A conversation with:
Ariana Aghevli, Luke Stohler, Jon Bryan, Josh Sexton

Hypertension Monitoring for the Modern Age

The medical field has always thrived at the forefront of innovation and advancement. However, the spotlight is increasingly falling on an emerging group of young innovators who, with their unique set of skills and passions, are gearing up to reshape the future of biomedical engineering. These inspiring talents recently participated in Coulter College, a multidisciplinary academic research event that encourages participants to innovate based on unmet medical needs and subsequently prepare investor pitches. They reveal their journey, experiences, and vision for medical innovation during a special edition of a med+Design podcast conversation.

A New Generation of Medical Innovators 

Joining us for this captivating conversation were four talented students: Luke Stohler, Ariana Aghevli, Jon Bryan, and Josh Sexton. Beyond their impressive academic exploits and unique personal journeys, the energy and zeal they bring to the realm of biomedical engineering are noteworthy. From wanting to better understand the border between the human body and engineering to personal health challenges that drove their desire to innovate further in the medical engineering field, these young engineers harness their experiences to shape their professional aspirations.

A Formidable Challenge at Coulter College

Their collective experience peaked when they participated in Coulter College, an event organized by the Wallace H. Coulter Foundation where they worked on a specific disease state - chronic hypertension. Going through the stages of research, discussion, and planning, they faced the overwhelming challenge of designing a solution to increase treatment compliance in hypertension patients.

Initially, their approach was largely clinical, but as the event progressed, they pivoted towards focusing on the early diagnosis stage. This shift was driven by their realization that the problem of chronic hypertension was more intricately connected with patient compliance and accuracy of data collection than initially considered.

An Innovative Solution with Commercial and Clinical Applications  

Their solution involves a wearable patch that uses ultrasound technology to measure blood pressure and hydration levels continuously. While the device's clever design won the award for best design in their category, Ariana significantly highlights the difference between cool ideas and best ideas, stating, "Just because something seems super exciting doesn't mean it's going to be the winning solution." This wisdom appears to capture the group's approach to innovation—grounded, pragmatic, and user-needs oriented.

Takeaways to Shape Future Innovation

Each of them gleaned key takeaways from their invaluable experience at Coulter College. Josh underscored the crucial balance between adhering to a methodical scientific approach and maintaining the connection to realistic, concrete user needs. Luke stressed on trusting one's instincts and holding one's ground while navigating different perspectives. Ariana echoed reinforcing one's understanding of the problem before debating the solutions or methods, while John emphasized starting from a broad perspective before narrowing down on the solution to fully explore all potential pathways.  

Innovation, at its core, is defined by an unwavering focus on the end-user's needs. This multidimensional powerhouse demonstrated how the most significant innovations often hinge on balancing the scientific precision of solutions and the agility to adapt and change direction as necessary. Their story exemplifies how the future of medical innovation belongs to those who leverage knowledge, creativity, and adaptability to deliver solutions that resonate with real, unmet medical needs.

Episode Transcript

[00:00:00] Jared: Hello, everyone and welcome back to a special edition of the med+Design podcast. As always, we aim to bring you closer to the stories and innovations shaping the medical world. But today we're taking a slightly different route. Instead of our usual one on one with seasoned medical professionals, we're shining the spotlight on the future of medical innovation.

We have with us four incredibly talented students. Each with their own unique stories and aspirations in the realm of biomedical engineering. These young minds recently participated in Culture College, a multidisciplinary academic research event that challenges participants to innovate based on unmet medical needs and prepare investor pitches.

Joining us today are Luke Stohler, Ariana Aghevli, Jon Bryan, and Josh Sexton. Their collective experience at Coulter College, their approach to the challenge, and their vision for the future of medical innovation is something that we believe needs to be shared and celebrated. While they may be students now, their passion, dedication, and innovative thinking are indicative of the bright future ahead for the medical field.

In today's episode, we'll not only delve into their experiences at Coulter College, but also get a glimpse into their personal journeys, aspirations, and challenges they faced along the way. So without further ado, let's get started. Welcome Luke, Ariana, Jon, and Josh. Yeah,

[00:01:12] Jon: thank you for having us.

[00:01:13] Luke: Yep, thank you for having us.

[00:01:15] Jared: Absolutely. And so as a precursor to the discussion Ty, if you could give us a overview of what Coulter College is, how did it get started? How has it evolved over the years, with Trig's involvement and, going into this year as well, how big was it?

How many teams participated? And and then also, what were some of those unmet needs that were tackled? Okay

[00:01:36] Ty: Coulter College as an event was something that came about through the Wallace H. Coulter Foundation, and their objective has been to and really try to promote biomedical engineering and put forward great programs.

As part of that education mission, the Coulter College event really came about as part of trying to train the next generation of biomedical engineering educators. And so with that's also turned into a student event that has happened. Trig was invited to be part of it for our first time in 2015.

