Imagine being able to more precisely figure out which part of a stroke patient's brain is damaged, or ascertain if their limited movement is associated with neurological or muscular problems. Imagine being able to better integrate real-life clinical data with lab research to generate targeted rehabilitation therapies.prosthetic-leg-stroke-tests-netherlands-weinstock

These advances are being worked on by Dutch researchers at the NeuroControl consortium, one of eight centers of research excellence in the Netherlands housed under the Innovative Medical Devices Initiative (translated).

Next week, as part of a delegation accompanying King Willem-Alexander on a trade mission to the United States, leaders from NeuroControl will sign a memorandum of understanding to expand an existing relationship with the Rehabilitation Institute of Chicago. NeuroControl also has a relationship with Northwestern University Feinberg School of Medicine.

“Precision diagnostics let us know where the brain is injured,” Agaath Sluijter, business director of IMDI NeuroControl, said during a briefing at their lab last week during my tour of the Netherlands. “Targeted therapy will let us tailor therapy to the patient, even in the home.”


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Working with entities like RIC and Northwestern enables NeuroControl to better integrate clinical data into its research, Sluijter said.

During last week's tour, I tested a couple of tools that they are advancing. One, pictured in this blog, assesses how patients respond to force and resistance. Grabbing a joystick of sorts, you have to basically “paint” a straight line while the device applies varying levels of resistance. It is hard. In a clinical setting, stroke patients will be hooked up to monitors and clinicians can assess if the problems are in the brain or with the muscles, said Alfred Schouten, a faculty member at Delft University of Technology. His team is embarking on a research project with stroke patients to see if the technology can indeed improve rehabilitation efforts.

Another innovation I got to check out targets gait therapies. Walking on a treadmill, sensors pick up your normal gait. Therapists then can program in various sequences of movement to force specific actions. How? A camera displays squares on the treadmill to which the patient must match their steps. Again, sensors capture real-time data and clinicians can immediately study gait patterns and make adjustments on the fly.

The system is designed by Motek Medical, which has a host of other nifty advances including creating virtual reality environments to help patients with prosthetics learn how to maneuver around a variety of terrains.

One device we didn't get to try, but did see, was a new prosthetic leg that hopefully will better mimic natural body conditions. Heike Vallery, pictured on the left, says that the idea is to quantify something like joint stiffness through sensors in the prosthetic and then have it make adjustments. Vallery, a mechanical engineer at Delft University, is partnering with RIC on this research.

Needless to say, the research being sponsored by NeuroControl is impressive. But what really brought it home for me is that they are partnering with an institution like RIC to find ways of bringing these innovations to caregivers and patients.

Self-healing Cement and Stem Cells? Really?

Looking back on a weeklong media tour of the Netherlands, it is clear that innovation is made of equal parts ingenuity and passion.

 

Netherlands looking back

Editor’s note: This blog was slated to run Friday, May 22, but was delayed due to technical difficulties — how is it possible that in 2015 a transatlantic flight would lack Wi-Fi?

AMSTERDAM, Netherlands — What do self-healing cement, orchids, tomatoes and stem cells have in common?

No, this isn’t some bad joke I heard in the security queue at Amsterdam Airport Schiphol.

I’ll give you a minute.

Nothing?

OK, here’s a hint: Innovation, ingenuity and passion.

During my weeklong tour of the Netherlands, I was exposed to some incredible advances in a host of industries — life sciences, health, horticulture, chicken farming and egg production, and construction. Regardless of the field, a theme emerged: Embracing those three attributes is key to staying ahead of market forces, responding to customer needs and pushing the envelope.

To be sure, our guides from the Dutch government handpicked the cream of the crop for this media tour, most of which set the stage for King Willem-Alexander’s visit to the United States early next month. Still, meeting with these visionaries only reinforced my long-held belief that embracing innovation, ingenuity and passion is what separates the wheat from the chaff.

Here are a few musings from the tour:

  • Researchers at the Hubrecht Institute in Radboud — sort of the MIT of the Netherlands — are on course to build the world’s first living biobank. At first, this advance in stem cell research will focus on colorectal cancer, but eventually will expand to other areas. As Marc van de Wetering, senior researcher at Hubrecht, explained to us, biobanks today rely on frozen cells. In this “living” bank, Hubrecht researchers will grow tumor tissue and test various drug therapies in the hope of leading to more personalized medicine. They are also exploring other elements of stem cells and gene repair. In fact, in 2013, Hubrecht teamed with the University Medical Center Utrecht to treat two children with cystic fibrosis using genetically repaired cells. “If this works the way we think it will, it will improve health care for everyone,” Wetering said humbly. “I am really proud of what we are doing here.

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  • Ter Laak Orchids ships 80,000 plants from its vast greenhouse weekly. Richard Ter Laak can tell you how many leaves and flowers were on every one of them. That’s because the grower has implemented a ridiculously sophisticated data management system. Every orchid is potted in a plastic vase with a QR code, which is then inserted into a base that is equipped with an RFID tag. Plants move along a vast conveyor belt and ultimately pass by a camera that catalogues the key elements of the plant and matches it to the RFID tag in a data repository. Ter Laak said he can even assess how well workers do at staking the plant to plastic rods intended to keep the flowers upright. Is moving an orchid from seed to blooming flower to shipping as complicated as monitoring a diabetic patient? Probably not, but there’s something to be gleaned from Ter Laak’s impressive use of data: the ability to assess where and when system failures may occur and how to adjust accordingly.
  • For years, Greenco was a market leader in the tomato world. Eventually, the competition caught up to the pesticide-free grower, and market share plateaued. Jos van Mil, managing partner of product at Greenco, knew something had to be done. So the company introduced “candy tomato” to the market. It is ingenious, really. They merely repacked cherry-sized tomatoes into baggies and other containers, brought to life a clownlike character to promote the “Tommies” and, voila, you have an instant hit. They even created a nifty little carrying case that fits neatly into your kid’s lunch. The concept has been such a hit that a couple of years ago Greenco inked a deal to license Tommies to Walmart. Where is your Tommie idea going to come from as competition continues to encroach from retail clinics and other disrupters?
  • Henk Jonkers is a biologist by training, but now he mixes cement. More to the point, cement that essentially can heal itself. A researcher at Delft University of Technology, Jonkers and his colleagues have been looking to nature to find cures for manmade problems. In this case, he figured out a way to add a limestone-producing bacteria to cement mixtures. In doing so, Jonkers created a compound that essentially heals itself — no more cracks, basically. They are now tinkering in the lab to apply the same science to asphalt. Imagine, no more potholes. He spent a good hour detailing the science behind it all, and it was truly fascinating, but I won’t go into that here. What I will point out is that Jonkers, like everyone else on our tour, had an infectious passion for pushing innovation to the edge.

