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FACULTY SYMPOSIUM Medical Technologies: Both Glitter and GoldAt the June 5 HMS Faculty Symposium, speakers dazzled the alumni audience with four facets of the technological revolution in medical education and practice. These included taking the curriculum online, mapping brain activity during surgery, applying genomic data to disease, and creating the operating room of the future.
Peter Black describes advances in surgical "navigation" that he says have "revolutionized our treatment of brain tumors and changed the way we think about surgery and what we can do with it." (Photo by Graham Ramsay) John Halamka, HMS chief information officer and associate dean for educational technology, discussed the MyCourses Web-based medical curriculum. The innovative system "does not replace teaching with technology," he said, but rather uses technology in ways that can best assist students and faculty. Among the MyCourses functions that wowed the audience was the capability to "navigate four years of knowledge." For example, students can search videos of all course lectures for each use of the word stroke or use the "physiology explorer," a series of interactive animated diagrams that help them better understand basic physiological mechanisms. Integration of ExpertiseHalamka was followed by John Parrish, the Edward Wigglesworth professor of dermatology at Massachusetts General Hospital and also the director of CIMIT, the Center for the Integration of Medicine with Innovative Technology.CIMIT expands the frontiers of medicine by identifying and adapting "enabling technologies" initially developed elsewhere, such as in the weapons, entertainment, communications, and computer industries, he said. CIMIT provides the funding, management, and technological development. Parrish described how CIMIT tapped the expertise of surgeons, architects, equipment makers, and MIT engineers to boost efficiency in the operating room. In the "OR of the future"--which became a reality at MGH in August 2002--an automated control system changes the room configuration for each procedure, moving unneeded equipment out of the way and adjusting settings, such as operating table height, to the preference of individual surgeons. This streamlining allows more procedures to be done in less time, and CIMIT is evaluating how it affects surgical outcomes. Honing SurgeryPeter Black, the Franc D. Ingraham professor of neurosurgery at Children's Hospital, followed with a discussion of technologies that are helping surgeons change from being "big cutters" to delicate operators of fine-tuned tools--gamma-knife surgery, focused ultrasound, robotics--that increase precision and minimize damage. Black used the case of a brain tumor patient to illustrate how intraoperative MRI and direct brain stimulation are applied to remove the malignancy without damaging brain areas that control speech, movement, and other vital functions.The final presenter was David Altshuler, HMS assistant professor of genetics at MGH, who explained how human genetic variations will become increasingly important in improving risk assessment and treatment methods. "We're going from treating people as population to treating them as individuals," he said. To complement the "consensus" map of the human genome, Altshuler and others are building a haplotype map focused on individual differences that are potentially important in determining who gets what disease. The future, he said, lies in working out the complex pathways of common disease--in which many genes play a role--and targeting therapies to the specific susceptibilities of individual patients. Symposium moderator Daniel Federman, senior dean for alumni affairs and clinical teaching at the Medical School, summed up the session, noting that the presentations vividly demonstrated "the power of bringing together, either deliberately or opportunistically, people from a variety of disciplines." --Tom Reynolds |
