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Health by design

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LIFTS FOR UNIVERSAL ACCESS

Purchasers looking for lifts or elevators probably know of Savaria Corporation, based in Laval, Quebec. Savaria manufactures both stair and vertical lifts for wheelchair users. They also produce automatic door openers, and a full line of residential and commercial elevators.

Jonathan Cadieux, Jr. Eng., first worked for Savaria to fulfill his final university internship, from April to August 2003. As he wrapped up his bachelor’s in mechanical engineering at the École de technologie supérieure (ETS), he continued to put in 30 to 35 hours a week, and then joined full-time upon graduation. Cadieux uses a three-dimensional software package called Solidworks to design products for the Savaria R&D team. Many of his designs tailor standard models to the needs of customers with limited mobility. “All our products are customized to the needs and environment of the people who buy them,” says Cadieux. “We can adapt our products to anyone, anywhere.”

Savaria has clients throughout Canada and the United States, as well as in Europe, Australia and beyond. Because it serves so many geographical markets, the company contends with a wide range of local electronic and mechanical standards — which sometimes change without warning. This recently happened in Quebec, when a safety code update required all new elevators to be equipped with a manual reset switch. Cadieux had one month to add the new switch to six elevator models already in production.

A quick turnaround was the first issue. Limited space was the second. Savaria elevators are designed to fit in tight spaces. All the mechanicals fit within the main elevator shaft, so that a dedicated room isn’t required. No model had space for additional switches. After grappling with the issue, Cadieux decided to adapt a small microswitch already on the elevators, allowing it to function as a reset switch that satisfied the code requirements. He made the changes just in time.

Such challenges are likely to occur more frequently as Savaria expands its operations. In little over a year, Cadieux has watched the company grow from roughly 80 employees to more than 400. “Right now, we’re in a transition period between the customizing we do now and the possibility of bulk manufacturing,” says Cadieux. “We have to find the right level between the two.”

MEDICAL DATA GOES DIGITAL

The medical imaging field is also experiencing rapid growth and transition, thanks to improvements in digitization. According to Alain Gauvin of the McGill University Health Centre, medical imaging started going digital in Europe and throughout the U.S. Army in the early 1990s. “As time has gone by, technology has improved. Storage, digital transport and processing capacities all keep falling in price, and there has been standardization in the way that medical equipment communicates. This has allowed for medical image exchange between different medical components, and it has had a large influence over the coming along of PACS [Picture Archiving and Communication System].” With digital imaging becoming the norm, the next step will be the integration of other medical data, such as test results and pharmaceutical histories, paving the way for a single, comprehensive reference system. As Gauvin stresses, “Making available the right data in the right location at the right time is important for clinical and economic efficiency.”

The federal and provincial governments are both encouraging health institutions to digitize, centralize and network medical data. At the federal level, a program known as “Canada Health Infoway” (www.infoway-inforoute.ca) subsidizes such projects. For its part, Quebec is setting up four regional medical databanks. Every hospital in the province is now affiliated with one of the leading medical schools — the Université de Sherbrooke, Université Laval, Université de Montréal or McGill — where the data will reside. “Each of those four sectors is shopping for digital imaging equipment right now,” says Gauvin. Since the Université de Montréal and McGill share the island of Montreal, the two sectors must communicate. They are purchasing their system together to ensure better integration.

Gauvin urges engineers to consider specializing in medical imaging. “Engineers bring hardware and software expertise to a job. They could have an important coordinating role along with other professionals.”

PATIENT CARE COMES FIRST

One engineer who’s successfully created a career in the field is Yves Amyot. Amyot holds an undergraduate degree in engineering physics from the École Polytechnique, a master’s in clinical and biomedical engineering from the University of British Columbia, and a master’s in health administration from the Université de Montréal. His ability to combine technical skills with patient care has led the Montréal Heart Institute (MHI) to create a new position for him. He’s now in charge of biomedical engineering, telecommunications and information services.

Putting patient care first means that engineers sometimes deal with crises differently than they might if they were concerned with technical issues alone. Amyot cites his response to the Heart Institute’s PACS system failure late in 2004. His team had been planning to migrate data into a new environment that would enable secure, redundant access to the main imaging archive, but they hadn’t yet. For a week, no diagnostic images could be retrieved. The data wasn’t lost, but they knew delays could interfere with patient care.

Amyot focused on retrieving the most recent images first, so that patients who needed surgery would know right away. “Our role was to push vendors to stay until midnight if necessary,” he says. “We needed to get the situation resolved quickly.”

It took two weeks to bring the system back online, and Amyot still remembers the scare. As MHI becomes an increasingly paperless environment, he plans to make sure nothing similar happens again. “We need to have a system where we can have a fully redundant PACS backup.”

Patients who rely on the equipment that biomedical engineers design and maintain definitely appreciate Amyot’s dedication to making sure it works as it should — as does the institution he serves. In Amyot’s own words: “Future bioengineers need to understand that they’ll work in a world where they’ll need clinical understanding.”

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