patterns to be used in developing wearable sensors to assess rehabilitation of stroke patients.
The Filipino Gait Database was developed by rehabilitation medicine specialists and engineers
from the University of Santo Tomas.
Another initiative from UST is the “Development of an Insole Pressure Sensing System with
Inertial Measuring Unit for the Prevention of Foot Ulcers in Diabetic Mellitus”.
This study aims to address the need for cost-effective alternative in the management of pressure ulcers of diabetic patients, by developing an insole pressure system with a wireless, wearable, self–monitoring device that can constantly analyze dynamic foot pressure parameters.
Boat Project : The Balance on Action Team or BOAT addresses the need for a balance rehabilitation equipment.
The developed prototype features an automated gamified balance board platform that aims for
a balance exercise tool for faster, more improved, and more motivated balance rehabilitation
process. This allows patients to have an interactive rehab session to aid in their recovery.
PCFS: The project entitled, “Development of Posterior Cervical Fixation System”, aims to develop modern, high-quality and affordable posterior cervical implants and instruments.
The system will address the shortcomings of the currently available system and will ensure
compatibility with the Filipino anatomy. The project team is led by engineers and orthopaedic
specialists from the Orthopaedic International Inc.
Lapara : This project provides an economic alternative to both manual and robotic laparoscopic instruments.
The LAPARA device would provide a tool that allows the ease of use and at least four degrees of
movement of the instrument compared to the usual two degrees.
This project is beneficial for the patients that will undergo the operation, as robotic surgery will
be more accessible in terms of availability and affordability. It will also introduce a new
technology by bridging the gap between a fully robotic and manual laparoscopic surgery which
integrates articulated joints to provide a flexible and mobile design.
Total Investment in BEHT: A total of Php 125.4 M has been invested on R&D under the BEHT program.
Development of biomedical devices are divided into four major phases; Prototype development, Bench Testing and Redesign, Clinical Studies and Redesign/Value Engineering Phase.
Currently one project, Reliefvent, is already on the value engineering phase. AGAPAY, BOAT and
GAIT will finish its clinical studies in 2019. PCFS has ongoing bench testing and redesigning
activities while recently approved projects, Tayo, LAPARA and INSOLE will finish initial prototype development. On the other hand, AXIS has been out in the market since 2015.
Philippine Biomedical Device Innovation Consortium : In 2016, the Philippine Biomedical Device Innovation Consortium (PBDIC) was established forming a consortium of science, engineering, health institutions and industry (manufacturing, distribution, repair and maintenance) that serves as an advisory board, designing and implementing activities that will support the biomedical device innovation ecosystem. To date, PBDIC has 19 partner institutions, 14 of which have formal MOUs with PBDIC.
Institute of Biomedical Engineering and Health Technologies: Another initiative supporting the biomedical device innovation ecosystem is the establishment of the Institute of Biomedical Engineering and Health Technologies led by the Program Leader, Dr. Nilo T. Bugtai of the De La Salle University.
The institute will provide a A One-Stop Shop for Information and Support Infrastructure on
Hospital Equipment and Biomedical Devices in the Philippines and conduct Capacity building
programs in biomedical engineering research to start the local biomedical device industry.
Eventually, this program is foreseen to be self-sustainable and will enable acceleration of
commercialization of products from biomedical device research and innovation.
Closing: In the end, we would want to address the lack of locally-available biomedical devices by engineering affordable Philippine Health Technologies. (MegaManila Science Journalists)