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Clinical Technology: the healthcare of the future

 

This academic year, the first Clinical Technology students will be completing their Bachelor’s at TU Delft, Leiden University (LUMC) and Erasmus University Rotterdam (Erasmus MC). The Bachelor’s degree programme in Clinical Technology is the first fully joint programme  run by the three universities. Why did they set up this programme? What does a clinical technologist do, and what is the professional field like? To get an impression of this, we spoke to researchers, lecturers and students.  

 

The fact that more and more technology is being used in medical care, especially more complex technology, has created a need for a new type of medical professional: someone who has both medical and technical knowledge. Someone who can provide a solution that is both appropriate and safe for the patient. Dr Marjon Stijntjes, a technical physician* who works at TU Delft as a lecturer and researcher: ‘We build the bridges between the patient, the doctor and the technology’.

 

Studenten werken in het lab

Students working in the lab

 

Qualified and competent

If we want to continue to provide patients with high-quality medical care in future, it will be necessary to develop and implement medical technology in healthcare. Doctors are finding it increasingly difficult to use all of these new technologies, because they are not trained for this. When it comes to certain treatments, a clinical technologist will be the best-qualified and most competent provider, because he or she has expertise in both the complex technology and in medicine. ‘Doctors have become social scientists’, says Pieter Leenen, immunologist and associate professor at Erasmus MC. ‘Medicine has moved from being a natural-scientific discipline to being a social-scientific discipline. What’s more, there have been massive developments in the technology. The gap between medicine and technology was getting bigger and bigger, and this programme filled that gap.’

Sustainable and affordable healthcare

The ageing population also has implications for healthcare: now and in the future, healthcare will need to remain sustainable and affordable. The number of elderly is growing exponentially. In 2040, there will be twice as many old people as there are today. Made-to-measure approaches result in higher-quality care and a reduction in costs. Technological developments play a key role in achieving this: we have to get them from the drawing board to the patient in a quicker, more efficient and more targeted way, and they need to be better linked to patients’ needs. ‘The clinical technologist makes these connections; the same person has both medical and technological knowledge. Clinical Technology is playing a crucial role here’, says Lioe-Fee de Geus-Oei, professor of Nuclear Medicine at LUMC.

Bench to bedside

It is extremely difficult to develop functional technology directly without first testing it in practice. According to De Geus-Oei, ‘These professionals, with their interdisciplinary training, can bring technologies from bench to bedside and back to the bench in rapid iterations. This facilitates the process of validating and improving the technology in healthcare, and adapting it optimally to the needs of the doctor and the patient.’

The curriculum

This constant integration of medical and technological education is evident in the Bachelor’s curriculum of the programme. The human body is addressed in terms of each organ system, such as the musculoskeletal system, the digestive system and the cardiovascular system. In this way, pathophysiological knowledge and anatomy are always combined with the most appropriate technological components, such as biomechanics, thermodynamics and medical imaging. ‘It’s really great to develop your knowledge of the human body, such as of anatomy. But it’s also interesting to work out how much force a particular muscle then needs to pick something up, and where the greatest load falls’, says Max Ligtenberg, a third-year student of Clinical Technology.

The medicine of the future

‘I think it’s important that the students are taking an interdisciplinary approach’, says De Geus-Oei. ‘Take big data, for example. Huge amounts of data are available: molecular, functional, morphological and pathological data, but also data on a patient’s medical case history, their symptoms and the lab data. The patient’s genetic profile and their social situation are also relevant. If we are able to draw links between these data in “clouds”, then we can develop made-to-measure healthcare. This is the medicine of the future.’

Solutions to medical problems

In clinical practice, a medical specialist will consult a clinical technologist if there is a need for medical-technological expertise as part of diagnostics or a patient’s treatment programme. According to Stijntjes from TU Delft, ‘In intensive care, for instance, one encounters many complicated medical problems. Take artificial respiration, for example. It’s fantastic that we’re able to help someone breathe, but what’s the right breathing technique for a particular patient? We can’t see whether the lung is expanding fully when we breathe, whereas of course we’d like to able to do so. Our colleagues from technical medicine are currently developing breathing models for this. In the third year of the Bachelor’s programme, we’ll also work on this with the students, and they will build their own model, step by step.’

Futuristic

Student Max Ligtenberg: ‘I feel that we’ve entered an accelerated phase. It’s possible to do so much using technology in healthcare. Take the study of the monkey with paraplegia, for example: the monkey was able to walk again after an electrode was implanted in his spinal cord. The whole thing sounds almost futuristic.’

* Universiteit Twente
The programme in Technical Medicine at the University of Twente has been training students to become technical physicians, also known as clinical technologists (ed.), since 2003. The Leiden-Delft-Erasmus programme in Clinical Technology and the programme in Technical Medicine at the University of Twente train students for the same profession.

 

A Master’s programme in Technical Medicine is currently being developed, which will begin in September 2017, once it has gained accreditation. This three-year Master’s will focus on deepening thinking and action in the area of medical technology, based partly on taught courses and partly on doing internships in clinical practice.

Ligtenberg (student): ‘Medicine and technology were two areas that really attracted me, so I didn’t need long to make up my mind. I’d love to help people and to cure them, and if I’m able to do that by developing technological applications, then that’s fantastic. I’m really enthusiastic about the programme and I definitely want to go on to do the Master’s.’

De Jong (student): ‘I like the idea of working with doctors. During the Master’s programme, we’ll also do an internship. We’ll have to find out for ourselves what role we could play in the department of a university teaching hospital. That’s great: we’re real pioneers. I think it’s a fantastic course, but I don’t enjoy the travelling much.’

Stijntjes from TU Delft: ‘At present it’s a wonderful profession, but also undoubtedly a tough one. The pioneers are working very hard to establish and clarify their position. It’s a tough process, because you’re not treading a beaten track.’

Link to the programmes 
Universiteit Leiden 
Technische Universiteit Delft 
Erasmus Universiteit Rotterdam 

More examples from practice
The Dutch Association for Technical Medicine (Nederlandse Vereniging voor Technische Geneeskunde, NVvTG) – the professional association that represents the interests of technical physicians in the Netherlands – describes a number of practical cases on its website.

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Leiden-Delft-Erasmus News December 2016
Leiden-Delft-Erasmus News December 2016