[00:02:09] Ty: And we've really been a joy to get to be a part of it because it's mixing kind of the balance of clinical advisors, business advisors, regulatory consultants who all work with the student teams and their professors, their academic advisors over the course of a summer where they're given a opportunity space to explore and then do all of the research and talk to clinical advisors.

And then at the event, it's a really a three day intense experience, I'd say where not much sleep is had, but you go from, need statement all the way through to VC pitch. And this team was really impressive and excited you guys were able to join because it was neat getting to work with you guys and go through that experience with you.

I really appreciate you guys are wanting to come on here and talk about it. Awesome. Thanks for that Ty. And so we'll just get into individual introduction.

[00:03:00] Jared: So we'll start with Luke. Luke, can you share a bit about your background, academic achievements and maybe what personal experiences led you to the field of biomedical engineering?

[00:03:10] Luke: Yeah, I would love to. So what got me into biomedical engineering was during high school, I was pre med my entire life, wanted to be a doctor, but I came down with an immune system disorder. And through that and with my work with the American Legion, I found the realm of biomedical engineering.

I started off wanting to go into prosthetics to help those who lost limbs overseas or at home just anyone of that nature, but through my curriculum and through my learning, I've really found a love for imaging sources diagnostics, ultrasounds, MRIs, anything of that nature, and it was that led me to a lot of what I brought to the table at Coulter College, and before I joined, Coulter College

I had a lot of research experience in Parkinson's disease using instrumentations, things of that nature. But that's basically my academic story up till now.

[00:04:03] Jared: Awesome. Welcome. And then Ariana what were some of the early influences that drew you into biomedical engineering? And also you've had your own personal health challenges as well.

How did that influence your professional aspirations?

[00:04:15] Ariana: Yep. So some of the early influences that drew me towards biomedical engineering is I grew up in a family that kind of had the attitude of fixing anything that they could possibly do. So we never had an electrician in my house ever growing up.

And I remember my parents fixing everything. So from a young age, I was If we can fix cars and fix all the electrical issues in our house, then why can't we fix the human body? And that's when I started to roll into biomedical engineering. I've always been interested in the interaction of research and medicine directly.

I've done cancer research for about five years now, so it's been a very long time. But more recently in the past year I've been dealing with a disability. So I recently got diagnosed with fibromyalgia, which is a disorder that causes muscle pain, weakness, a variety of different influences. And I've always wanted to do an MD PhD program because I think that the interaction between the PhD and more the research side of the field and the MD medical clinical side of the field is really important and really cool.

But now, especially with a disorder that there's not a lot known about and a lot of people don't really know how to treat it, it's become a very personal thing because I can relate to patients who have had their own difficult medical journeys going through a long period of not having something diagnosed and trying to figure out how to treat it.

So yeah, that's how I ended up here.

[00:05:28] Jared: Wonderful. Yeah, I have some family members that are suffering with that as well and really hope that during your career you're able to make some strides. That would be incredible. That's awesome. And John, can you talk about your academic journey and experiences and leadership roles?

And, where do you see yourself in the future of biomedical engineering?

[00:05:44] Jon: Yeah, for sure. So my father is an engineer and I was a part of a lot of engineering extracurricular or why I guess I'll say more general science, technology, extracurricular activities as a high school student. So I was on a robotics team, a couple of the things. I in high school had a really impactful anatomy and physiology class, which kind of led me to discovering the field and I'm getting to know some people who are in programs for biomedical engineering from there. I really enjoyed it. I went to the major and here I am now as a senior and future plans and where I might see myself, I will likely move on through my masters, which I started some research for. And then after that, probably to a managerial position, somewhere for supervising and hopefully getting into some project management.

[00:06:34] Jared: Wonderful. You're going to have your hands full on project management. That's for sure. For sure. And Josh, how has your role as an undergrad researcher and TA shaped your perspective? And, what are your future goals, especially in terms of medical education and advancement?

[00:06:47] Josh: Yeah, of course. So as far as undergraduate research goes, entering college, I didn't honestly even know that academic research was a thing. I thought that most things happened through industry and that's just the way things work. But as I've been exposed to academic research and I've seen the impact that it can have, especially on the medical field, and how a lot of innovation comes through the academic route before it is seen in industry and before it's applied within actual hospitals, it's really opened my eyes to the possibilities that research and science has to treat medical disorders and to cure diseases.

So it's definitely impacted my kind of view of what's possible with medicine and how far we can reach with technology to help people. And then for the teaching assistantship part of it, and the educational part of it, as I've gotten more and more into research, you realize how long everything takes.

And with some of these projects and some of these research focus areas taking many decades to really develop. It's really showing me the importance of propagating knowledge to future generations of students and for me being a teaching assistant, It's the first step in learning how to do that more effectively, learning how to communicate technically, and then also learning how to mentor other students.