Lest you think I’m done with my reporting from the Netherlands, I’ll have another blog later this week detailing some amazing things happening on the physical rehabilitation front. Some of these innovations are already making their way to our shores.

 

Dutch King: U.S. Hospitals Lead the Way in Advanced Care

His Majesty King Willem-Alexander is set to visit the United States next month. In anticipation of that trip, which includes visits to health care institutions, he discusses the goal of sharing best practices across the sea.

THE HAGUE, Netherlands — Wednesday’s itinerary included this agenda item: 14:00 — Interview with King Willem-Alexander at Noordeinde Palace. Our driver pulled the blue van up to the palace gate promptly at 1:30 p.m. (13:30). A policeman climbed in and took roll call of the seven reporters and four Dutch government officials on board. We were cleared to pass.


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As we disembarked, a royal guard directed us to the visitors' entrance where we were greeted by Marco Hennis, Grand Master of the Royal Household. The grand master is the highest official of the organization that serves the king.

After a brief stay in the formal waiting room, we headed to the grand master’s office. It’s a large chamber with elegant blue-striped wallpaper, high ceilings and a glorious chandelier. A painting of Albrecht, the long-gone prince of Prussia, hangs on the wall behind Hennis’ desk.

After some preparatory comments, the royal guard re-emerged and led us to the Putty Room. The king — I still can’t get over that — gave each of us a firm handshake and warm greeting as we entered. It is an impressive room. Red, white and pink roses arranged in bouquets on the table were beautiful complements to the deep pink wallpaper. Gold-painted trim popped off of the doors.

We were all a little nervous; we’re American; what do we know about interviewing kings? We were quickly put at ease, however, by King Willem-Alexander’s disarming manner. He’s quick-witted and a comfortable conversationalist, whether talking about advances in green farming or what it’s like to raise children under unusual circumstances. His responses showed a strong grasp of the varied topics on our agenda — health care, horticulture, the rich Dutch history of Western Michigan.

While the setting was formal in nature — journalists on one side of the table, the king on the other flanked by his staff — the conversation had a relaxed feel. It was set up as a background briefing and one caveat was that we couldn’t quote the king directly, we could only paraphrase his comments.

He discussed his goals for next month’s trip to the United States — largely intended as a trade and education mission during which several of the companies profiled in my travel journal this week (plus others in agriculture and sustainable development) will promote Dutch ingenuity to American politicians and business leaders. He also wants to celebrate the close relationship between the two nations and especially pay homage to the 70th anniversary of the Allied forces’ liberation of the Netherlands from the Nazis.

While in Michigan and Chicago, the king will participate in a couple of health care events. In Michigan, he’ll join Parkinson’s expert Bastiaan Bloem as he signs a letter of intent with the Van Andel Institute to expand a new model for Parkinson’s care to the states (see the blog entry below). The topic is of particular interest to the king, whose father had Parkinson’s. The king will tour the Rehabilitation Institute of Chicago and discuss advances in cancer care at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University in the city.

There are considerable differences between the nations’ health care systems — principally that the Dutch have universal coverage. Everyone must buy basic insurance, while long-term care is state-sponsored. Still, King Willem-Alexander noted that the two countries face a similar challenge: taking costs out of the system to ensure that increased access remains viable. He also firmly believes that we all need to more aggressively promote healthy living and aging. And, he said, the Dutch will continue to look at hospitals in the United States as world leaders when it comes to treating complex conditions.

If I may be so bold as to summarize the royal point: Most problems in health care are universal and we can better solve them by looking to pioneers and sharing innovations.
When the 30-minute briefing was over, thanks were said and we bid the king and his palace goodbye. Yep, just another interview … with a king.


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Parkinson's Expert Gives Patients New Hope

Or is it the other way around? By listening to patients, says Bastiaan Bloem, clinicians can create better models of care.

NIJMEGEN, Netherlands — One of the things that I was most looking forward to on this trip was our visit with Bastiaan Bloem, a neurologist at Radboud University Nijmegen Medical Centre and creator of ParkinsonNet. Having done some advanced research, including watching his TEDxMaastricht talk, I knew that Bloem was a passionate advocate for reshaping care delivery and making patients true partners.

Our hour-long visit did not disappoint. A tall, slender man, Bloem exudes confidence, but not in an off-putting way. He is confident that we can — and must — start "listening to the patient" and finally embrace shared decision-making.

In the video below, Bloem details how ParkinsonNet — which is entering into arrangements with health care organizations in the United States, including Kaiser Permanente — is advancing patient-centered care and explains what applications it has for other chronic conditions.

The video runs a bit longer than our normal interviews, but I hope you'll stick with it. Bloem has some important things to say.