The NIH Pipeline in Digital TechnologiesFNIH Remote Digital Monitoring Workshop

Jill Heemskerk, Ph.D.Deputy Director

National Institute of Biomedical Imaging and Bioengineering

February 19, 2020

No funding authority

Office of Research Infrastructure Programs

National Instituteon Aging

National Instituteon Alcohol Abuseand Alcoholism

National Instituteof Allergy and

Infectious Diseases

National Institute of Arthritis and

Musculoskeletal and Skin Diseases

National Cancer

Institute

National Instituteof Child Health

and HumanDevelopment

National Institute on Deafness and

Other Communication

Disorders

National Institute of Dental and Craniofacial

Research

National Institute of Diabetes and Digestive and

Kidney Diseases

National Institute

on Drug Abuse

National Instituteof EnvironmentalHealth Sciences

National Eye

Institute

National Institute of General

Medical Sciences

National Heart,Lung, and Blood

Institute

National HumanGenome Research

Institute

National Institute

of Mental Health

National Institute of Neurological

Disorders and Stroke

National Instituteof Nursing Research

National Instituteon Minority

Health and Health Disparities

National Center for Complementary and Integrative Health

Fogarty International

Center

National Centerfor Advancing

Translational Sciences

National Library

of Medicine

National Instituteof Biomedical Imaging and

Bioengineering

Office of the Director

NIH Clinical Center Center for Information Technology Center for Scientific Review

http://www.nih.gov/icd

>300,000 researchers

>2700 institutions

>55,000 applications

NIH Structure27 Institutes & Centers

~$40 Billion Annually

~$1.2B commercialization

No funding authority

Office of Research Infrastructure Programs

National Instituteon Aging

National Instituteon Alcohol Abuseand Alcoholism

National Instituteof Allergy and

Infectious Diseases

National Institute of Arthritis and

Musculoskeletal and Skin Diseases

National Cancer

Institute

National Instituteof Child Health

and HumanDevelopment

National Institute on Deafness and

Other Communication

Disorders

National Institute of Dental and Craniofacial

Research

National Institute of Diabetes and Digestive and

Kidney Diseases

National Institute

on Drug Abuse

National Instituteof EnvironmentalHealth Sciences

National Eye

Institute

National Institute of General

Medical Sciences

National Heart,Lung, and Blood

Institute

National HumanGenome Research

Institute

National Institute

of Mental Health

National Institute of Neurological

Disorders and Stroke

National Instituteof Nursing Research

National Instituteon Minority

Health and Health Disparities

National Center for Complementary and Integrative Health

Fogarty International

Center

National Centerfor Advancing

Translational Sciences

National Library

of Medicine

National Instituteof Biomedical Imaging and

Bioengineering

Office of the Director

NIH Clinical Center Center for Information Technology Center for Scientific Review

http://www.nih.gov/icd

>300,000 researchers

>2700 institutions

>55,000 applications

NIH Structure27 Institutes & Centers

~$40 Billion Annually

~$1.2B commercialization

Engineering

Clinical Center

NIBIB tech

NIBIB: ~$400M, ~1000 grants

Office of the Director

(ORWH, OAR, OBSSR)

Engineering the Future of Health

NIBIB: Bioengineering Impact at NIH• NIBIB ~1% total NIH Budget • ~13% NIH Budget to Bioengineering

Bioe

ngin

eerin

g $

(Bill

ion)

NIH

Bud

get $

(Bill

ion)

60

40

30

20

10

0

5

4

3

2

1

0

13%

2008 2009 2010 2011 2012 2013 2014 2015 2018 2017 2018 2019

NIBIB: Bioengineering Impact at NIH• NIBIB ~1% total NIH Budget • ~13% NIH Budget to Bioengineering

Bioe

ngin

eerin

g $

(Bill

ion)

NIH

Bud

get $

(Bill

ion)

60

40

30

20

10

0

5

4

3

2

1

0

13%

2008 2009 2010 2011 2012 2013 2014 2015 2018 2017 2018 2019

Bioengineering will be >90% of NIH budget

in 30 years

NIBIBCreating Biomedical

Technologies to Improve Health

BRAIN Initiative HEAL

SPARC

DSI-AfricaPOCTRN

Alzheimer’s Supplements

SCGE

NIBIB Impact: Partnerships

Add ~ $50M/yr since 2014(~12-20% of appropriated budget)

$5.2B Projected total for lifetime of BRAIN

$ in

Mill

ions

NIH BRAIN Initiative

~67% Bioengineering

0

100

200

300

400

500

600

700

800

900

FY 2014 FY 2015 FY 2016 FY 2017 FY 2018 FY 2019 FY 2020 FY 2021Est.

FY 2022Est.

FY 2023Est.

FY 2024Est.

