Improving Rural Healthcare: Medical Devices That Increase Health Access
Dasha: [00:00:00] .Welcome to the Biomedical Frontiers Podcast, where we explore pivotal research projects and disruptive innovations aimed at translating scientific advancements into tangible healthcare solutions. I'm your host, Dasha Tyshlek. 
Aileen: Once you start to see these symptoms return, you have a very short window of time during what you can go seek care in order to make sure there are no long-term effects from this. Because, you know, it can result in brain damage or even death if this isn't treated quickly.
Dasha: Is that hours, days? 
Aileen: The rule of thumb is that by the time you are seeing symptoms return, you probably only have about an hour, at most.
 Dr. Mark Witcher, wanted to provide a way for patients to get an early warning that their shunt had failed. He envisioned a way of monitoring the flow itself and that would provide the patient extra time to go seek care. 
Dasha: How did the doctors, the nurses, react to your engineering team being [00:01:00] out there watching procedures, gathering ideas? 
Aileen: Sometimes people have been dealing with a problem for so long that they don't even realize it could be something that was, that was solved. 
 We try to be, very low profile in any sort of observation situation, but we've received nothing but excitement. 
Dasha: Welcome to another season and a new year of Biomedical Frontiers. The next six episodes, we've planned something a little bit different. We're gonna be looking at innovation in healthcare that is being developed at the bedside, that is being led by physicians, therapists, nurses, and even the patients themselves.
Today's guest is Dr. Aileen Helsel. Director of Innovation at Carilion Clinic. 
David: Board member 
Aileen: of the Roanoke Blacksburg Innovation Alliance Chorda Pharma and ArchiveCore. Leader in development and commercialization of new inventions at Carilion and the region's biomedical entrepreneurial ecosystem.
Dasha: Previously, she commercialized life science innovations at Washington State [00:02:00] University.
Aileen, welcome to the show. 
Aileen: Thank you so much. It's so good to be here. 
Dasha: Well, let's begin with Carilion Clinic and rural healthcare. Can you help us understand why rural healthcare is different from maybe urban healthcare systems and what are the unique challenges as well as opportunities for innovation in this setting?
Aileen: Yeah, absolutely. So just a little bit on Carilion Clinic in general. We are a nonprofit healthcare system. We serve about 23 county region in central and southwestern Virginia, and in southern West Virginia. And we serve about a million patients throughout that region. We have about 850 physicians. We cover 85 specialties.
We have a medical school, multiple residencies and fellowships. We run clinical trials. And we're also a rural healthcare system in a lot of ways. So we operate seven hospitals and three of those are considered rural and two of them are there are two that are some [00:03:00] of Virginia's seven critical access hospitals.
17 of our 41 primary care practices operate as rural health clinics as well. So, it creates an interesting dynamic because we have a lot in Carilion Clinic that is very forward thinking and very modern. And we serve a rural healthcare population, which is very interesting. And, and in rural settings there are some very specific challenges that they are facing.
So access to care is always a challenge. So, you know, I can see a hospital from my front porch, but many of our patients would have to drive an hour to get to somewhere they could receive healthcare. Some of the other challenges, you know, I think healthcare systems across the entire nation are facing workforce challenges right now.
And we feel that really acutely. So, several of our service areas are in what are called healthcare professional shortage areas. So we feel that, you know, that pinch, that, that challenge with [00:04:00] getting staffing even more acutely than, than other systems across the nation. Another big challenge is that patients, the patient population is a little bit different, so tend to be older.
About half of our patients are over 65 and about a third of them are dealing with chronic health challenges. So hypertension, diabetes, heart issues. We're serving a population that tends to be a little bit older, a little bit sicker. And when you combine that with the challenges with access, when they, when they find it hard to get to a healthcare site that, that creates some unique challenges.
So, you know, our commitment is to improve the health of our communities, not just maintain it. So we are really dedicated to innovating in this space, to providing unique solutions for patients that are in a unique situation.   
Dasha: One word you mentioned is access. And you mentioned a specific term, [00:05:00] "critical access" as a kind of definition to a particular set of hospitals.
Can you explain what that really means and the breadth and depth of the access issue itself? 
Aileen: Yes, that's a great question. Critical access hospitals are a really important part of the healthcare system. They are defined as hospitals that are at least 35 miles away from another hospital.
So they are sort of this sole provider. They represent this location that is kind of the only place that a lot of people are gonna be able to get care from. So they, play this pivotal role in providing for patients who don't have anywhere else to go, in a lot of ways. And so they need to be very multifunctional and they need to be able to provide excellent care to a wide variety of patients.
And also identify times when those patients need to maybe be sent elsewhere as well. 
Dasha: Yeah, that's really interesting. So 35 miles from another hospital, it's still at least half [00:06:00] an hour to get to the hospital if you're living in between them.
So I don't know actually that if I did 
Aileen: the math right, yeah, yeah. 35, 35 minutes. And, and, and that's a, you know, and that's a, that's a minimum a lot of the time it can be more than 35 miles away. So we can talk about places that can be fairly isolated. 
Dasha: Yeah. So one thing that's a big question is what can be learned from rural healthcare that makes all healthcare better?
Aileen: Yeah. I think in a lot of ways. There are, there are many things because what rural healthcare systems are experiencing are a lot of the same problems that you see with healthcare systems across the nation. It's just sort of amplified. So, you know, you hear a lot about healthcare systems experiencing challenges with staffing and access and, you know, our entire nation is experiencing a lot more chronic healthcare issues.
So really we're, we're seeing all the same problems. It's just amplified. And so [00:07:00] in a lot of ways, the ways that we address those issues are extremely translatable. We kind of have to be at the forefront of solving those problems and addressing those issues because they are so much more critical to us.
But I think a lot of the lessons that we learn through increased efficiency and providing more ways for our patients to basically stay out of the hospital and not have to come to the clinic; those are all things that we that I think are very translatable. So, for example, providing healthcare providers with a lot more assistive technologies that will allow them to practice at the top of their license and not have to perform menial tasks, you know, and allowing them to streamline their workflow and make the most of their time and be extremely efficient.
Those are things that we've looked into and implemented across the system because we have to, you know, we have to be very efficient with our time. We've been very proactive in identifying remote patient monitoring systems and different ways [00:08:00] to provide in-home care for patients that allows them to stay healthy at home and seek care when they need to without without coming in unnecessarily.
And I think. That's something that is really important regardless of where, where a healthcare system is. Those are things that, that, that need to be addressed across the board. Because this really frees up space for urgent patients. It reduces costs something else that we, you know, that everyone is struggling with.
