Proving Immersion Matters: UVA Pioneers Engineering-to-Medicine Faculty Fellowships

(Top L to R: Anil Vullikanti, professor of computer science; Dr. Donna Broshek, co-director of the UVA Acute Concussion Evaluation Clinic and neuropsychologist; Tom Fletcher, associate professor of electrical and computer engineering and computer science / Bottom L to R: Dr. Costi Sifri, director of hospital epidemiology at UVA; Matthew B. Panzer, deputy director of the UVA Center for Applied Biomechanics and associate professor of mechanical and aerospace engineering; Dr. Jeffrey Elias, director of stereotactic and functional neurosurgery at UVA / Photo credits: UVA Communications)

“Once my students began shadowing the surgeons and seeing surgeries, they became even more motivated to help improve care outcomes and improve patients’ lives,” said DONALD RICHIERI GRIFFIN, University of Virginia assistant professor of biomedical engineering and chemical engineering. Griffin and his students are collaborating with UVA orthopedic surgeons, plastic surgeons, radiologists and mechanical and biomechanical engineers to create new treatments for arthritis, a debilitating disease that affects more than 32 million adults annually in the United States.

Griffin advises students who are taking advantage of the unique collaboration model supported by the UVA CENTER FOR ENGINEERING IN MEDICINE and its $10 million effort to promote innovation at the interface of engineering and medicine. The model, called embedding, is where one research team member physically co-locates in the other team’s lab or department to work on a specific engineering-medicine project, usually in a critical medical need area.

Engineering students walk away with new skills and a new perspective.

“I had never been involved in medical research before,” said Homdee Nutta, a UVA electrical and computer engineering Ph.D. student. “Now I have learned how to talk to patients and their families about our technology and research. I get to hear their input into our designs.” Nutta embedded in the UVA Palliative Care Clinic and helped to DEVELOP AN IN-HOME SMART HEALTH SYSTEM FOR CANCER PATIENTS.

So far, embedded team members have been mostly students. One of the goals of the center is to inject the future workforce with a new kind of cross-disciplinary skill set. Through training, workshops and other opportunities, engineers learn to fluently “speak” medicine, and clinicians learn to fluently “speak” engineering. A type of cross-culturally adept researcher is an outcome of the embedded, immersive experience designed by the center.

Since its inception in the fall of 2017, the center has funded many high-impact engineering-medicine collaborations that have incorporated student embedding, some of which started helping patients right away. Examples include DEVELOPING A DRUG DELIVERY PATCH TO MANAGE PAIN WITHOUT ADDICTION, USING BIG DATA TO IMPROVE DRUG DOSING FOR DIALYSIS PATIENTS and many more.

After abundant success with students, it seemed only natural that embedding collaborations would expand to include faculty. Although faculty have been advising embedded students and have helped drive the success of the program, it was time to put faculty on the front lines. The center created faculty fellowships, which come with a small amount of funding that allows faculty to separate from their busy academic schedules — the biggest obstacle to first-hand faculty embedding — so they could engage in the same intensive research experiences. 

“Faculty fellowships are a unique opportunity to allow individual faculty to take a deep dive into a field they are not familiar with,” said DR. MARK SOCHOR, director of the UVA Center for Engineering in Medicine and the vice-chair for research at the UVA Department of Emergency Medicine.  “This cross-pollination of engineers and clinicians allows communication and idea generation that would not normally come about with a chance encounter. This is the water cooler conversation on steroids.”

Engineers and clinicians make progress in ways that would not be possible if they were not working in an immersive collaboration. “Faculty embedding creates a research-ideas portfolio that leads to a long-term relationship between the engineering and medical teams and bears fruit for years to come,” Sochor said.

One of the first to take advantage of the Embedded Faculty Fellowship was SCOTT ACTON, professor in the Department of Electrical and Computer Engineering, who began applying biomedical imaging analysis to RESEARCH ON DEVASTATING NEURO-IMMUNE DISORDERS SUCH AS ALZHEIMER’S DISEASE with neuroscientist Jonathan Kipnis.

“I’m still experiencing the impact of my faculty fellowship,” Acton said. “After we launched our first projects, we continued to collaborate and map the human brain and its immune system. We’ve published several papers, including two high-impact papers — in NATURE and the JOURNAL OF EXPERIMENTAL MEDICINE — which have over 300 combined citations.

“I also believe my embedding and close cross-disciplinary collaborations with the med school gave me the experience I needed to become a NATIONAL SCIENCE FOUNDATION PROGRAM DIRECTOR FOR SMART AND CONNECTED HEALTH. In this role, I’m managing research that deals with viruses, including COVID-19, and how to prevent future pandemics. So, in addition to contributing to ground-breaking scientific discoveries with Kipnis, now I’m able to be on the frontlines helping to solve an urgent large-scale public health problem. I believe that advances in computing, coupled with breakthroughs in biology, are keys to avoiding future global health crises.”