And so that's how it's affected my perspective so far. And then as far as future goals I want to be a doctor at some point. I'm very interested in the research side of it, but my ultimate goal is to be a doctor in the future.

[00:08:21] Jared: Great. You're going to change some lives.

Yeah. The basis of why we're here, right? Culture College. And, one of you give us an overview of the challenge that you all tackled, at Coulter college was it something that you chose to innovate on? Was it assigned to you? And then what was the day just in general?

I think before we get into, your solution, it was three days experience. What was day one, day two, day three I know it was super action packed and I'm sure it was a blur, but just from your own perspectives.

The challenge at culture college so to get into culture college as a undergraduate team, your faculty applies and you're selected through your faculty. They apply just to the program generally. And then you're assigned a disease state to work on.

[00:09:06] Jon: Early in the summer, and the college was in august, so I think maybe it was May or just before we got our disease state, which was chronic hypertension. And from there, they cast us with doing a background research type of report. We interviewed a lot of clinicians. We did background research on our own, looking into the disease, looking into the market behind it, all sorts of things.

And coming up to the college, we really didn't have much thinking about the solutions. It was mostly just the background research. And then, when we got to the college we had user needs statements and we had things to build off of, but that experience in and of itself was mostly for the purpose of coming up with those solutions.

And I can let somebody else explain the flow of the conference if anybody else would like to.

[00:09:54] Luke: So he gave us a brief overview of how we got our disease state in the first couple days of our culture college experience. Once we got our need statement, we then went to go find our solution. We sat for the first night, and we looked up research articles, we looked up the literature, for us, we did increasing the exposure and the increasing data of chronic hypertension, even though that wasn't specifically what the task was given for us. After talking to so many physicians, we decided that this was probably the best course of action.

So we went over different iterations, different types of solutions, those with bands, without bands, patches things of that nature. And when we went and presented it to venture capitalists. And those who were consultants with the National Institute of Health, we would go back to the drawing board every time and...

It would change every single time trying to make it more patentable, more accessible, easier for use. If anyone else would like to expand.

[00:10:51] Ariana: Yeah, I think the conference was very fast paced because we essentially did what was like a speed dating style of innovation. So we'd go to different rooms essentially and talk to people about our solution. And that meant that sometimes it. So I'd be In normal medical industry experiences that I've had, you innovate over a very long period of time.

Like when I did a co op at DePue Synthes, which is the orthopedics company of Johnson Johnson, we were working on a project for six months plus. At Coulter College, it was, let's do that, but let's do that in three days. So we ran through it. We came in with an idea of what we thought we wanted to do, and then just kept changing every single day, whether that be talking to Trig, talking to, the different consultants, as Luke mentioned.

And just trying to get different ideas and look at different perspectives to help make the product better.

[00:11:36] Jared: Fascinating. And so how was this split up into this three day event, so every single day you're pitching this essentially, like you're fine tuning the pitch every day before the final one at the end, which you all you know, have with you today as well.

[00:11:51] Josh: Yeah. So the I think we got there on Thursday, right? There's something Thursday night. And then Friday, we had pretty much all of Friday to just work on our idea and continue to perfect it and get it prepared for a presentation. And I remember correctly, we had our first presentation on Saturday and then we had our final presentation.

And that was the longest presentation and that was on Sunday morning.

[00:12:13] Ty: Distinctly remember you guys had was it one of your advisory sessions just shut down the direction you were going in and you had this decision to make of just huge pivot with your concept. And that's real life.

But I thought that was, watching you guys go through that decision making process was fascinating.

[00:12:31] Josh: Yeah, it was definitely challenging. But then, like you mentioned, in one of the sessions we were in the venture capitalists that we were talking to suggested a completely different kind of target market, and it was going to change some of the focus of the device that we were trying to ideate and develop through.

So that is an adjustment we definitely had to make very rapidly and kind of change our presentation or documentation, change our mindset very quickly based on the information that venture capitalist provided. So it definitely gave us a little bit of a taste of how hectic things can be in that space.

It was definitely a really awesome experience. I really love the fact that they bring venture capitalists into this because, in school, you can want to innovate on any particular thing that's interesting to you, but at the end of the day, this is gonna have to be funded and for you to be able to get that kind of live feedback

[00:13:18] Jared: in real time. I think that's just absolutely invaluable. And so we want to talk about, the solution as well.

[00:13:24] Jon: Yeah, I can start to talk through it. So one of the major issues with hypertension is just the aspect of patient compliance. So there's plenty of effective drugs. There's plenty of effective strategies as far as lifestyle change but there's still a major issue that is chronic hypertension. Initially, our thought was, we're going to try and find some way to make compliance easier or smoother in some way.

