Success stories

© Photo Fraunhofer IPA, Rainer Bez

Ways of making healthcare affordable in the future

The good news first: our chances of living a long and healthy life have never been so good. In the last 60 years alone, the average life expectancy has gone up by 12 years in Germany. Currently, on average men live to be 78 years old and women as old as 83. This trend is continuing.

People are not only living longer, they’re also staying healthy longer. But progress has its price. That’s the bad news. Already today, across the world almost 10 percent of the gross domestic product goes towards healthcare. “With the predicted demographic change, the strain on our healthcare system will continue to rise”, anticipates Urs Schneider. The doctor is head of “Medical Engineering and Biotechnology” as well as the department “Biomechatronic Systems” at Fraunhofer IPA. “To make it fit for the future, we need to cut costs: for example, by optimizing and automating the processes to develop and manufacture pharmaceutical products, by developing affordable therapies, improving healthcare procedures and by doing everything in our power to prevent people from becoming dependent on care in the first place”.

In short: the healthcare system must become more efficient.

Focus

Together with customers from the pharmaceutical industry, the Fraunhofer research scientists in Stuttgart are searching for ways to optimize workflows when new drugs are developed.

More than almost any other sector, biomanufacturing and drug research can benefit from the methods and synergies offered by the digital revolution. The highly-regulated units act as networked data factories to help us understand complex illnesses and diseases.

Fraunhofer IPA helps partners and customers to successfully implement validated methods in the healthcare sector that have their origins in industry, such as the automotive industry. Besides using networked cyber-physical systems, the holistic approach taken by Fraunhofer IPA also involves the adaptation of purely organizational processes to improve efficiency. Within the scope of the work carried out by the field of expertise “LEAN Lab”, an interdisciplinary team led by Oliver Schöllhammer and Mario Bott develops analysis and wastage prevention tools for use in the laboratory that are based on LEAN management methods.

People are different - drugs that help one patient may be completely ineffective for others despite having the same symptoms. The aim is to provide individual therapeutic products that are affordable for everyone. For this reason, research is focusing more and more on personalized medicine. Its objective is to manufacture drugs tailored to individual patient needs, as well as to reduce side-effects to an absolute minimum.

Complex systems are needed to produce Advanced Therapy Medicinal Products, in short ATMP, on a large scale. These are currently still at an experimental stage. The Fraunhofer scientists from the group “Automated Cell and Tissue Culture” are developing, for example, production and automation strategies for cell therapy medicinal products. Research is aiming at improving manufacturing efficiency, which in turn will increase throughput, enhance quality and cut costs.

Even in classical chemotherapy, there’s a need to optimize, explains Professor Jan Stallkamp, Head of the IPA Project group for Automation in Medicine and Biotechnology PAMB in Mannheim. His team works closely with doctors at the local university hospital. “Our aim is to network and automate diagnosis and therapy, which go hand-in-hand with personalized medicine.”

 

Now, cancer patients in hospital have to spend time in different departments before the oncologist can recommend treatment. Sometime in the future, optimized processes combining various steps will speed up diagnosis. Particularly cancer patients whose primary tumors have already metastasized will benefit from the new accelerated diagnosis process. On the BMBF research campus M2OLIE – short for Mannheim Molecular Intervention Environment – the Fraunhofer team is collaborating with experts from research and industry to develop a process capable of localizing, removing and analyzing up to five different metastases all at the same time. “We want the complete diagnosis process and the first therapeutic measure to take place within the space of a single morning”, resumes Stallkamp. This efficient treatment concept will save patients wearing days of waiting and is also inexpensive.

Looking after people in need of help in hospitals and homes is often back-breaking work for staff. This can lead to disorders of the musculoskeletal system, which are the main cause of an incapacity to work among the 60-plus generation. Research scientists at IPA are now able to provide carers and heavy laborers with the added strength they need: an exoskeleton supports shoulder and elbow joints with drive modules and stabilizes the spine. It is easy to put on, and lightweight and comfortable to wear.

Residential homes for the elderly and hospitals are also faced with challenges due to the lack of trained staff. Therefore, in the project “SeRoDi”, research scientists at IPA are working on technical solutions to relieve the physical strain on carers as they carry out their routine tasks, as well as reduce the amount of time required for them. For example, the “intelligent care trolley” advances autonomously to where it is needed at the time.

With their research, the experts at IPA are helping to make our healthcare system fit for the future. This will ensure that comprehensive medical care remains affordable despite the current demographic change and ever-decreasing budget without losing sight of the most important aspect: humanity.

Analyzing tissue samples is a standard process in medical diagnosis. Today, in addition to the preparation and subsequent analysis of tissue sections, based for example on specific staining techniques, cell-based technologies are becoming increasingly common. This is thanks to an ever-better understanding of molecular biology and cell biology processes in diverse clinical disorders. But how can we obtain the cells needed to examine the condition of tissues? As a rule, a predominantly manual method is used to dissociate tissue and isolate single cells. In the process, it is vital that cells are not destroyed or their structure altered. Currently, there are only a handful of semi-automated systems on the market which can be implemented to facilitate this. Enzymes are also often used to reduce tissue cohesion but unfortunately these attack interesting structures on the cell surface.

“TissueGrinder” gently isolates single cells from tissue samples. The key element is a compact laboratory device, which can be used as a stand-alone solution or integrated into a larger system. Within a very short time the system generates and analyzes single cells, which often serve as a basis for medical decisions.

Developing the demonstrator was quite a fiddly job: it took over two years for the scientists to perfect it. The research work forms part of the EU project MITIGATE involving three European universities, three research organizations and several small and medium-sized enterprises. These developed new technologies to improve the diagnosis and treatment of metastasizing tumors of the digestive system (gastrointestinal stromal tumors, in short GIST). The scientists of the Project group for Automation in Medicine and Biotechnology (PAMB) in Mannheim focused mainly on the preparation of tissue samples.

For TissueGrinder, different technologies for dissociating tissue were tested and optimized until the right method - one that did not destroy cells - was found.

An apparatus that combines two different mechanisms was the answer. Toothed sprockets arranged in a circle rotate against one another, cutting or grinding the tissue as required. In the case of the system developed in the MITIGATE project, this core technology was integrated into an overall system which uses negative pressure to automatically aspirate samples. Inside the grinding chamber, the sprockets rotate at a specific distance from one another that can be pre-set. The chamber is tightly sealed during the grinding process to prevent any loss of fluid. A valve then opens and the single cells generated are transported by negative pressure into a sampling vessel. Here the cells are filtered out of the suspension without the need for any manual intervention. This paves the way for accelerated analysis in the future.

© Photo Project group for Automation in Medicine and Biotechnology PAMB, Mannheim

Demonstrator and construction of the TissueGrinder

© Photo Project group for Automation in Medicine and Biotechnology PAMB, Mannheim

Laboratory assistant is inserting a sample into the tissue tissue