And all in all, I mean, I think it kind of folds into increasing preventative care keeping patients healthier. And as I said this, these are all things that everybody is dealing with. We have to deal with it a little bit more urgently right now. And so I think those are all very translatable lessons.
Dasha: One thing that kind of comes to my mind is kind of areas that seem acute with the access as well as the staffing shortages. I'm thinking, okay, if people have a really hard time getting to the clinic, like [00:09:00] preventative medicine is, even if you are person oriented towards preventative action is just harder.
Right? But also I'm guessing there's impact to emergency medicine. If it takes longer for people to get to the hospital then your physicians and staff have less time to do critical urgent care actions because of the amount of time a person might have to be transported for. Aileen, one of the things that's so interesting about your journey is you started out in academia doing research but now you're in a rural healthcare setting directing innovation.
Can you share your personal journey and what you've learned in, in contrasting these different scenes for innovation? 
Aileen: Yeah, it's been, it's been a really interesting journey. I don't think, you know back when I started my doctorate research, I don't think I would've ever expected to be where I am right now.
But it's been, it's been definitely the best path for me. When I was in graduate school doing research for my PhD, I absolutely loved bench work. I loved being able to go in every day [00:10:00] and think of a question that I wanted to answer and design some, you know, an experiment that would answer that question.
It was very fulfilling and I was really passionate about that. You know, one of the things that I started to realize though is that there's sort of this gap between the foundational research, so much amazing research going on in labs across, in academic settings, across this the US and
getting that out into the real world where it can have an impact on patients. You know, it's happening every day, but but, but not many people are, are in that space in between. So I really wanted to be that, be part of the bridge between that foundational science and, and getting it out into the real world.
So I started working in technology transfer for Washington State University. I managed their life sciences portfolio for them for several years. And that was really, I mean, it was an amazing learning experience, just going from that very science focused, data-driven, just produce the results, write papers present [00:11:00] into
having to translate that into business speak. Basically, being able to say, you know, give the value of that science in business terms and how that could have an impact in in the real world. So it was an amazing experience and I absolutely loved working in that space and learned so much. And I started to get really interested in that same, those same concepts applied in a healthcare system because really you are at that point, you are addressing some of the most urgent needs that patients have.
You are identifying some of the most critical needs, and you're able to solve those problems right there in the real life setting. And that just was really motivating to me. I'm very, you know, from a practicality standpoint, it, you know, being, being right there in the mix and being able to address those problems on site was very, it was very interesting to me. And, and so I was talking to some different people and I, you know, looking at different opportunities and when I got to Carilion clinic, it was really clear [00:12:00] that Carilion as a whole is very dedicated to that innovative mindset, to patient first, to identifying things that matter to our patient population.
And that was really inspiring. And I just loved, I loved that approach. And I also just really liked the Roanoke region. It's beautiful here, wonderful outdoors, and that, that never hurts either. So making that transition from more of an academic setting to a healthcare system, it's been a huge learning curve for me.
Healthcare is complex and, and challenging, but it's, it's something that I've really started to embrace and and learn a lot from. And, and as I suspected, it is very fulfilling to be right there bedside, seeing, being able to see these problems translated into solutions in real time. 
Dasha: What's a kind of a difference between tech transfer within a university setting versus kind of driving innovation and creating that engine for developing new, including technologies,
but in a hospital setting [00:13:00] instead. 
Aileen: You know, when you're translating research from an academic setting, you are working with people who they've been in research for forever. They know research in and out. They are, this is their job, this is their, this is what drives them and this is what they're really passionate about.
They are researchers and that's, that's amazing because their knowledge and their, their understanding and their commitment to it is incredibly deep and and, and very impressive. And working with them, it's easier for them to translate a lot of that into technology transfer. That's their whole world. The what I love about working with healthcare professionals is that they come to us, they just wanna solve a problem for their patients. They're very, that is their primary focus, is they have identified a problem. Sometimes it's a problem they've dealt with for years and years, and they want to be the one to solve that problem and to provide that solution for their patients.
It's a very [00:14:00] practical practical approach. And it's also, you know, it can be a lot quicker too. You know, they, a lot of the time these are they can even be very simple, but very profound improvements. And, and that how rapidly you can go from identifying a problem to implementing a solution is something that I, as a very impatient person, have also really appreciated about this setting.
Dasha: Now, you're also pursuing an executive MBA right now, and so that's a, you've got the engineering perspective, you've gone through tech transfer process. And now you're, in you know, very practical setting where healthcare is just being delivered and innovation is just a result of people encountering challenges.
But, the business side of things, how does that play into what you do? And what are you learning from the business perspective of things that's contributing to your ability to transfer ideas into innovations that are applicable and applied and ultimately delivered? 
Aileen: Yeah, that's a great question.
I mean, I think that the things that [00:15:00] I've learned from going through an executive MBA have been very impactful. Something about this job that is unique. Is how much cross-functional collaboration is needed. And a lot of that collaboration and leadership that has to occur there occurs without any clear authority, I guess you could say.
So I need to be able to and, you know, get people to work together and push towards a common goal and do that across departments, even outside of our institution. You know, we have many collaborators outside of Carilion Clinic. So being able to do that effectively has, I have learned so much about effective communication and really all those soft skills that go into that type of work.
That's honestly been a huge, huge benefit of being in a program like UVA's Darden's Executive MBA Program is, it is so rich [00:16:00] in all of that, in skillful communication and effective leadership. I think that's really been the biggest benefit that I've seen from being in that program. 
Dasha: So I think you brought up a great point, which is it sounds like, you know, we've got seven hospital systems, tons of outpatient clinics, hundreds of doctors, a million patients.
How do you create an innovation engine within an organization that is so geographically distributed, serves so, such a large population, it has so many different people involved. What does it practically look like to be the Director of Innovation in, in such a scope? 
Aileen: Yeah, that's a great question. I think, you know, I've really learned a lot about what, what it needs to be over the last few years.
I think, I think we, it's, it's easier to get to be marketed essentially to some of the more Roanoke based healthcare providers and folks, but we want to be able to tap into all of our [00:17:00] sites and hear from everyone across our entire system. So a lot of it has been, it's been a lot more marketing, I'd say, than I expected when I came into the job.
A lot of it is about outreach, about how people across the entire system understand what it is to innovate, what does it mean to work with innovation, how can we help you take your problem and turn it into a solution? And I think that's really starting to pay off. We're starting to see engagement from even from, from across the entire system, from hospitals that are out in more, in our more rural areas and from those close to Roanoke.