And then as the college progressed, like you were mentioning earlier, we had to make a decision and part of that decision was moving towards focusing on the early diagnosis stage and fine tuning of the medication as our target use case. But yeah, the major innovation as far as a 3 day challenge goes, it has to be something probably related to their compliance or a new way to measure the blood pressure is because of something like a pharmaceutical would be just completely outside of the scope of the college. And a lot of those solutions already exist. And it's pretty difficult to compete at that level.

So for us. Like I said, we moved from compliance generally to more of the initial diagnostic stage and our solution was based on the patch or wearable that would ultrasound to take blood pressure and hydration measurements. So that's some technology that is not fully validated and based on some of our experience.

We figured that presenting some technology that was not fully validated would be something that was acceptable at the colleges because of previous teams and other teams that are in our class. I guess you would say there's a little bit of hand waving that might go on and say this will work.

And there is research to back it up. Like I said, it's not validated for clinical use, but I'm sure in time, if that technology was lucrative enough, it certainly would be. For us, we decided to try and go through private, right? I guess you'd say the supplements or health and fitness industry as an unregulated device at first. Just because that makes it a lot easier to get the initial funding.

So part of our VC pitch was developing a device that wasn't actually for clinical use. It was just for, hypothetically for hydration tracking and sports and exercise. That's the main point of it. If I missed anything, jump in.

[00:15:43] Ariana: I think part of how we got on the hydration track in the first place, because obviously the challenge is, chronic hypertension focused and hydration always isn't a, a noticeable link.

The main inspiration behind going hydration route was partially that we were trying to find a way to make it unique and make our solution non obvious for the patentability side of it, because something talking to the VCs that came up a lot is would you actually be able to get a patent on this device?

Because if you can't get a patent on the device, then you can't eventually get go on and sell it in consumer or in healthcare setting. So that becomes a really important aspect, but we did some research too, to figure out, what could be related to chronic hypertension that people don't usually consider.

And hydration is actually one of those big things. Cause a lot of patients and a lot of people who are tracking their blood pressure take diuretics. So they're losing water out of their body consistently. So tracking hydration can actually be super important to make sure that the patient's healthy overall.

So that's part of how we came up with hydration idea.

[00:16:38] Jared: It's fascinating. I also want to dig more into that pivot point also. I wanted to ask you about, the difficulties that you all faced and challenges that you were overcoming, during the event.

And I feel like that pivot point must have been something for you as well. And if you could talk a little bit about that and any other difficulties that you guys feel like you hurdled together or individually.

[00:16:58] Luke: One more thing about the solution was with the ultrasonic pouch patch our goal was to make something that was more of a put on and forget

early diagnostics tool because one of the huge problems in the chronic hypertension world is that about 7 percent of Americans do not fit in the validated state of cuffs. We at first we were going about and trying to make a cuff design, but with this America's not keeping up with the obesity rating of chronic hypertension.

And... We wanted to do something that would be able to fit any size, any person, as long as with the theoretical solution that we have it would have to be within five inches of the outside of the arm to the artery running through the inside of your arm. So that fits a majority of people in the United States.

Going to the pivot point. We were really confident about our device and what it could do and what it could provide for people. But one of the pivot points we had to do was figure out how to fund it, how to get a patented like these were all splits in the roads of things like, oh, we didn't think about this.

How do we go about this? And as some of our teammates would go off and try to figure out how to make it patentable while other ones would go off and try to figure out more literature and more research and make sure that this is feasible. We were fortunate enough to talk to a patent lawyer and figure out that if you combine the ultrasonic blood pressure monitoring with hydration, which can be used using the same device it would fall into unique enough and it would allow us to have a patentable device.

Very cool.

[00:18:34] Ty: We had a question come in from Kelly, and she made an observation that patients on diuretics were supposed to be dehydrated. And was that something you considered?

[00:18:45] Luke: And if yes, what are your thoughts on how to manage the measurements?

[00:18:49] Ariana: So that was something we considered. We were trying to obviously find a balance because, even if you're supposed to be dehydrated on a medication, there's obviously a balance between not getting too dehydrated. I think for the second part of that question, we were trying to figure out a way to make the device, more applicable to a variety of patients.

I think to get on the point of the pivot point of the project a little bit, it was a little bit scary trying to decide between moving from like a healthcare style solution to a consumer style solution because we've talked a lot about how there were VCs at this competition, but there were also doctors on the panels and we were being pulled in a lot of different directions and that everybody wanted us to do something different because they thought the device could be better used for their specific field. Part of pivoting was trying again to figure out that funding like we've discussed before but it was also trying to figure out how could this apply to the most people overall and how could this be used.

So ultimately what we came up with was targeting consumer first because there's a lot of money there. It's a little less regulated. And then moving eventually to something like clinical use could be a helpful way to get it more into, be able to fund the research ourselves, first of all, and then be able to move it into the hands of more people who need it.

