Merging Engineering and Medicine: The Case of FilmArray 

Byington knows about medical innovation and translational science firsthand and is a fellow of the National Academy of Inventors. She is one of the collaborators responsible for FilmArray, a diagnostic tool used in 70 countries and in hospitals across the U.S. that has transformed our ability to diagnose infections since it was introduced in 2011. When the first version of the technology was being developed, it tested for just one type of virus: SARS (severe acute respiratory syndrome).

“It was beautiful technology and chemistry and there was no doubt that it worked,” said Byington, “but there was just one problem, as I discussed with the engineers: No physician would ever use it. The range was too narrow. What we really needed was something that would test for the majority of pathogens that cause the syndromes like respiratory distress or fever that we see all the time. We needed to test for viruses and bacteria at the same time. That had never been done before.”

Byington worked with engineers and basic scientists to perfect the technology, eventually creating a tool that tests for 21 of the most common viral and bacterial pathogens that cause respiratory infections from influenza to pneumonia. If a patient comes in with severe respiratory symptoms, a single, relatively inexpensive test can now determine the likely cause in about an hour, leading to faster, more accurate care.

They have since created additional FilmArray tools to test for gastrointestinal illnesses, sepsis and fever. Another benefit of the FilmArray technology is that accurate diagnoses can reduce the inappropriate use of antibiotics for viral infections, leading to fewer antibiotic-resistant “superbugs.” If a doctor can determine quickly that a patient is fighting a virus and not a bacterial illness, they won’t prescribe unnecessary antibiotics.
 
The respiratory FilmArray product was used in the rapid detection of the pandemic H1N1 flu in 2011 and the enterovirus D68 that caused polio-like symptoms in hundreds of children in 2014.

Engineering the Future

A key differentiator at Texas A&M is that the College of Medicine exists as part of the Health Science Center, where collaboration occurs between researchers and practitioners in all the health disciplines, from dentistry and nursing to pharmacy and public health. “Team-based medicine and working with interprofessional health teams will be incredibly important in addressing health disparities,” said Byington, stressing that health care cannot be the sole responsibility of physicians. “There are not enough physicians to deliver the one-on-one care that we need to really address chronic issues in the communities we serve. We need to engage the whole team of providers and address needs in a holistic, integrated way.” 

This is especially true in rural Texas, where rates of chronic illness and cancer are higher, access to health care is limited, life expectancy is lower and doctor burnout is pervasive. “The College of Medicine was created through the Teague-Cranston Act to serve the rural poor and assist the veteran population of Texas,” said Byington. “In this, our 40th anniversary year, we have recommitted to that mission in a big way. Our history, combined with the Aggie core values of respect, excellence, leadership, loyalty, integrity and selfless service, make Texas A&M the ideal place to transform care for rural and military populations.”

Improvements in both areas require innovation, and Byington need not look further than a few miles for a promising partnership. “Texas A&M has one of the finest engineering schools in the nation,” she said, “and the ability to partner health sciences with engineering gives us an opportunity to dramatically advance health through innovation.”

Enter a new degree program called EnMed (Engineering Medicine), the brainchild of Byington and M. Katherine Banks, vice chancellor and dean of engineering. This interdisciplinary partnership, to launch in 2019 in collaboration with the Houston Methodist Hospital, will create a new kind of health care provider: a “physicianeer,” or a scientist with the ability to see health problems in a radically different way and find technological solutions that have never been considered before.

Fifty students will comprise each class of EnMed scholars and in four years, these talented students will earn both a medical degree and a master’s degree in engineering. The hope is that by combining medical knowledge with engineering technical prowess, new technologies will arise—technologies, for example, that can connect physicians and patients remotely without losing the same quality of care as in-person treatment; technologies to help those in the military to be safer, to have fewer injuries, to recover from injuries more completely, and to give them better quality of life; and most importantly, innovative new tools for diagnosis and treatment.

A handful of students piloting the EnMed curriculum are already advancing the medical field. One fourth-year medical student, Nga Tang ’18, is developing a tool to detect dehydration in infants with a smart pacifier, an invention that won a South by Southwest competition last year. Two other students, first-years Cannon Woodbury ’21 and Kenneth Livingston ’21, are working on a device that will help ophthalmologists examine premature babies, who are at high risk of visual impairment and have special challenges in examination.

These students are training to be translational scientists, capable of taking discoveries from one area and translating them into results in another. “This multidimensional approach will push the envelope for health care transformation,” said Byington. “This is the kind of training we need to create 21st century doctors.”