And, and we're starting to see this. And that's something we track because that's really meaningful to us. We, we want people across the entire system to know that we're here for everyone. We want to hear from everyone. And everyone's problems are worth solving. And so that's been a big part of what I've been doing over the last couple years is a lot of outreach so that people, a lot of it's just education and, and explaining and, and establishing that culture [00:18:00] of innovation throughout the entire system.
Dasha: What does it look like for somebody in your system who has an idea or, or a problem that they're encountering and they'd like to see a solution? What does it look like for them to kind of reach out? What happens next? What's your process look like? 
Aileen: Yeah, that's a great question and something that we're always a little bit workshopping as well, because we learn a lot from each interaction.
But, you know, overall we, we want to make it a very low lift for them, for our inventors. You know, their primary focus is always going to be providing care for our patient population, and we wanna be the framework and the the system that allows them to solve their problems. But we don't wanna take all their time doing that either.
They have very limited time, of course. So we try to make it as streamlined as possible. We have, you know, we try to make everything online if we can. You know, we have an online disclosure system, so the first step they take is go in and fill out this questionnaire and we always make it clear, you know, fill out what you can.
You're not, you're not an entrepreneur yet, and you're not an inventor yet necessarily, [00:19:00] but, but, you know, answer the questions as best you can. Questions around, you know, what is the problem you're solving? How do you see solving this as, you know, improving patient care? Do you, what's the current solution?
And what companies might be interested in this solution if it were to come available. So some very basic questions, just that we can get a sense of what problem they're addressing and how they're, how they're expecting to do that. Once we receive one of those disclosures, we love to have a, a, a conversation because you can get a lot more from a conversation and understanding the problem more deeply through talking to the person who's dealing with it.
So we'll have, you know, a, a usually an hour long conversation with them after receiving a disclosure. And we really like to take a, a problem focused approach to solving these problems. The last thing we wanna do is start creating a solution for something that's actually a symptom of a larger problem.
So we dig into that problem, you know, we'll even do site visits if appropriate. If we need [00:20:00] to watch a surgery that is the subject of the invention, we'll, you know, get access to that. You know, we try to embed into the system and take advantage of the fact that we are a part of a healthcare system as much as we can.
So once we've really identified that core problem and we know that we're addressing a real need often, we'll, you know, we'll take a look at the solution they propose, but a lot of the time it, it becomes a conversation of how can we change this to really make this even better? And, and there's often a lot of change to it during the process.
I mean, some people come to us with very fully formed solutions that they've thought a lot about, extensively because you know, they, they've maybe been thinking about it for years. And some people come with more of a concept. So it doesn't matter to us which form you come to us with, we're gonna take it through a rigorous process that makes sure we're really solving the right problem.
We have in-house engineers [00:21:00] who can create prototype devices based on these ideas. And that's a very iterative process as well, of creating these devices, testing them out, modifying them. Creating this cycle to, to make sure that we're ending up with the best solution to the problem.
Another group that is really key to our success here and a unique a resource really that, that Carilion has, that not a lot of systems have, is we have an embedded human factors team within our simulation center. So, you know, a simulation center is, is a facility that has very high fidelity settings, so places like operating rooms, patient rooms, exactly what you'd find in a hospital setting but obviously very low risk.
You know, you can, you can try out devices in there, nobody's, you know, no risk involved. And the, this human factors team, they're a group of highly trained [00:22:00] professionals who. Know, in and out how people work. They understand how to make products that will be really easy to use correctly, really difficult to use incorrectly, which is, which is really key when you're talking about designing new healthcare products.
So partnering with them very early on has been key to our success as well. They really keep us in the rails and make sure we're heading in a direction that makes sense for an end product. So when you look at that combination, I think that's a really powerful part of what we do as well. And de designing through that phase, getting to a prototype that makes sense, bench testing it, and then being able to take it right into the real life situation and test it in the real world where it would be deployed.
I think that's really the, the strength and the, a really key thing about innovating in the healthcare system. 
Dasha: That is so exciting that you have an [00:23:00] in-house human factors team and a stimulation space. Was that something that was in place because of the innovation focus or, or was there some other reason you guys had this resource already being built up?
I'm so curious about that. 
Aileen: Yeah. It's one of those groups that a lot of people haven't heard of, and then once they hear of it, they're like, of course everyone should have that. It's amazing. That's so important. No, I mean, originally their, their, their focus is to serve the hospital and also help with training.
So there's a lot of, you know, medical students, residents who need this training in the, in this in the simulation center. And, and so they, they really, the, the critical role they play for the hospital is going through and identifying challenges, more process oriented or workflow, or how work is being done and helping,
helping make that work better for our healthcare providers. We are we're just really lucky that they love working with innovation [00:24:00] as well. They enjoy that creative process and as well, and have been wonderful partners willing to work with us on our projects as well. Although the, you know, the bulk of their time is spent serving our hospital system. 
Dasha: What really stands out to me about this, now, I don't personally know how many hospital systems have a human design kind of team helping with process procedure improvement,
but what stands out to me is that you have a group that's centered around maybe like medical device, technological innovation, but it's not the only team within Carilion Clinic that's actually thinking about innovation very actively. And there's actually a group that's proceeding even even what you're doing here with focusing on things that are just like procedural and workflow oriented.
You are not the only ones doing innovation. There's different sides of it, some more like a new technology and others are like, how can we improve process or things that already exist [00:25:00] without developing a new technology but approaching the situation differently or having people move around the room differently or have a, a different set of steps to kind of optimize the situation.
So that to me already speaks to such a high degree of a commitment to innovation. And it raises for me this question, which is, you don't really hear much in the news about like rural hospital being committed to innovation at the heart of what they do. How did this idea really come about within Carilion Clinic? And then, how does it tie to the mission and vision in a kind of big picture way?
Aileen: Yeah, I, I what you point out is so true. It's innovation in Carilion clinic is something that permeates the whole system. I mean, it's really something that our leadership talks about constantly and actively supports. And I think it's it's a testament to where we started and how we've developed over the years.
So, you know, we were established 125 years ago as a community hospital. And Roanoke has [00:26:00] changed a lot over the last 125 years. And Carilion Clinic has changed with it. You know, they've been very effective in figuring out how to serve today's population, not yesterday's population, but continuing to change and grow and and provide,
provide our, our patients of today. So I think that's been something that has always been part of our culture. And you know, curiosity has always been one of our values and that's been really exemplified in all of our leadership and, and in the, in people who are serving, serving the patients here. So I think it is a little less common for, in fact, I think, I think Carilion Clinic may be the only system in the nation that has an innovation group, a simulation, simulation center, and human factors all housed together, which is I think a very, very powerful combination.
