Medicine in motion
September 03, 2019
The problem started as many do, with a gap in the marketplace. To distribute medications to patients, hospitals typically choose between expensive robotic carts or basic plastic tubs on wheels that anyone could purchase at a home improvement store.
VCU Health hospitals use the latter, but the carts require workarounds to secure controlled substances and protect patients’ privacy. Two years ago, VCU’s hospital pharmacy staff saw an opportunity to improve the cart, but didn’t have the time to dedicate to research and development and, ultimately, design. They worked with a vendor who tried to adapt an existing product, but the end result failed when put to the test.
“Something like this really needs to be designed from the ground up,” said Shanaka Wijesinghe, Ph.D., assistant professor in the Department of Pharmacotherapy and Outcomes Sciences.
That’s why, when Wijesinghe walked into pharmacy operations manager Michelle Harrison’s office last summer, searching for a project to bring to VCU’s da Vinci Center, Harrison was all ears.
Wijesinghe has been involved with the da Vinci Center — a collaboration of VCU’s schools of the Arts and Business, and colleges of Engineering and Humanities and Sciences that advances student innovation — for years as a mentor, and had been looking for more opportunities to leverage the in-house creative resource to address challenges on the MCV Campus.
“In a sense, we are like Google,” Wijesinghe said. “For every challenge, we also have the ability to generate the solution. It’s just a matter of bridging the campuses and getting people talking to each other.”
In addition to the security and privacy concerns, Harrison pointed to issues with navigating tight hallways, and the need for lockable enclosures that didn’t require staff to carry keys. Not to mention, the cart needed to be more durable than the plastic tubs. Wijesinghe saw potential in the project, and brought the pitch back to the da Vinci Center.
That’s where an engineer, a sculptor, a maker, a designer and a business marketer came up with the answer.
At the start of every semester, Allison Schumacher’s window is covered in sticky notes — a visual map of the projects and students coming to the da Vinci Center.
As director of academic alchemy at the da Vinci Center, it is Schumacher’s job to sort through pitches and skills to find the strongest matches. She’s shepherded more than 60 projects, and has a matrix for what makes a successful one.
First, students have to be able to accomplish real goals within a 15-week semester. The end product has to be tangible, whether it’s a physical prototype, a digital design, or a mobile app. And there has to be a cross-disciplinary aspect.
Finally, project sponsors must be engaged in the process, offering clear guidance, facilitating access to the users and customers, and being open to wherever the process might take them.
“In a sense, we are like Google. For every challenge, we also have the ability to generate the solution. It’s just a matter of bridging the campuses and getting people talking to each other.”
Garret Westlake, Ph.D., executive director of the da Vinci Center, said students benefit from the freedom to challenge assumptions, whether they’re working with a professor, a doctor or a Fortune 500 company.
“[Our students] go in and research the proposed solution to understand if that’s what the end user really wants and needs,” Westlake said. “Oftentimes, people come up with solutions based on a hunch, or because it would be great for them, but not the hundred other people that work in their environment. As long as our students show their work — that they conducted interviews and first-person research — then we’re always supportive of their prototype.”
Wijesinghe also saw his role as a bridge connecting the 2 miles and different vocabularies separating the MCV and Monroe Park campuses.
“A big challenge when you try to bring the humanities and health together is that the problem that is visualized on the MCV Campus doesn’t always get translated into a solution,” Wijesinghe said. “There always needs to be somebody who understands what the health sciences wants and how the students think. In simple terms, I’m acting as a translator.”
With a viable product, an alignment with da Vinci student expertise, and a sponsor on board, the PharmaCart was ready for its next step: the fall 2018 session of Andrew Ilnicki’s Product Innovation course.
GENERATING INNOVATIVE IDEAS
Ilnicki’s course isn’t just about bringing teams together, assigning projects and sending them off to come up with proposals. Instead, he starts with the big picture: how to work together, how to generate truly innovative ideas, and how to zero in on the ones that work.
“Studies suggest that after 50 or 60 ideas, you start getting into the realm of novel and highly creative,” said Ilnicki, who is also the director of strategic technology for the VCU School of the Arts. “If I said, ‘Come up with a hundred good ideas on a given topic,’ they might struggle to do that. But if I bring them through this curated process of advancing certain concepts and building off each idea, and withholding judgment until things are incubated a bit — then they can get into some really interesting spaces.”
The PharmaCart team was made up of students from across the university, and each brought specialized expertise to the project. Mary Metzger’s background in illustration and design as a Communication Arts major and Honors College student aligned with product visualization needs. Mechanical Engineering student Sierra Semel created a 3D model and detailed drawings of components using CAD software. Graphic Design major Tommy Ryan worked on physical prototyping and branding. Peter Manville, a Craft/Material Studies student, brought experience in woodworking to the prototype construction. And Calvin Price, a Business Marketing student, focusing on product and brand management that helped tell the team’s story.