[00:20:01] Jon: I can share the slides, we have a slide just talking exclusively about our path to market. I worked on this slide late at night on Saturday. It was very sleep deprived, but I'm proud of it. So I think maybe some of the text is a little bit off just because of the

the format. We had an initial stage for commercial validation being like just getting the technology to the point of useful for just hydration and fitness enthusiasts, exercise, people sports teams, that type of stuff.

And that was one of our ask points is where we want some capital for that type of research and then also that introductory, manufacturing and marketing stage of launching the product that we named hydrosonics, which is our over the counter or just direct to consumer product. And then we take the cash flow from that initial product and then continue with clinical validation funded by that cash flow. And then move forward to regulatory approval for the FDA. I believe this would be a device. It says 510K on the PowerPoint. I think that's the incorrect pathway through the F D A and then finally launching a device through medical channels just for clinical use.

And a big problem we had is that a lot of the venture capitalists were like, no, you should just stop this whole timeline at the launch of your over the counter device. Because in a real situation, it's too far out to plan because if you commit to this plan and you get through the over the counter advice, and it's a huge success and it's just a pain to go through the research and regulatory approval for that medical device.

Most of them wouldn't do that, but for the challenges of the conference to designing a medical device, trying to help hypertension, we thought it was a little bit much to move away completely from hypertension and just say, oh, that might be something that maybe is the future direction, but, we're not even going to mention it.

So that was a decision our team had to make. And it was a little bit of a challenge just trying to talk to those venture capitalists because it seemed mostly like they just thought we should stop right at about step 2 in this 5 step process here.

[00:22:08] Jared: I know, Josh, you were going to say something as well before we've got the slides up. Keep the slides up, though. I think we should also delve into these more. This is really interesting stuff. Yeah, for sure.

[00:22:16] Josh: I was, it's built on what John was saying as well, but one of the things that was very difficult about the conference was sorting through all the information, all the streams of information that we were receiving, and we're getting a bunch of different perspectives, which was great.

But like John said, the perspective from the venture capitalist was different from the perspective of the doctors and the perspective of the engineers. And from our perspective, having done background research on the problem. So there was a lot of streams of information and there were times where it was difficult to sort through those and really determine what was objectively the best path to go through.

And for me, it was definitely a learning moment to see that a lot of times there's going to be a lot of conflicting information and sometimes you just got to go with your gut and got to rely on your instinct rather than overthinking things and falling into that paralysis by analysis.

And I think that can definitely translate to things in the future as well, whether it comes to research or if any of us are involved in startups. Listening to everybody, but then really just trying to synthesize information down and relying on instinct.

[00:23:24] Luke: If I can add one thing so with the Coulter College's task was to increase compliance with chronic hypertension. And so the use of adding hydration was a way for us to try and hit that. This goes back to the question before of individuals are supposed to be dehydrated, but if you are too dehydrated, individuals might stop their treatment plan for chronic hypertension because it makes them feel bad, not knowing that they're over dehydrated, rather than that the plan isn't working, it's that they're over dehydrated, and that's the reason why they're feeling bad. We were trying to figure out a way of increasing compliance while sticking with this type of medical device that we think could actually do a lot of good in the chronic hypertension realm.

[00:24:09] Jared: Yeah, absolutely. A lot of this goes back to, something that's going to happen time and time again throughout your careers, which is managing the different stakeholders and everyone's got like their own little angle that they're trying to work within it. But I think a North star that I find fascinating that comes from a Ty's teachings about innovation.

Anyway, it's always about empathy first and all about understanding the end user and what their actual needs are. And then developing and innovating based upon those unmet needs that you've been able to identify from the very beginning. And I could be wrong, Ty, but I just think it's really interesting to see how this all kind of ties back together to stuff we do at med+Design.

[00:24:46] Ty: Yeah, it's fascinating how, with the launch of your consumer product, that's an out, that's a stable revenue source, and then being able to then go through the thought process of what it would look like to come back in and try to do a regulated medical device.

In some case, you think about like outlet and they went down that path of seeing how hard it is to clear the FDA and they had an out to do a consumer product. And then doing that pathway back in to try to do a regulated device they've had multiple challenges trying to get back into regulated device.

And so it's definitely an uphill battle to try to if you can avoid it, then that's a pathway to revenues, but then getting back to that core point of, is this actually addressing the, larger patient needs that are out there? And I think that's something you guys had to sift through with both the objectives of the conference, your own personal mission in what you're excited to do with your own careers and then how to go through this exercise of really trying to put forward a plan to achieve the mission, whether or not you have the first out from a cashflow standpoint.