And I think, you know, we talked a bit about rural [00:27:00] healthcare and the unique challenges and because of those challenges, I mean, another way of thinking of it is innovation is more important here than anywhere else. You know, we, we have to innovate to serve our patients and those innovations are very translatable outside of our system as well.
So in a lot of ways, you know, our leadership has been very forward thinking and realizing, of course we should be innovating. Of course, we need to be doing this. Our mission isn't to serve, just to kind of maintain, our mission is to improve our, our patient's health. And that means being innovative. I think,
I think that's an essential part of it. 
Dasha: Well, let's turn a little bit to actually analyzing a couple of case studies for how you go from the bedside to developing a new technology. One thing that you and I talked about ahead of our recording here was this wearable device for lymphedema. So could you start with a little bit of a description of.
The problem and also [00:28:00] how this problem came to be bubbled up to, for you guys to work on. 
Aileen: Yeah, that's a, I mean, that's a really important one to me. I this has been an exciting project that's been running over a couple years. So lymphedema is a condition that a lot of people, I, I think maybe haven't heard of, but a surprising number of people suffer from.
So it's often associated with cancer treatments. So patients who have undergone therapy for cancer often end up living with lymphedema. It's considered treatable but not curable. It's a, it's a painful, uncomfortable, and sometimes debilitating swelling of extremities often, but it can also be the trunk, head and neck.
And it's a result of a buildup of lymphatic fluid. So, you know, the, the fluid right, kind of right under your skin, that that can build up when your lymph nodes aren't really draining the way they should, or, or you just have excess fluid, you know, either, either one of those can, can produce this [00:29:00] this condition.
And currently, the best way to manage lymphedema is through manual lymphatic drainage. It has to be done by a skilled therapist in a clinic. It involves massage therapy and different wrapping techniques. And, you know, it's, it's a fairly complex procedure that can take a fair bit of time, but provides the best relief for the patient because it's very targeted.
There are some alternatives for at-home care currently available. A lot of them are challenging for patients because they can be difficult to put on and take off. They can , they immobilize you for long periods of time. Often they need to be plugged in. And so you're, you know, you're on the couch or you know, out of, out of commission for, for quite a while, while you're getting your treatment.
And we had a therapist, Tara Newberry, come to us who she had been serving patients with lymphedema for many years, and she's highly skilled. And what she was [00:30:00] seeing was patients who wanted the care, it was sometimes difficult for them to even get in. You know, once again, coming back to our rural patients who might have to drive a long ways to get to a clinic for their treatment, take a day off from work, you know, this, this care is best provided on a weekly basis.
And that's a huge ask for patients to be doing that. So she, you know. Being the very thoughtful and compassionate and smart person that she is, she said, you know, there's gotta be a better way. There's gotta be a way we can provide care for these patients in their home, or wherever they are. So she envisioned this product that would be very low profile.
You know, you could wear it under a sweatshirt and not even know somebody had it on that would provide compression and vibratory therapy that would, you know, provide relief from this, from lymphedema, no matter where you were. So we engaged with her, couple years ago. And, and you know, she just, she's been a very [00:31:00] passionate and very engaged inventor who is so dedicated to seeing this on her patients
'cause she cares about them so much. And, and so she's been a delight to work with and, and we were able to develop this device and we're, we're now at the point where we have a second prototype version of it. And, you know, we've done some early safety studies with it. We have finished up some, a clinical study just recently and seeing some great results coming out of that.
So that's one that's been really exciting to see go from that very early problem all the way to a solution that appears to be working quite effectively. It's very exciting to see the thesis of our innovation department play out. You know, where we can see going all the way from a problem to a solution that works right here within a healthcare system.
I think that's been that's been really exciting to see. 
Dasha: It's a beautiful story and it also shows how something like a problem where you first think of it in terms of access. Like it's hard for patients to come [00:32:00] in weekly and it's expensive and it's just like an ongoing chronic thing can actually turn into like, you can, you can solve some of this through technology .
What were some of the unique challenges for this developing this concept into a product? 
Aileen: You know, thankfully working with Tara, she's so knowledgeable about her field that she came in with some fantastic ideas that we were able to implement pretty quickly. But, you know,
we don't have all the resources in the world and thankfully we, you know, something else that we're able to do a lot of the time is collaborate. So we were able to collaborate with Virginia Tech on this one to help with that, the development of that first prototype version. And, and I think that's another strength of systems like ours is, you know, being being a smaller system, not, you know, one of these behemoth huge systems.
We know that we can't be everything all the time and we know that we can create strong collaborations that allow us [00:33:00] to accomplish so much more than we would on our own. So that was, that was a huge benefit to that project. Some of the other challenges are we wanna be thoughtful about how we approach clinical testing and things like that.
So I think that's, you know, that's been a, something that we've learned a lot through is how best to go through these, go through, you know, testing these out in real life situations and, and when to engage with human factors and, and just figuring out that whole process of, of how, how to create the best product, I think has been a, a lesson and learning how to create the best workflow for that.
Dasha: So, practically speaking, I'm envisioning this device, but having a hard time envisioning, you know, some people have lymphedema, like you said, of the trunk, others of the neck, others of the extremities. What, how did you have to approach it in order to create a solution that would be practical and what are sort of the next steps for, for you guys in terms of translation into product that's 
Aileen: available?
We decided to focus on the arm first for a lot of reasons. One of which is that a lot of patients [00:34:00] who have been treated for breast cancer, that's, that's a very common side effect. So, you know, Tara was treating a lot of patients who, who had, who were experiencing lymphedema in their arms and. You know, you're, you're right.
It, it does require a lot of specific knowledge. From years and years of serving these patients, she understood, okay, this is how you would have to program the device to deliver the compression and the vibration in these very specific PA patterns to make sure that the drainage happens effectively.
Because you can't just expect the lymphatic fluid to just drain automatically. It has to be done in a very systematic way, moving up the arm, for example. These are all, you know, insights that we would never get except that we are working with people who have, you know, been, been treating patients for decades.
And so I think it was a great example of the types of insights that are unique to that you can uniquely [00:35:00] get through working with healthcare providers. 
Dasha: Yeah. That's so cool. What about some other examples of devices that have been brought forth or maybe that you have developed kind of more proactively?