The newest cohort of embedded faculty, whose research is poised to help millions of U.S. patients, includes research between the UVA schools of Engineering and Medicine about brain injury and trauma, hospital-acquired infections and tremor surgery.

MATTHEW B. PANZER, the deputy director of the Center for Applied Biomechanics, an associate professor of mechanical and aerospace engineering and a member of the UVA Brain Injury and Sports Concussion Center, RESEARCHES THE BIOMECHANICS OF CONCUSSION, an injury that occurs over three million times in the United States each year. He is also studying how the cumulative effects of sub-concussive head impacts may lead to long-term neurodegeneration, a condition that may explain some of the cognitive deficits observed in retired professional football players. For his faculty fellowship, Panzer is shadowing clinicians at the UVA ACUTE CONCUSSION EVALUATION CLINIC, including neuropsychologist and co-director DR. DONNA BROSHEK, to gain a clinical perspective on how the forces from motor vehicle collisions affect symptom presentation in brain injury patients.

“While Matt has learned from our patients about how they have been affected by collisions, we have all learned a great deal from him about how the forces in motor vehicle collisions can be mitigated by different types of safety features in motor vehicles.  It’s been fascinating to have him work with us,” Broshek said.

Through this faculty fellowship, Panzer is developing a comprehensive model for studying traumatic brain injury by forging links between his own area of expertise — injury prevention and impact biomechanics — with neuroradiology and neuropsychology, fields that are traditionally unconnected to biomechanics. By using this comprehensive, multidisciplinary approach, Panzer and UVA collaborators hope to gain deeper insight into traumatic brain injury and its effects with the aim of helping clinicians improve patients’ treatment.

ANIL VULLIKANTI, a professor of computer science and a member of the UVA BIOCOMPLEXITY INSTITUTE, is researching C. diff., a hospital-acquired infectious bacterium that can harm patients’ treatment and recovery. C. diff. affects over half a million people in the United States each year. For this fellowship, Vullikanti is creating a way to combine multiple specialties in medicine with different tools from artificial intelligence, machine learning and statistics to detect C. diff spread and design interventions for minimizing outbreaks. Vullikanti is collaborating with COSTI SIFRI, the director of hospital epidemiology at UVA, and DR. WILLIAM PETRI, vice-chair for research in the Department of Medicine and a professor of infectious diseases and international health.

Vullikanti’s work has potential for significant impact. “The work that Dr. Vulikanti is conducting to utilize machine learning tools to design ways to prevent infection by C. difficile is key because this is the most common and potentially the most deadly infection acquired in hospitals in North America,” said Petri.

The team’s research has already been recognized by the UVA Global Infectious Disease Institute, which awarded them a grant to expand their research using this method and design solutions that go beyond traditional disease control methods. In addition, Vullikanti is using the same approach to develop proposals for studying other hospital-acquired infections and even address opioid addiction related to hospital anesthesiology. Vullikanti also applies this same expertise in his new role AS THE SCIENTIFIC COORDINATOR ON A $10M NATIONAL SCIENCE FOUNDATION GRANT that aims to thwart future pandemics.

TOM FLETCHER, an associate professor with joint appointments in the departments of Electrical and Computer Engineering and Computer Science, is working with DR. JEFFREY ELIAS, director of stereotactic and functional neurosurgery at UVA, to help tremor patients. Fletcher is using diffusion MRI imaging and data analysis techniques to help understand the causes of tremors and to create a better means for preoperative planning and postoperative evaluation of tremor patients. Tremor disorders affect over 10 million people annually in the United States.

Fletcher has already teamed with radiologists and technicians to recalibrate the MRI machine settings so the diffusion images are optimized to collect better data for planning and evaluation. In addition, when enough data is collected, he will have developed a type of brain map that could help customize care to patient groups who have similar brain imaging patterns. Fletcher envisions that future applications may go beyond pre- and post-op uses and provide real-time data for decision-making during surgery.

Fletcher has been working in an engineering-medicine capacity ever since he started doing medical imaging in graduate school. “I wanted to use my love for math and engineering to somehow contribute to society. Just add the medical component and it all comes together,” Fletcher said.

After experiencing embedding first-hand, Fletcher was so enthusiastic about the center and its mission that he ACCEPTED A POSITION AS THE CENTER’S ASSOCIATE DIRECTOR in September, 2020.

The UVA Center for Engineering in Medicine plans on supporting seed grants and student and faculty embedding fellowships every fall and spring semester until the end of its official grant period in 2022 and perhaps beyond. The center has developed a successful and robust sustainability plan that includes investing in critical-need research areas that can later garner return-on-investment funds via grants from other institutions. This allows the center to reinvest in more promising, early-stage research.