[00:25:49] Jared: We've got an interesting note as well from Brian Spencer. He says as a venture capitalist, just because VC won't fund a solution doesn't mean the problem isn't worth solving. The profit and scalability of the solution may not be enough to prompt the VC investment, which makes a whole bunch of sense. And also, for the panelists, assisting in the product development, listening to the physicians and venture capitalists, it's good.

It'll help understand what's needed, physician driven and what will be investable VC driven. However clarifying the problem needs to be solved first should drive the product service solution afterwards.

Yeah, it goes by, it goes behind a lot of the, like I said, the thesis of what we have here at med+Design as well. It's interesting to see the synergy. And so we have your slides up. I think while they're up, does anyone want to, comb through them a little bit and talk about some of the rest of it before we move on to the next.

Should we go to the slide where it's explaining what our device is so that we can have a better representation of what so that the audience knows what we're talking about or gets visual of it.

[00:26:47] Jon: If you're comfortable with that.

[00:26:49] Josh: So the idea that we came up with was to develop a patch that's very similar to a glucose monitoring patch. Don't remember what the specific glucose monitoring patch that we were comparing things to was. But essentially the goal of having this patch is that it would be an ultrasound enabled patch and it would be able to measure blood pressure.

So obviously this goes into the chronic hypertension thing, and that would be able to continuously monitor blood pressure throughout the day and then throughout the night as well. And that would give the patient's data to be able to track their own disease and also the physician's data to be able to adjust to be able to adjust medications and their recommendations to the patients.

And then the second part, which we've talked about a little bit has the hydration part. And that part for patients who are on diuretics would help them gauge their hydration level so that they're not becoming over dehydrated, like Luke mentioned. And so that's the actual physical component of the device itself, but we also had some additional kind of software solutions that we ideated in order to solve some of the workflow issues in some of the patient facing patient education issues that we talked about. A couple things that we talked about that we tried to develop was first a report that would go to the doctor, because obviously if you're getting a daily report of all the information from all your patients, that's going to be very overwhelming, and especially with how much is on clinicians plate to begin with.

We definitely don't want to overwhelm the clinicians with data regarding all of their patients. Too much data is not useful. So the figure that we came up with in talking to clinicians was that most people would like a biweekly report. So getting data from patients every two weeks, that would give them the optimal frequency of information to be able to adjust their medications and be able to optimize their treatment plan for each patient.

And then the second thing that we have illustrated with this. With the next part of this is the patient facing part. So just data display to the patient that would allow them to keep track of their hydration and their blood pressure as it's changing throughout time in response to life choices that they're making, but also in response to their medication as well, so that they can see that their medications are in fact working.

And that is the sum of the solution that we developed.

[00:29:17] Ariana: Yeah, and we thought that the educational patient facing aspect is actually a really important part of this. Because part of the issue with treating chronic hypertension, part of the reason why there's such low compliance with medication to begin with, is because people don't feel the difference until chronic hypertension gets very bad.

So a lot of times people have the mindset, or patients have the mindset of, why am I taking a medication if it's not helping with anything? Or why do I need to keep taking this if I just feel the same with or without it? So we thought by making a platform that was more accessible in terms of an educational perspective and showing people how

the fluctuations that they're experiencing could affect their health in the long term, how their choices could, it would help increase sort of patient compliance with medication down the line because they begin to make those connections better in their head just rather than being like, oh, I don't feel any difference with my medication, therefore I no longer need to take it.

[00:30:09] Jon: Going through our patient care diagram might be as well. That was Luke's specialty at the at the college.

[00:30:15] Luke: What I have here is the current cycle of care and current pain points in the cycle of care. We have first screening and diagnosis in which a physician first flags you for hypertension, you go home, you monitor yourself some more.

Because of white coat syndrome, your blood pressure may be high just because you're at the doctors. But once you are diagnosed with chronic hypertension, you then transition over to the treatment cycle, in which you take the treatment, you're monitored, you record, you're supposed to record your blood pressure then talk to your consultant in which they'll either continue the same treatment or revamp your treatment and give you some different medication or stuff.

But some of the pain points that are in this current cycle is there's insufficient clinical data in which doctors are not receiving enough data of their treatment of their blood pressure points because you need to take your blood pressure in a certain position before you drink any coffee, before you really do anything, before you eat in the morning. Non compliance in treatment. Doctors are most of the time unable to tell during the facts if you aren't actually taking your medication. So they don't know, is your treatment not working because you're not taking your medication? Or is it not working because it's the incorrect dosage?

And then inaccurate measurements is taking your blood pressure. A lot of the affordable and non electronical blood pressure measurement devices are all very subjective to when you think you hear the upper number versus when you think you hear the lower number. And so when you give those to the doctor, they just have to trust that you did it correctly.

So our device was to try to alleviate all three of these pain points. Yeah, I love that perspective because there's also like how you said, there's people that are complying, but they're just doing it wrong in general. So their data is going to be totally incorrect. And then for me, just with other family members that have had to go through this cycle that recording process there is just, it's few and far between.