Aileen: Yeah, so another device that I think a lot of when we're thinking about challenges with getting as far as getting to a site of care is a device that we've been working on for, for monitoring ventricular peritoneal shunts. So these shunts are placed in patients who have excess cerebrospinal fluid in their brain.
And when you have too much CSF in your brain and it creates pressure that can be very damaging to the brain and and can even result in death if, if it's not treated. So placing these shunts is incredibly important for the patient's survival and wellbeing, and it drains fluid from the brain and is it drains it down into the abdominal cavity.
So these are placed long-term [00:36:00] often in pediatric patients and obviously very important for maintaining proper pressure in the brain and and maintaining brain function. So unfortunately, you know, these devices, while extremely effective, have multiple points of failure that can occur. I think the most common is occlusion.
Basically they get blocked and they're no longer draining and obviously. That's gonna, that's gonna cause some problems. And about, I think it's about 98% or something will fit, will fail within 10 years. And these are placed long term. So, you know, patients will, will have these for a lifetime. So you're basically looking at a very high chance that your, your shunt is going to fail at some point.
And unfortunately, right now, the only way a patient would know that, that had happened is they would get, they would start to see symptoms return. So they would, you know, blurred vision or, you know, loss, loss of consciousness, whatever it might be. And unfortunately, once you start to see these symptoms return, you [00:37:00] have a very short window of time during what you can go seek care in order to make sure there are no long-term effects from this because, you know, it can result in brain damage or even death if, this isn't treated quickly.
So we, you know, we have a an amazing neurosurgeon, Dr. Mark Witcher, who wanted to provide a way for patients to get an early warning that their shunt had failed. You know, he envisioned a way of monitoring the flow itself that would be able to tell a patient, "hey, you know, your, the flow through your shunt has really decreased significantly, or stopped, you need to go have this checked out right away."
And that would provide the patient extra time to go seek care. And so this one was fairly complex and challenging, but it's something that our, our engineers were able to address and created a small device that will likely be able to be placed sort of in line with the shunt that can monitor this and, [00:38:00] and provide the patient some extra warning through Bluetooth connectivity that would, would allow the patient to know when it would be important that they go seek care.
Dasha: Well, that one sounds very complex and like the path to get something like this developed is, is, very difficult, I'm guessing. First question that sort of pops into my mind is you mentioned that when the shunt fails, it's, it's very time sensitive. Mm-hmm. Are you, is that hours, days? 
Aileen: The rule of thumb that I've kind of heard is that by the time you are seeing symptoms return, you, you probably only have about an hour at most to get.
Wow, that's, 
Dasha: so that would be, you know, this is a problem obviously that exacerbated in a rural setting, but is is, is a very complex problem in any setting. I mean, a congested urban setting could also create problems getting to the hospital. So an hour is not very much time to, to take critical action.
I'm also guessing neurosurgeons are very hard to come by. I mean, it's a very difficult profession. It takes many years of training to become a [00:39:00] neurosurgeon and and if someone is having an emergency and someone else is in another procedure, it's just very difficult within a hospital setting to manage all of that critical condition .
So I can see how the problem is, is very complex. What about the solution? What were some of the challenges and how did you approach kind of developing that within the hospital setting? 
Aileen: You'd have to talk to the engineers to get all their heartache and, and their answers to that question.
But I think, you know, one of the biggest challenges was creating something that could effectively measure flow, but also be absolutely tiny. Because you don't wanna, you, you know, you have to make a device that's very small that's, you know, gonna go fit with the shunt as well. So that's, you know, that's been a huge challenge, but one that we've really been able to been able to rise to that and, and create something that I think is gonna work really effectively.
And I think, the other thing is, figuring out the best ways to test this out. You know, we've been creative in identifying bench top testing and different ways that we can make sure that it's working the way we expected it to work. 
Dasha: Can you [00:40:00] describe that a little bit?
Because I, I can imagine, I mean, sometimes figuring out a bench top test is, is a huge challenge because when you're trying to model some, some complex biological system mm-hmm. 
Aileen: Yeah. I mean, so we, you know, we had to, he, the engineer had to come up with a system that well we had to buy synthetic CSF, which is an interesting thing to have to purchase.
But so we had to, you know, identify a good solution that would be a proxy for CSF initially. And then, design a, a system that basically sends through a very small amount of, because it, you know, the flows, these aren't huge flow rates, right? They're not, they're not it's, it's almost more of a drip a lot of the time.
And so design a system that would send through a very specific flow rate with this sensitive system that can then measure that flow rate and confirm that we are, we are detecting it accurately. You know, it was, it was pretty complex to get that set up, but we were able to do that and, [00:41:00] and make sure that we can go down to a very, very low flow.
And still be able to detect and measure that. 
Dasha: Wow. And, and then in terms of testing, what are some of the, where are you right now in the development of this and then sort of what are the upcoming challenges that you're, you're trying to work through? 
Aileen: Yeah, we're, I mean, we're looking down the path and, and, and anticipating some kind of early experimental testing in you know, in a very controlled setting which will be great to see.  
We always kinda have to make a decision at some point during the life cycle of these projects, of what is the best path forward to get this to patients as quickly as possible. You know, our goal is always to get this out to the patients in the most efficient and expedient way because.
That's who we care about. That's who we're doing this for, is the patients. We wanna make this available. And sometimes that means continuing in-house development and sometimes it means finding a partner as quickly as possible. You know, identifying a company [00:42:00] that will be able to partner on this and help us push it forward.
A partner that has experience in this area, because as you said, it is very complex and we will hit the limit of what we are able to do in-house and, and need to turn to a company or a group that will have a higher level of expertise in that, in that space. So I think this is a great example of a case where we would love to find a partner for this one as soon as possible so that we can make sure to continue to develop it at, you know, the fastest rate possible.
Dasha: Yeah, that, that makes a lot of sense that the devices are just this two examples already such different. I, I can see it requires different types of engineering. You've got one as a surgical device that goes inside the body. Other one is external and it used to work with Bluetooth. You got, you know, all these different elements to it just on the technological challenge.
Not to mention how differently the clinical trial process and then ultimately translating it into a practice and [00:43:00] dispersing it, you know, training physicians to use it. And all of that, the network required. What are, what do you look for in a partner in general in order to figure out if there might be a good case for a partnership for a product?
Aileen: You know, it always comes back to the patient. I know I've said this over and over again, but we, we wanna work with partners who, who obviously have a dedication to the patient partners who see it as more of. A collaboration a lot of the time than just a handoff as well. You know, we, we would love to where it makes sense, stay as involved as possible, as, as we kind of see this product through to the market.
