By Mark Derewicz
Driving to the Triangle Health Innovation Challenge, aspiring pulmonologist Jason Melehani had an idea: What if patients with chronic obstructive pulmonary disease (COPD) could breathe through a device to create the necessary pressure to keep the airways deep inside their lungs from collapsing? Wouldn’t they be able to climb stairs without being winded? Maybe they’d be able to exercise a bit more? Wouldn’t they be healthier? Wouldn’t their lives improve?
At the innovation challenge, more than 100 budding entrepreneurs, mostly from UNC, NC State, and Duke, met to brainstorm ideas and create new solutions to “pain points” in modern health care. Melehani, a sixth-year MD/PhD student in the UNC School of Medicine, pitched his idea, which went like this: people with COPD intuitively purse their lips when exhaling because it creates pressure in the tiny branch-like structures at the end of the respiratory tree. This pressure, the theory goes, keeps the tiny cavities deep inside the lungs from collapsing. It helps patients alleviate COPD symptoms such as shortness of breath, frequent coughing, wheezing, and chest tightness. Melehani thought, what if we could create a device to better alleviate these symptoms simply by creating back pressure that pushes air back into the deep recesses of the lungs?
His team was composed of fellow UNC MD/PhD student Chris Giardina and four students from Duke and NC State, and they liked the idea. But when they checked the marketplace, they saw that others had beaten them to the punch.
“Other devices exist and are in use,” Melehani said, “but a big part of this innovation challenge was to create a device that could connect to an app on a phone. And that kind of technology for COPD doesn’t exist. We thought that a new digital device could provide instant feedback to people, improve their mobility, and potentially reduce the number of exacerbations. It could also provide important data to doctors.”
The team searched the scientific literature to find that pursed-lip exhaling is recommended by pulmonologists for people with COPD. In four clinical trials, pursed-lip breathing was safe and improved the distance COPD patients were able to walk in six minutes by an average of 35 to 50 meters – or an increase of about 30 percent when compared to COPD patients who did not engage in the breathing technique. Study participants practiced pursed-lip breathing three times a day for 15 minutes at a time for either four, six, or eight weeks.
“The interesting thing is that the longer they did this kind of breathing, the more they could walk,” Melehani said. “We think this could really help patients improve their mobility in their everyday lives.
The team got to work and over the course of 16 hours they came up with a prototype. It looks a little like a small kazoo, except that instead of making noise, it creates pressure inside the lungs. There’s a flap connected to electronic sensors, and at the end of the device are two narrow holes. When you exhale through it, pressure builds up. When the flap opens during exhalation, the electronic sensors collect data on the amount of time the flap was open.
Giardina came up with the idea that a Bluetooth- and app-enabled version of the device could function like a Fitbit. Instead of tracking how much you walk or run, this new device would track how often it is used and help manage exercise routines.
By the end of the weekend – after 16 hours of work – the team had created a 3-D printed prototype, which helped them earn second place at the inaugural Triangle Health Innovation Challenge and a check for $2,000.
“We’re not sure how much that money will help us develop a product,” Melehani said. “It might help us pay for a provisional patent. But right now our goal is to carry this forward into a real company with a real product to help people. For that, we need to talk to physicians and find funding.”
And they might need a new name for the device. During the competition they called it “breeze.”
“We’re working on that,” Melehani said.
Melehani is a fourth-year graduate student in the lab of Alex Duncan, MD, PhD, associate professor of pharmacology and medicine. When he finishes his PhD, he will return to medical school for the final two years before entering his residency. He plans to focus on pulmonology.
Giardina is an MD/PhD student in the lab of Douglas Fitzpatrick, PhD, assistant professor of otolaryngology/head and neck surgery. He earned an Impact Award from the UNC Graduate School earlier in 2015 for his work on cochlear implants.
Duke students involved were Kenil Thakkar, a second year MBA student, and Dillon Arey, a recent graduate of Duke’s biomedical engineering program. NC State’s Katie Myers, a senior majoring in biochemistry, and Davis Ranson, a senior majoring in biomedical engineering, were also part of the team.
UNC undergraduates Mihir Pershad and Meghana Shamsunder were part of the grand prize winning team, which created a wearable device that tracks physical therapy exercises to ensure patients perform them regularly and correctly. They won $4,000 and the Validic mHealth Prize -- $500 plus $5,000 in Validic API credit.)
The third place ($500) group, which created a smart algorithm for patient-specific clinic appointment schedule, included UNC School of Medicine student Rivers Woodward, who is also a 2011 graduate of Carolina. UNC Eshelman School of Pharmacy students Melissa Rhoney and Kate Ke, and undergraduate Ben Smart were also part of the team.
Winner of the Mosaic Health Solutions Prize ($500) included UNC MD/PhD student Robert Corty, who works in the lab of Will Valdar, PhD, in the department of genetics. This team, which also included UNC employee Adrian Meyer, created a “live EHR Integrated Agenda” that allows physicians to stay on top of evolving patient data.
Check the Triangle Health Innovation Challenge webpage for more information.