James Day: Hello and welcome to the Point-of-Care Ultrasound Certification Academy podcast where we focus on POCUS. Here we will discuss all things related to point of care, ultrasound, the practice, the trends and its impact on healthcare. Our program will engage thought leaders who are defining global patient care with the stethoscope of the future.James Day: James Day here today, recording live from the Focus on POCUS studio. Today we have Jason Moore as our guest. Jason Moore received his BS, M.S and Ph.D. degrees from the University of Michigan in 2006, 2007, and 2010 respectively. He is currently an associate professor of mechanical engineering at the Pennsylvania State University and director of the precision medical instrument design laboratory. Professor Moore’s research interests include studying the interaction between medical instruments and bone and tissue in the body and utilizing mechatronics and advanced simulation to improve medical ultrasound training. Hi. Jason. How are you today?
Jason Moore: Hello, I’m doing great. Thank you for that wonderful introduction.
James Day: Yes, I’m singing your praises, but it’s all true ladies and gentlemen. This is great to have a scientist like yourself. I was just going to ask you why the gate, the significance of mechanical engineering that’s somehow going to help improve medicine.
Jason Moore: Yeah, that’s a great question. So actually, obviously you mentioned all my degrees, my background is really all kind of focused on mechanical engineering. However, my lab, the work that I really do, really focuses on medicine and how we can really try to apply these mechanical engineering principles to try to ultimately improve medicine in various ways. And I see there are really huge opportunities right now, not just in mechanical engineering, but really all other types of engineering fields addressing kind of medical problems. So, a lot of times I make the analogy that in mechanical engineering, some of my colleagues, different people work in areas such as tribology or that’s the kind of friction and bearings. So something that’s been researched up very extensively for the last 150 years or so. It’s difficult to make really significant improvements impacts in areas where you have this ongoing long history of research. However, in medicine, there are lots of great opportunities because many people in my area in mechanical engineering haven’t had as much knowledge about medicine until more recently. So we’re a lot more of this kind of cross-disciplinary work that’s helping to lead to a lot of these improvements.
James Day: Oh, so what do you feel the significance of improving this medical training?
Jason Moore: Yeah. You know, I think there are huge opportunities in just medical training itself. Actually when we got into this work now about like four or five years ago we initially started working down with doctors at Hershey Medical Center and we had heard about significant problems in a specific procedure with ultrasound-guided needle insertion as specifically as a central venous catheters patients, a very large needle being placed into a very major vein of the body. And initially when we kind of looked at this problem, we asked ourselves, well, yeah, we build devices in mechanical engineering, maybe we could build a new, fancy, sensorized needle to help improve their care. And we got down there and we started talking to them and we realized that no, it wasn’t so much the instrument’s fault, but it was more the amount of training and how prepared the doctors were to actually try and go out and perform this procedure. So that really led us down this path of how can we, tried to develop devices and software and programs that can really try and prove a point of care ultrasound and to really try to better prepare people to merely to perform these very delicate procedures.
James Day: You know, I’ve heard of improvements made with needles that are pitted or dimpled, like a golf ball that helps refract and reflect the ultrasound beams. And I’ve, I’ve seen some machines that have, where you can press and change the angle to like 45 or perpendicular to make it really pop so you can see the needle. What do you listen to, what are you currently working on now at Penn State University? Are you at liberty to speak?
Jason Moore: Yeah, definitely. So we have a number of products that we’re working towards for training simulation. So, the longest-running one we have right now, we call it the LX 2000. Essentially, it’s a, a large computer-based, a robotic system that you know, has a, with the, we call a haptic robot. So it’s a robot that recreates the feeling of inserting a needle through multiple levels of tissue. And then this robot works alongside a, what we call a virtual ultrasound system. So basically it looks like your standard ultrasound probe, however, it’s not actually performing an ultrasound, rather, the computers generating a virtual image of what the ultrasound would look like. And so we’re able to display this on a computer screen in real-time just like a regular ultrasound would work.
Jason Moore: And this allows people to kind of practice this procedure practice moving the ultrasound, identifying doing sanoa anatomy identification and practice, the feeling of inserting and guiding a needle, specifically into the location in the body where it needs to insert and some of the real benefits to this and being at more of a computer-based system rather than I think a more traditional kind of mannequin or a phantom approach is that with this, that computer we’re able to simulate all different types of scenarios. So we have right now I think about 18 different scenarios programmed into it that really represent a kind of diverse patient profiles so that we’re not trying to train people on the average human that happens to walk through the door. But you know, trying to give people a more diverse experience. So what is it going to look like and feel like if I have to do this procedure on Jeff, someone that weighs 600 pounds or someone that has kind of slightly unusual anatomy or perhaps a very tough skin that you have to puncture through
James Day: And you’ll be able to track these metrics in all the nuances of hand movements in ultrasound?