And so that, those are some of the, the things that we really look for. And expertise. I mean, you, you wanna know that, that you're working with a group that has, you know, done related work and, and is gonna be able to apply that very specific expertise to this product and accelerate it to the market.
So those are, those are definitely some of the things that we look at when we're considering potential partners. [00:44:00] 
Dasha: One of the steps that devices have to go through most of the time during the research, testing processes, animal models, do you guys also have that capability in house or are you using partners to do that?
How, how you've approached that piece of the research and development? 
Aileen: Yeah, that's a great question. So we've had a few that, that, that has been applicable to, and, and we've partnered with Virginia Tech in some of those cases, so they, you know, they have animal facilities.
It comes back to, once again, collaborating and partnering to fill any of those gaps. Because we, we do have gaps in what we can do. And so identifying the right partners for that has been really effective. We, we can find, we can find people who can, who wanna collaborate on those things. 
Dasha: One other case study we brought up, which I thought was so interesting when you and I discussed it because you guys actually took a very proactive approach with the engineering team, was the kind of arm holding device. Yeah.
For a particular surgery. Surgery called FEVAR. Could we talk a little bit about that as well and what was [00:45:00] different about that versus the other two? 
Aileen: Yeah, that one was, that one was really fun because, like you said, it was a little bit different. Instead of somebody coming to us with an idea, we were talking amongst ourselves and, and the engineers were really excited about getting out into the, you know, into the hospital and, and observing and, and seeing what they might see and what they might see differently than the healthcare providers because.
Sometimes people have been dealing with a problem for so long that they don't even realize it could be something that was, that was solved. So that's kind of, that was what kind of made us want to get out there and start, you know, kind of being more embedded in, in these different parts of the hospital.
Now interestingly, when they, when they did this this time, the, the problem that they identified was something that the surgeon was very aware of and had in fact started, you know, he'd very, very thoughtfully kind of designed a solution in his head and, and, and I think even on paper a little bit, so.
You know, [00:46:00] the engineers were observing these different procedures and so we, you know, they invited us, they said you're welcome to come see some of these procedures, see what's going on.
So one of the things that they noticed was they, you know, they were in this FEVAR procedure, which is a non in or non-invasive procedure that allows for repair of it's, it's endovascular aortic repair. And they just noticed this kind of funny thing that, that, oddly enough, they didn't, they didn't seem to have a really good tool for positioning the patient's arms, which seems, you know, it was creating kind of some challenges for them. You know, they had to have the arms positioned in such a way that the imaging equipment could move around the patient effectively and wouldn't be obstructed. The anesthesiologist needed to have clear line of sight as well, and access to the patient to to, to do his job.
And then the arms needed to be positioned in a way that was ergonomically correct as [00:47:00] well, which is something that, you know, a lot of current arm positioning devices don't take into account. You know, the it, it can result in what's called frozen shoulder. If your arms are maintained in a position that's not, is that, that's not ergonomically correct for too long.
So. 
This is on the patient themselves, like a. Yeah. A pain. It causes pain if, if you have an arm mispositioned or positioned in a non ergonomic way, as you said during the surgery. 
Exactly. Yeah. And it's kind of one of those things that that can be this really problematic side effect essentially from having gone through surgery and had your arms in this, you know, ergonomically incorrect position for too long.
So, so, you know, they were being very mindful of all those things, but having to sort of improvise a solution because they didn't have a tool to solve that problem. So, you know, the engineers were seeing this and they said, you know, we could, we could design something for this. You know, there's, there's obvious inputs here.
There's obvious very clear needs and, you know, a, a solution could be engineered. [00:48:00] So they worked with Dr. Adams, who has performed, you know, hundreds of these procedures here at Carilion and is nationally recognized as a real expert in that procedure. And, and they were able to work with him and, and the team there to create this arm mount that, you know,
accounts for all of those, all of those challenges and all of those needs. And it was really cool to me because they were able to go in there and then within about four months they had this fully functional prototype that, you know, solved all these problems and, and could be, could be used. So I think it was just a great, another great example of being able to, that access not only to the experts, but also to the places where these devices are being used.
That combination is, is extremely powerful for accelerating. Innovation because you can get from problem to solution so quickly when you have that, that kind of access. 
Dasha: Just in terms of impact, arm positioning, it [00:49:00] sounds a little bit trivial, right? For somebody who maybe hasn't seen a surgery, how much time does something like this actually take?
Does the arm, like without this device that fall outta place, like what are some of the before and after you could say improvements for having a device like this? 
Aileen: Something that we've really looked at a lot with a number of our projects because like you said, it can seem kind of like, oh, okay, that's nice.
But when you're talking about OR (operating room) time that makes a huge difference because, OR time is so valuable and, and, and really ultimately so expensive that any reduction in or time, you know, reduction in or time is measured in minutes. And so this definitely saves a lot of time as, as the patient is being prepared for that procedure.
And then also in outcomes as well because as I mentioned, you know, I think frozen shoulder is what it's called when, when the arms are in improperly positioned. That's one of the most common complaints after these types of surgeries and can be quite [00:50:00] debilitating. It's, it's quite difficult to manage.
And so this one really checks the boxes of. Saving money through decreased or time, as well as providing a much better experience for the patient as well. And, and honestly for the healthcare providers as well, who, who now have a simple, easy to use device that they can implement quickly and makes everybody's lives a little bit easier.
Dasha: Bit easier. Yeah. I can see also how just the standardization aspect of it can also be helpful. Just knowing that every patient, every doctor going through this has the same positioning. You can kind of tweak the device over time if you needed to make additional improvements or, or, or other things.
That is really impressive. How did the doctors outside of this particular case study, how did the doctors, the nurses, react to your engineering team being out there watching procedures, gathering ideas? Was there any pushback? Was there any questions that you had to deal with and, and how did you approach that?
Aileen: Yeah, [00:51:00] that's, that's a great question. I mean, to be honest. People are really excited when, when, when we show up. And I mean, once again, we try to be, you know, very low profile in any sort of obs observation situation, you know, blend into the wall more or less so that we're not disrupting anything. But I think, you know, we've, we've received nothing but excitement for the most part.
When, when they know that people are showing up specifically to say, hey, you know, how can we help you? How can we solve problems for you? How can we partner with you to solve these problems? They get really excited about that. I've, that's, that's something that I've noticed and really appreciated about Carilion is once again, that, that, that culture of innovation, that culture of curiosity and wanting to, you know, make things even better is it permeates the whole, the whole system.