[00:32:11] Jared: Sometimes you just forget, sometimes you're just living life and once you break that habit of recording it daily and at certain times and according to how they tell you and you get lazy with it and, it's just I love the fact that you're accounting for the human error side of things and that this is a huge way to be able to make this make that data actually far more usable, for the physicians.

I'm curious for you guys, what after having gone through the culture college experience and want to appreciate you guys be willing to share your presentation. But what do you see is like the outcome for you having gone through this? You've gone through and done this exercise of trying to generate new intellectual property to, really deeply understand the use case try to understand the trade offs between business concerns clinical concerns so i'm curious what you guys see as like an outcome of this.

[00:32:59] Luke: I'll go before the phd people go because i'm someone who wants to go straight to industry but after culture college, it really fermented my love for research and design and it's where I want to be, where I want to see myself.

I would love to be at places like Medtronic who has great facilities, great culture, great research. But yeah, I loved every moment of it. Talking to people who are knowledgeable in different subjects the reworking, the going around hurdles to come up with an outcome that is just satisfying and It's so rewarding in the end, and I just I want to do this again.

[00:33:35] Josh: I'm sure you will

Yeah, so for me, I guess the main takeaways was, especially coming from more of an academic research background I think for me the main takeaways where everything has to be connected to reality at some point.

Definitely being in a lab all day and constantly when working on the bench top, it can be easy to get lost in the science and dissociate it from the clinical needs that exist out there so to Brian Spencer's point, you brought up a great point that everything, has to be derived from

the customer needs and from the actual needs that are out there, and for me, it really emphasized that point and really inspired me to go back to research with that in mind of, okay, I need to be thinking about the translation and the clinical and the patient outcomes perspective of everything that I'm trying to develop and every facet of my research that needs to be a priority so that I'm cranking out research that's actually going to have an impact on people one day.

And that can legitimately contribute to solutions that are going to help people. So that's the main takeaway that I brought home from it. Very cool.

I would say for me, part of it was that a solidification of the idea that cool ideas are not always the best ideas. And I think we have a cool device and I'm really proud of our design. I think it's very innovative and we won an award for best design in our category, which I'm proud to say that we did, but there are a lot of cool ideas you could take.

Even with our device, you could do sorts of different things, trying to apply them to all sorts of different target markets as we mentioned previously, there's just so many people telling us, oh, you could do this application here in this subsector or here and whatever medical setting. But just because something seems like it'd be super cool, doesn't mean that it's going to be the winning solution.

And obviously we didn't go through the whole process of taking this into market or trying to make this into an actual company. But just based on, the theory and talking to these people, it's like that solution is really cool and stimulating intellectually, but here's why it wouldn't work.

And you have to realize that as an engineer or scientist that just because something is exciting to you. It really does, like Josh said, it connects back to the user. Do they really need that? Does that really help them in the best way? Or is there something that does it better? Less complicated, even though your solution might be something that you just think is, the best in the world, it has to be grounded.

[00:36:02] Ty: That's such a great point. I often say that the hardest test you'll ever take is for somebody to actually pay with their own money. For something you've designed to solve their problem. And the cool whiz bang ideas that are flashy and whatnot, may or may not actually achieve that


[00:36:19] Ariana: I had two main takeaways. The first one, I've worked at startups. I've worked in industry. I've worked in academia. It's how interconnected they truly can be when you're making one product. And that sometimes you have to listen to everybody from each of those different areas. In order to come up with the best product.

But I think on more of a personal note, what I really enjoyed was the fast paced environment and actually being pulled in multiple directions. I hadn't really had that experience much, being an engineering student yet, and being told, you should do this, no, you should do this. And then trying to figure out as a team our own path, I think was a very educational experience, because it taught us to trust our guts a little bit more.

And figure out how we wanted to approach things as opposed to how other people wanted us to approach things.

[00:37:03] Jared: Yeah, I love this, introspection that we have going on and I guess with this introspection phase, is there anything that you feel like you could have done differently,

would you take anything back or you do it all again the same exact way?

[00:37:14] Jon: I think a lot of it would be pretty similar for me. As far as like the design challenge and all that, like it's we got some feedback that was maybe slightly sparse, but it was, I was very proud of our final presentation and our final pitch and design and all that. It's hard for me to say there's a ton of things I would do differently.

Maybe there's some small stuff like polishing certain points of the presentation, but I'm sure all teams have that. Because, timeline was so compacted, I think just anything that would be something small like that. Just, oh, we didn't get this slide quite the way we wanted.

[00:37:47] Luke: Yeah, following up from John I probably would do a lot of the same thing. One thing I probably going back is probably hold my own a little bit more and really follow what I really believed rather than letting those with professional knowledge, even though you should take. So like we had a lot of physicians telling us a lot of different things.