Their varied ways of thinking contributed to the idea-generation process, beginning with research into the existing product marketplace. They studied similar products, such as dry cleaner racks and janitorial carts. They found specialized wheels that would allow the cart to move easily in all directions. They even visited the hospital to measure doors and push around early prototypes in a live setting.
Then the team put their sketches and prototypes in front of da Vinci mentors and hospital pharmacy staff to test and tweak.
Some of the resulting changes seem obvious in retrospect. Waste bins needed to be close to the push handle, and staff needed a workspace for writing notes. After struggling with how to best install slash-proof, pull-down Kevlar panels along the sides, the team found the perfect solution in standard window shades, which they installed on the prototype to test the mechanism’s ease of use. If that mechanism is successful, the final product would feature Kevlar panels that rise and fall on a roller.
Other testing revealed that some features were unnecessarily complex. For instance, the team originally proposed a fully modular design, where whole parts of the cart could be added and removed based on the needs of the day. While great in theory, the pharmacy didn’t have storage space for pieces left behind.
“It went from modular to customizable,” Ryan said. “They can take the shelves and the bins out, but not leave five pieces behind in the middle of the floor.”
DEVELOPING A BUSINESS PLAN
With the prototype and some initial testing behind them, Metzger and Price enrolled in da Vinci’s five-week Pre-Accelerator (Pre-X) program, designed to support student entrepreneurs and innovators. Since the program’s founding in 2015, student participants have raised more than $2 million in investments and revenue, and competed in national pitch competitions.
“You have this assumption that you’ve been given an assignment and it’s super cool because it’s real, but maybe once the semester is over, the project is over,” Ryan said. “But it wasn’t. We had a break, got back together, and were like, ‘OK, now what do we do?’”
With guidance from Vida Williams, the da Vinci Center’s innovator in residence, they developed a business plan, a business model, branding and marketing tactics, and prepped the PharmaCart idea for market. They also submitted the concept for a patent.
At the same time, Schumacher, through the da Vinci Center, hired the team to continue to iterate and build two new prototypes, incorporating the feedback they heard from mentors and pharmacy staff.
“It’s pretty exciting to see it go from a sketch to the real thing,” Ryan said. “And then it’s going to be the real-real thing when it’s shiny injection-molded plastic and steel.”
IN THE FIELD
“We don't want these projects to die as a PowerPoint,” Ilnicki said of the da Vinci Center’s commitment to the long-term life of projects.
That’s why, this summer, the PharmaCart team sent two of the latest prototypes to VCU hospitals for extended testing in a functional lab.
“It’s been awesome having the hospital so close as a resource,” Metzger said. “We’ve been able to get our prototypes in the hands of physicians to push around all day, which is crazy valuable and kind of rare.”
The results will determine where the PharmaCart goes from here. The project could be assigned to another da Vinci Center group for more testing and iterating, or be picked up by local entrepreneurs or a medical device manufacturer with the goal of developing a commercial product. Wijesinghe hopes that, by the time VCU Health’s new 16-story ambulatory care center opens in 2022, PharmaCarts will be supplied for the entire hospital.
One possible path forward is to seek funding through VCU’s new Health Innovation Consortium. Launched in January, the initiative commits $7 million over three years to support the development of new innovations in health care, leveraging VCU Health, faculty research, student talent and the city’s entrepreneurial ecosystem.
“The level of collaboration between our medical units and our academic ones is fairly unprecedented and offers students opportunities to solve real-world problems,” Westlake said. “There’s almost no limit to the type, the depth, and the breadth of problems that can be solved.”
THE FUTURE
Wijesinghe also hopes the PharmaCart can serve as a model for more partnerships to come. He already sees potential for projects around predictive analytics to balance patient load, and a pre-registration and check-in system — similar to airline pre-flight check-ins — that would reduce the time patients spend in waiting rooms, surrounded by other sick patients.
“The PharmaCart is just one challenge on the MCV Campus,” he said. “We have plenty of challenges that require simple solutions that a group of multidisciplinary, creative students can solve in one semester — some that we’ve been trying to solve for 10 years.”
As the PharmaCart moves into its next stages, so are the students who created it. Metzger, Manville, Price and Semel all graduated in May, and Ryan will follow in December. While they’ll retain the intellectual property rights to the PharmaCart, they’re also looking ahead to careers in their own disciplines.
Wherever they land, all agree that their experience developing the PharmaCart has prepared them for today’s innovation- and collaboration-driven work environment — just as the da Vinci Center intends.
“There’s a popular saying that you need a hacker, a hipster and a hustler at the heart of any good startup,” Westlake said. “And what they’re really talking about are cross-disciplinary teams. Why wouldn’t we teach students in environments where we’re bringing those disciplines together in that