And you see that when you, when you show up and, and you know, maybe even our inconvenience and people a little bit, they don't. They're not gonna complain. They're, they're excited to have [00:52:00] access to people who can help them solve their problems and help their patients. 
Dasha: So what ultimately does success look like for for your role, for your team and also for Carilion Clinic having this initiative of innovation?
Aileen: Yeah, that's a great question. And, and, and the, honestly, the first thing that comes to my mind is the, you know, kind of the look on, on a healthcare provider's face when they have gone through the process and they have a solution to the problem that they've been dealing with for years and years. I mean, that's, that's kind of irreplaceable.
People get, you know, so excited about that. And they're they're willing to give extra time just to be able to do that. So I feel like that's, in my mind, that's a really important metric. But we also can measure actual. Engagement as well. And I, you know, that, that translates into numbers. So, you know, we, we really look at how many disclosures are we getting every year.
You know, how many people are engaging with us? Is that representative of people from across the entire system? [00:53:00] These are all important because we're here for everyone. We wanna solve everyone's problem. We don't want this to be seen as a department for only certain job descriptions or departments, you know, engagement from across the system.
That's really important. And, and knowing that we're getting a good sampling across the system is, is definitely a, a metric of success for us. You know, we also, of course keep track of things like, how many patents are we filing? You know, because that's an indication of how many things have we gotten through our, our fairly rigorous process of determining if it's still worth pursuing and getting all the way to the point where, you know, we're, we're filing.
Intellectual property and, and protecting these new devices. That's something that we, we keep close track of and we wanna see that steadily grow over the years. And ultimately, you know, this is a long, developing a a medical device is an incredibly long cycle. You know, it, it takes a long time. But we are getting to the point now, you know, as, as we talked about these, you know, in just a couple of the projects we're doing, we're getting to the point [00:54:00] now where, you know, licensing these out and seeing them in healthcare provider's, hands treating patients, that's becoming something that's gonna happen quite soon.
You know, we hope, and as we think about that, you know, we really, we want to make this a very sustainable department. We want to be able to financially benefit from the success of these products so that we can take that and reinvest it. In the next project we're gonna be working on in the next solution for our patients.
We wanna create a system that can continue to grow and thrive and do more and more for our patients through, through the good work that we already have done. And so for me that's, you know, I think getting to that sustainability point will be will be a big, a big sign of success for us as well.
Dasha: Is there something that patients should be aware of as you're doing these types of innovations in ways that either they can contribute or benefit from something [00:55:00] like this over the long term? 
Aileen: Ooh, that's a great question. You know, we haven't we haven't worked with patients specifically, but, you know, I think it's awareness throughout the community that this is something that Carilion is really dedicated to and working on.
I mean, I think I think Tara's therapy device is a great example of. Her listening to the patients. So I think, I think that their needs are really translated through our healthcare providers because Tara could have just kept providing care for her patients and doing her job and not really realizing that they had a need that went beyond the clinic.
Right. But she was listening to her patients and she was understanding their lives as a whole. And I think that is another really unique thing about healthcare systems that are in more rural settings is the healthcare providers tend to have closer relationships with their patients and to be more [00:56:00] connected to their patients because of that community feeling, and they tend to listen to their patients more.
So I think there's a higher likelihood that the patient's voice will come through into innovation in a more rural setting because our healthcare providers are so dedicated. To their patients and their whole lives and them as people. 
Dasha: I like that. So zooming back out, kind of looking at the innovation engine your team and all the things that you're learning through all these different case studies, the specific projects that you're working on, how are you balancing kind of the long-term innovation versus sort of things that address immediate clinical needs?
How are you figuring out which projects to take on? Because obviously, especially as the culture of innovation grows and you get more disclosures, more ideas, you're gonna have to be selective. How, how are you thinking about that process in general? 
Aileen: Yeah, the selection process can be tough because we get a lot of great disclosures, but we, you know, we always have to make sure we're pursuing the most promising, you know, because [00:57:00] limited resources.
But you know, what we really look at when we're assessing these is first off, is there a clinical need? And I mean. The chances of there being a clinical need are pretty high when someone who is serving patients come to us with that, with that problem. But we still want to make sure that it is a problem that goes beyond Carilion.
You know, we're, we're, we're interested in commercialization, which means it needs to go beyond Carilion Clinic. It needs to be a problem that is experienced by a lot of different, you know, healthcare providers throughout, throughout the nation. So doing some sort of basic customer discovery, I guess you'd say around the problem.
Making sure that this is something that goes beyond our walls. That's, that's kind of step number one. Obviously, you know, when we're, we're wanting this to commercialize, there needs to be a market, there needs to be a market need and a real and a, a real path to commercialization for it as well. So it's something else we need to consider.
And then from a technical standpoint, you know, we are [00:58:00] also, aware of what we can do and what we need to find partners for. So sometimes it's clear that we could quickly take on a project and engineer a solution, and sometimes, you know, we, we need to find partners outside of Carilion who could help us with them because they're, you know, maybe a little bit more technical and challenging.
And, you know, the other thing that we haven't really talked about yet, but I think is something that's always in the back of our minds is regulatory. So we, we will usually we usually limit ourselves to class one and two devices because class three can be very challenging to to work on. I'd love to get to the point where that's not a limitation for us right now, but practically speaking right now, we really, we really do have to limit ourselves in that way too.
So those are sort of our, our evaluation criteria that we try to apply when we're looking at different opportunities. 
Dasha: I mean, it sounds like you have kinda a small agile team, but you have this, distributed geographically, many, many physicians, nurses, [00:59:00] staff therapists who could be contributing ideas.
Are there any tools that you're using to be kind of an innovation engine to be effective? I'm, I'm guessing that even relative to universities, you might find yourselves more resource constrained. And so you have to maybe think about innovation processes in a more kind of commercial, efficient way.
You're, you're working within a highly efficient system for sure. One that's always in emergency mode and, and things have to move quickly. What, what are you doing to kind of innovate the innovation process itself? 
Aileen: Yeah, that's a, that's a great question. I think it's something that we are, you know, we do reevaluate, especially because we're growing and changing and, and a lot over the years.
We have to, we have to be nimble. But we, you know, we've implemented some new tools that have been really helpful. Obviously AI has just been ridiculously helpful when it comes to that early evaluation of these opportunities. You know, there are different tools. I use one called Turbo Innovate, that that can just so [01:00:00] quickly take, you know, this, you know, high level summary of the solution you're planning on implementing and, and really break it up and tell you, okay, here are the companies already working in that space.