And we allowed them to pull us in a lot of different directions and ultimately we landed here, which isn't super far off from what we started, or what we were originally believing, but we allowed so much time and so much effort of considering the other pathways that we try to make everyone happy, and in the end, we had to figure out that we can't make everyone happy, and I wish I made that realization earlier, and I think it would have made the entire process a little less stressful.

[00:38:41] Josh: Yeah, piggybacking off of that, I think one thing that, I wish I might have done a little bit better or one thing that I feel like I can do better in situations like this in the future. And this ties back to a little bit of what I learned is just really understanding the user needs before I get into conversations around that and really letting those ground me and be my anchor point as you go through as I go through all those conversations so that if things do get a little bit off topic, I can then go back to, okay, what are the actual user needs? And what are we actually trying to achieve?

I think for definitely to Luke's point, I definitely let my mind get tugged in a bunch of different directions and at some points get tugged away from the user needs that we are ultimately trying to address. So for me that's definitely something that I need to work on for the future and definitely something I could have done better.

[00:39:27] Ariana: Yeah, I think one other thing to add on to this, I think we could have done a better job as a team in ideation because I think we came up with ideas as we needed them. Less starting from the point of starting super broad and then narrowing in, and I think it would have been helpful to start a little bit broader, think of every possible solution we could think of, and then go in more into which is preferable.

[00:39:47] Jared: Absolutely thank you so much for your time today. I got one more question for you before we kind of wrap things up here. And it's just, for a piece of advice for teams that are going to be following you in the years after for them that they also want to be successful.

This is a really challenging thing to navigate, it's very fast paced you're getting tugged in a bunch of different directions, like how you said. And so for teams also want to be as successful as you were, what advice would you give to them?

[00:40:12] Josh: I think for me, starting off, and this kind of aligns with a lot of what everybody else was saying just now, but pick one thing, one user need, one solution, one use case, and stick with that early. Obviously our team pivoted, and that pivot was based on our solution. But if you pick that user and you're trying to focus on, which we didn't really do, which is, I think, part of our pivot, but if you pick that user need, which you have to focus on, I think it limits, especially those people talking about, oh, you could have this type of solution all the way over here, different industry, having a clear idea, and especially of who your user is.

Is very helpful for trying to bring in all those different ideas that's coming at you for sure.

Yeah, that's a great point. I think your user that you identified shifted over time and that as your north star, if you can narrow your user down and the specific problem you're solving for, then that limits the amount of, the kind of direction tugging that can happen.

[00:41:15] Luke: My advice towards people who are, who would be going into something like Coulter College or even making a device in for actual consumer use or professional use is be confident in yourself.

You're capable. Don't let a person tell you your design is terrible. It's not patentable. Don't let someone tell you what you can or can't do. Be confident at your presentations. Everyone there is just as nervous as you are. The first presentation standing up, even though it was only 20 seconds to talk, I was scared.

But by the end of the week, I realized that everyone here is not so different than me. Even though there were some very important people in the room, the president of BMES was there. But by the end, I was more confident in myself and my ability and my team and our device. That it wasn't as big of a deal anymore.

[00:42:04] Ariana: Yeah, I guess this is going to sound kind of cliche, but my advice would be just to embrace it. I think it's really easy to come from like a university background or come from whatever background you come from in terms of internships and all those sorts of things, and go I know how this works, I know how this specific thing should be done.

And I think that when you have something like Coulter College where there's so many different experts, you need to learn to listen to everybody because sometimes they'll say things that surprise you and things that you had never thought to consider about. And yes, you have to stick with your own gut and go with that.

But it's also, it's always good to learn from people around you and it's an experience that you won't get in a normal university setting ever. So it's important to take everything that you can away from that, whether it be positive experiences or negative experiences.

[00:42:48] Josh: I think the piece of advice that I would give this just I think Ty brought this up actually in the presentation he gave at the beginning of Coulter College is it's always best to start with the user instead of on the benchtop. And obviously, it's something that I've touched on coming from an academic background, but sometimes in academia, we have a tendency to try to fit cool things into user needs, but I think developing cool things specifically for specific user needs in mind, I think is always the best route to go.

[00:43:19] Ty: It's awesome. It's bedside to bench back to bedside instead of bench to bedside, right?

[00:43:23] Jared: And on those notes, Luke, John, Ariana, Josh, thank you for joining us today. Thank you for sharing with us your innovation. And the future of biomedical engineering is bright with you all in it. We're just excited for the futures that you all have ahead of you. So thank you for your time and good luck with graduation ahead of you.

[00:43:39] Luke: Thank you for having us.

[00:43:40] Jon: Thank you for the opportunity.

[00:43:41] Josh: Thank you both for having us.