Jason Moore: Yes. So the program has a system we have right now, it’s really nice because we have the user, they go through the scenario, they perform it, and then they ultimately get feedback about how they did and we actually give them a grade, A, B, C, D, based on how their performance is and then try to give them some specific metrics that really strongly relate to the success of the procedure. So did they go in at the right angle how centered were they in the vein? Did they kind of pass-through and through? Did they hit the artery instead of the vein? So we try to give them this a bit more automated feedback so they understand, okay, this is what I did wrong. This is how I can ultimately improve this procedure.
James Day: I used to work at a sim center and we had a bunch of surgical simulators, a lot of symbiotics products and a couple of a lot of the task trainers and I’ve seen many of these. But you’re talking about something that a large piece of equipment that will be sitting, sitting at a Simpson is not something that’s scalable.
Jason Moore: Please. So, yeah, no, it’s a, it’s a lot of ways very scalable. It’s like a, it sits on a cart. So it’s about a two by three-foot carts that you can wheel around. And right now we have a two and a half of them had made and that every summer for the last, let’s see, three summers now we’ve been, integrating this into Hershey medical centers, a surgical residency training program. So this is being used to train the surgical residents before they actually go out and do this on real humans.
James Day: Well, that’s impressive that that’s, I mean, the only other question to ask really is, what do you think just the future of medical training? This is how it’s gonna be simulators and that tracks haptics and metrics.
Jason Moore: Yeah. You know, I think there are lots of benefits to trying to improve and try to kind of push forward a medical stimulation that traditionally when we think about medical education, we have a bit more than an apprenticeship model about how people kind of learn. They see one a then they actually do want to teach one. And so yeah, I see there being a bigger and bigger place for simulators to try and help really bolster a lot of these skills that primarily for patient safety so that people are, if you add to a very sustained level before they actually go into the clinic. So I see lots of big benefits with that. And also I, I see and benefits in allowing kind of a, just improve medical education overall to be offered that these simulators that we have, we’re able to provide very accurate quantitative feedback to the user about how they performed.
Jason Moore: And so right now we have medical schools across the country that teach this with experts, surgeons, if we can have devices that can really teach people and help people learn to become experts that can have huge benefits to medical education and providing this high-quality education throughout the world. And so that’s a kind of a lot of I think a momentum for the future and you know, why this area is so exciting and why I’ve gotten so involved in it.
James Day: If you’ve got any other cool toys at your, had there in your lab, sounds like you’re working on a lot of things with them. All that you said the LX 2000. Yeah,
Jason Moore: So we have that. That’s kind of the guy that’s been funded through national institutes of health for the last four years now. But we actually have a kind of a more recent one that a device we’re looking to develop and we call it the lt 100 and essentially what this is, is it’s a kind of a low-cost version of this kind of higher costs, more of a robotic system that we have. And it’s kind of unique in that we don’t have haptic robots, so we don’t have kind of this expensive robot that goes with it. But rather we’re able to accurately recreate at least the feeling of inserting the needle through multiple levels of tissue. And then with software, provide people some level of feedback about how steady was their hand motions, did they insert a needle at the correct angle and you know, what was their overall performance. So we’re looking to try to integrate that a bit more into now to more labs and a nursing school programs and kind of earlier a medical type education.
James Day: Well, Jason. Wow, that’s great. And by the way, in our studios are outside Philadelphia here. And you’re right there in the middle of Pennsylvania,
Jason Moore: Not that far. Okay. Yes. I’m just a couple hours north. It’s a cool day here in a state college.
James Day: Yeah, it’s good. It’s kind of chilly here on here in the, in the mid-Atlantic too. So Jason, listen, thank you for taking the time to be here on today’s show.
Jason Moore: Oh yes, thank you so much for having me. Yeah,
James Day: Great. And listen, I, I appreciate the audience for listening and don’t forget for even more POCUS talk, follow us on Twitter at POCUS academy and on Facebook at poke is cert academy and Jason, it was an honor to have you today on our podcast and I thank you so much for having me. You guys have a good day. All right, thank you so much. Take care. Bye. Bye.
James Day: We hope you enjoyed today’s podcast, Focus on POCUS. Be sure to tune in with us next week for more interviews with thought leaders that are on the forefront of the global point of care ultrasound.
James Day: The thoughts and opinions expressed in this podcast are the views and opinions of the guests and not those of Inteleos. This podcast is for information purposes only.