Here are the patents that are out there that are already in this space. You know, just so much information at our fingertips. And that's been incredibly useful for evaluating these early projects. ' cause you're right, we, we, we don't have a large team and so, you know, a lot of the time it'll be me, the innovation manager kind of, kind of playing these roles and, and we have to be smart about the tools that we're using when we're evaluating them.
Dasha: Turbo Innovate. I haven't used it myself, but I'm gonna have to check it out. Yeah. You also are on the board of the Roanoke Blacksburg Technology Council. Let me make sure I said that right. Innovation Alliance. What's the role that you play there and what is what is this alliance, how does this relate to your role at Carilion Clinic?
Aileen: So, yeah. RBIA has been a huge [01:01:00] supporter of biotech and life science and healthcare ecosystem here in Roanoke and Blacksburg. Roanoke has gone through a huge transformation over the years. You know, originally very dependent on the train industry and rail railways and has really had to reinvent itself to be,
a brain town as they say, you know, research and healthcare and biotech and, you know, have done so very effectively because of these really important partnerships amongst multiple groups. So, working with RBIA has really been the way that we've, you know, when we think about innovation in Carilion Clinic, it doesn't just stop at creating that device.
We also wanna see economic benefit to our region from this. So a lot of the time that means, you know, a startup company that can spin out of Carilion, you know, around one of these new devices that can stay in Roanoke, that can grow here, hire people here, continue to collaborate with [01:02:00] Carilion. So creating a an ecosystem that supports those companies has been a big part of that partnership.
And in fact, we'll be having we'll be opening some, incubator space. So kind of a soft landing spot for new startup companies that are healthcare or biotech focused. And that will be opening later this year. So probably late fall 2025. And it's gonna be, it's gonna really have wraparound services, so lab and meeting spaces, shared resources, access to a lot of the resources throughout the entire community, including things like, you know, legal support, business plan support, coaching, mentorship creating those wraparound services for startup companies.
Because we really, we don't, you know, as I said, we don't see this innovation stopping at our doors. We wanna see it go outside of Carilion's doors into our community and benefit the e the [01:03:00] economy around us as well. 
Dasha: We'll have to make sure we mention when the opening does happen since we know a lot of our, our listeners do reside in Virginia or the surrounding through southern region.
So I'm sure a lot of people will be really interested to hear about this opening. Aileen, what's kind of your personal big vision for healthcare and innovation in healthcare or particular ways that you see healthcare changing the next five to 10 years, or maybe ways you'd like to see it change?
Aileen: Yeah, that's a great question. To me, I see healthcare changing because healthcare has a big role to play in guiding the development of tomorrow's technologies. There has historically been more of a vendor type relationship with innovation where you, you bring something in-house once it's been fully commercialized and you try to make it work for your system.
Right. And really we're seeing a shift to healthcare systems being much more involved from [01:04:00] the beginning, you know, having a say in how these products are developed because in the end it's our healthcare providers who will have to use these, these new tools and our patients who will benefit from their implementation.
So I think overall we're just seeing a much earlier engagement with healthcare systems from startup companies especially, which is really exciting to me. And I think we will see products that are better and better because of this partnership. I think that siloed design of medical devices and tools can obviously create
a host of challenges. And breaking down those barriers, creating collaborations, making this a partnership I think is really what's going to accelerate solutions and improve cost of care as well. 
Dasha: Wow. That's a big vision. But you're actively working on it, so that, [01:05:00] that's awesome. And take note for anybody who is trying to start a company or thinking about it, that instead of trying to seek your own ideas, you could be partnering with Carilion Clinic or even maybe a doctor's office next door to you if they have ideas to, to find the problems and solutions that are
immediate needs that are already being recognized. There sounds like there is so many problems yet to be solved. We, we certainly haven't solved them all. Do you have any particular requests or anything that our audience can get involved with or anything that should know about in terms of upcoming future announcements?
Aileen: Yeah, I mean, I think overall, I, I would encourage listeners to really think about how they can be innovative. You know, I think, you know, you mentioned it towards the beginning, it's, it's not very common or people don't maybe immediately think of a healthcare system like Carilion being so active in the innovation space.
But I think it's really a testament to the [01:06:00] value that everyone can bring to innovation, to anybody who's experiencing a problem or, or, or has an idea for a solution. You know, figure out a way to, to be innovative and to be entrepreneurial. I think solutions sometimes come from very surprising places.
The other thing you know, as I mentioned, we're very interested in partnering with startup companies too. So if you are a startup company, if you're solving a problem, especially one that really is applicable to a rural healthcare population I'd love to hear from you. You know, I, I, we're always looking for opportunities to work with, with companies that are providing meaningful solutions to our patient population.
Dasha: Fantastic. Well, Aileen, it's been so wonderful having you and to start off the season to talk about all these different ways that solutions are coming from the bedside from the therapists, physicians and nurses or maybe embedded engineers who are working directly in a healthcare system in order to improve healthcare for everybody.
I'd [01:07:00] like to mention before we end this episode our team here at Coulter Center at UVA received a grant from the Glenn W. Bailey Foundation to support the ongoing growth and production of this podcast. We are so grateful and with this grant, we will be turning our podcast episodes also into short learning videos for Instagram.
So please check out our new channel Biomedical Frontiers so you can keep learning about emerging medical technologies. While you scroll. Additionally, we are making it possible for companies to sponsor our podcast. Please reach out if this is something you would be interested in to biomedicalfrontiers@virginia.edu.
You can find Aileen's contact information, her LinkedIn down below in the links so you can reach out to her directly. Or if you would like to go through us to be connected with Aileen, if you are one of those startup companies you can also reach out to us through that biomedicalfrontiers@virginia.edu email.
We would love to be connected and hear what what you found [01:08:00] helpful and interesting about the episode and how you wanna be involved. Thank you so much for your time, Aileen. 
Aileen: Thank you so much. Dasha. This was so much fun.
David: Thank you for listening to Biomedical Frontiers Stories with Innovators in Healthcare. My name is David Chen and I'm the managing director of the Wallace H Culture Center for Translational Research at the University of Virginia. Our mission is to help bring promising new biomedical research and technology into the hands of the provider and the patient.
If you found this episode valuable, please let us know by subscribing, following, or sharing. You can learn more about our promising translational research projects on our website. See links in the show [01:09:00] notes.