Working on the intersection between technology and healthcare

The clinical informatics post-graduate program is a two-year School of Medical Physics and Engineering Eindhoven course. It offers post-graduate programs to healthcare professionals. Each year, 12 trainees start the program. Upon completion, they receive a Professional Doctorate in Engineering (PDEng). As of September 1, that will be changed to EngD. The program is in Dutch, because the trainees work in Dutch healthcare institutions and need to master the Dutch language.

The trainees apply for a two-year internship in a hospital or healthcare institution. One day a week, they follow courses at TU/e; the other days, they work on small projects and a design assignment in the healthcare institution. There is also a three-month external assignment with an external party. “So they work and learn at the same time,” says the program’s co-initiator, Guido Zonneveld. 

The trainees should preferably have a few years of work experience before taking this course, says Zonneveld. “When you’re fresh out of school, you don’t know what a working life entails yet; it’s good if you’ve experienced that for a few years before starting this course. We also get people who’ve been working for years but want a better theoretical foundation. The program boosts their development tremendously.”

It works the other way round, too: “I learn something every day when I supervise trainees,” says Zonneveld. “I encounter complicated projects, discuss them, and add that knowledge to my expertise. I learn what's happening in the various hospitals and can use this to connect with other hospitals struggling with the same problem. I feel like a kid in a candy store, and it’s a privilege to work with young people.”

Zonneveld describes the training as ‘tough’: “The trainees often get difficult assignments, which haven’t gotten off the ground in hospitals for years. These become our trainees’ design assignments. They often tell us it’s incredibly hard work, but they wouldn’t have wanted to miss it.”

Most of the alumni work in hospitals. But some are also employed at, for instance, the Netherlands Comprehensive Cancer Organization where they try to improve protocols around cancer care.

The intersection between technology and the clinic. That is what Sade Faneyte loves about her job as a clinical informatician at Maasstad Hospital in Rotterdam. She studied biopharmaceutical sciences and biomedical sciences in Leiden, and did one of her internships in Erasmus Medical Center in Rotterdam. She then had doubts about doing a Ph.D.

“I love working in the hospital, so I decided first to get more on-the-job experience.” She did that in Aruba, where her family is from, where she worked in a clinical chemistry laboratory in a local hospital. “One day, I was introducing new lab systems, advising management; the next, talking to doctors or pharmacists. My interest in the interplay between technology and clinic grew by the day, and I wanted to return to the Netherlands for training in that field,” says Faneyte.

She found a post for a clinical informatician intern at Maasstad Ziekenhuis, applied from Aruba, and was accepted. Two years later, she is this PDEng program’s 100th laureate.

Roadmap

Faneyte has developed a roadmap to help in the decision of purchasing medical devices that use AI software. “It allows you to support the introduction of these new technologies and meet all the challenges that go with that in hospitals,” Faneyte explains.

“Using artificial intelligence (AI) in healthcare is inevitable if you want to keep care efficient and affordable,” says Faneyte’s supervisor Raymond Sladek. “Via the smart use of AI, the ultimate goal is to have more time and attention for the patient.” Faneyte adds, “You must know what AI software can and cannot do.”

“Medical devices are becoming increasingly predictive, thanks to AI. If they predict, say, a diagnosis, you have to carefully consider how to use this safely. What is the risk and impact? That’s even more complex with predictive systems than with normal software. You have to test the system, consider how you introduce it, and in which phases. And how to enthuse the healthcare professionals who have to work with it. They don’t want to know all the ins and outs. What they do want is to know whether the results the system provides are clinically relevant and reliable. I designed a plan of the steps that must be taken to ensure the software quality. It addresses all those issues. It’s a living document because the field is developing at break-neck speed.”

Next step

How is this roadmap going to be used? “The Maasstad Hospital Board of Directors will determine the outcome of Faneyte’s design. Then it can be used to aid medical software's life cycle,” she says. Supervisor René Verhaart adds: “I think other hospitals will begin using it too.”

Now that she has completed her training, Faneyte is staying on at Maasstad Hospital as a clinical informaticist. She hopes her design will be picked up even more broadly: “I shared it on LinkedIn, which received tons of enthusiastic responses from other hospitals that also want to use it. That can only improve the roadmap.”

Faneyte and her co-workers’ next project already awaits them at Maasstad Hospital. “we are going to implement an AI model that predicts ICU discharges. That’s a huge case study.”

Raymond Sladek (on the right on the screen) is a TU/e alumnus of Biomedical Engineering, received his Ph.D. from Applied Physics, and did the PDEng training to become a clinical physicist. He works as such at Maasstad Hospital in Rotterdam and was one of the supervisors of Sade Faneyte’s - who received the Clinical Informatics program’s 100th diploma last Friday - supervisors. He did so along with his colleague, clinical informaticist René Verhaart, who studied Biomedical Engineering at TU/e and received his Ph.D. from Rotterdam’s Erasmus University.

Sladek explains the difference between clinical physics and clinical informatics. “Clinical physicists focus on clinical equipment and devices and interact with patients. Clinical informaticians focus more on the software and process chain behind it.”

Clinical informaticist René Verhaart elaborates: “Medical devices are becoming increasingly software-driven. Take an ultrasound machine: the medical image processing is done entirely with software. The information from the ultrasound is sent via a network to be processed somewhere else using IT. That chain is the field of the clinical informaticist.” Sladek adds: “With the common goal of helping both patients and doctors.”

“The great added value for us, as a hospital, in participating in the clinical informatics training is knowledge, a lot of knowledge,” says Sladek. “The trainees receive masses of knowledge during their training that benefits us. However, the network is important too. Each year, about 12 trainees follow the PDEng program, forming a nice network of professionals that’s active in healthcare institutions throughout the Netherlands.” In this regard, according to Sladek, TU/e acts as a knowledge hub, one central place where all knowledge is gathered.

“The university in Eindhoven has always had great relationships with hospitals for training. These connections are valuable because they lead to great projects and collaborations,” says Sladek.

He is delighted with the thorough scientific supervision TU/e offers the trainees. Maasstad Hospital is not a university hospital. “TU/e’s scientific supervision is, therefore, very valuable to us. For medical technology, you really have to be in Eindhoven; many clinical physicists were trained in Eindhoven. As an alumnus, I’m quite proud of that.”