FY 2025Est.

FY 2026Est.

Base Funding FY 2020 increase 21st Century Cures Funding

2020: NIBIB Expanding MissionEngineering and Physical Science in Biology and Medicine

>

• Human Health a top priority of Engineering Schools- Adding ~1600 UG BME students, ~70 BME faculty/year*- ~30 ABET BME depts when NIBIB started, 119 in 2019*

• Medicine-Engineering partnerships: "Physicianeers”**-University of Illinois Urbana-Champaign-Texas A&M University

• Drive Human and Economic Health

*R. Hart, Annals BME, 2015** R. Pettigrew, TAMU

Engineering Impact: Patents

IMPACT

All NIH: $1 → $6 downstream R&D investment

NIBIB: $1 → $33 downstream R&D investment

Budget: 2002-2012; Patents: 2003-2015

NIBIB

Patents, Pasteur, and Productivity: A Model for Promoting Scientific and Economic Growth at the National Institutes of Health, M. Kalutkiewicz and R. Ehman (2017)

Citations per Patent

Pate

nts

per $

100

M o

f fun

ding

Pasteur’s Quadrant

Bohr’s Quadrant

Edison’s Quadrant

Current Health Care

Current Medicine: Static “Snapshots”

Time

Future Health Care

Future Medicine: Continuous Sensing

Dynamics

Time

Complex, Multi-parametric, Dynamic Data

Engineered Biology

Imaging Technologies

Therapeutic Devices

Sensors and Point of Care

NIBIB Mission: Technology & Innovation

Modeling, Computation & Machine Intelligence

S. Xu, UCSD

V. Venugopalan, J. Spanier, UCI

M. Garwood, UMN

Cambridge UniversityMonteris Medical, Inc.

P. So, MIT, P41-EB015871

Non-invasive NIR Raman Fiber Probe830 nm Diode laser

Sing et al. Analytical and Bioanalytical Chemistry (2018)

Oral Glucose Tolerance Test: N = 20

Transcutaneous Glucose Detection

Wearable Ultrasound Patch for Blood Pressure

• Ultrasound measure of central blood pressure• Flexible patch• Continuous recording of blood vessel diameter• Diagnostic for hypertension, heart disease,

valve dysfunction

Wang, et al, Nature Biomedical Engineering, September 2018

Continuous measurement of analytes in bloodSPARCElectrochemical aptamer biosensors:

• Fully implantable and wireless• Simultaneous measurement of multiple targets• Platform technology – glucose and insulin underway;

neurotransmitters and gut hormones are planned

• High sensitivity (pM-nM), spatial resolution (~10 µm), and temporal resolution (< 1 min)

Soh, H. Tom (Stanford): OT2 OD025342

Redox reporter

Microelectrode

Soh, H. Tom (Stanford): OT2 OD025342

Implantable ASIC

18

Microsystems-engineered

technologies.

Emory andGeorgia Tech

HIV/AIDS in low-and middle-

income countries

Northwestern.

CAPCaT

Heart, lung, blood or sleep

disorders.

UMASS LowellUMASS Medical

JHUSexually

transmitted diseases

Johns Hopkins

ACME-POCT C-THAN

POCTRN Coordinating Center at MGH/CIMIT

Point Of Care Technologies Research Network

NIBIB, NHLBI, NIAID, NCCIH, FIC, OAR, CMS, FDA

SmartPhone App: Anemia Detection

19

Measures hemoglobin in RGB images of

nail bed

GAITS: Guidance and Impact Tracking System

Public version: www.GAITS.org

10 Milestones

4 Deliverable Domains:- Clinical/Workflow- Market/Business- Regulatory-Technical/Science

Integrating machine learning and multiscale modeling-perspectives, challenges, and opportunities in the biological, biomedical, and behavioral sciences. Alber M, Buganza Tepole A, Cannon WR, De S, Dura-Bernal S, Garikipati K, Karniadakis G, Lytton WW, Perdikaris P, Petzold L, Kuhl E. NPJ Digit Med. 2019 Nov 25.

Interagency Modeling & Analysis Group

Grace Peng, NIBIB

Workshop: Integrating Machine Learning with Multiscale Modeling

October 2019

https://www.nature.com/articles/s41746-019-0193-y

NIBIB Strategic Planning

Data Science and Computation Engineered Biology

Sensing Health and Disease

Imaging Health and Disease

Advanced Therapies/Cures

Technology Development

Pipeline

Biomedical Imaging & Bioengineering

Workforce

Gilda BarbinoRashid BashirZeynep ErimIlana GoldbergRaphael LeeCarolyn MeltzerJulia Ringel

Christine CooperQi DuanMaryellen GigerJay HumphreyLydia KavrakiKyle MyersGrace PengBehrouz ShabestariHari ShroffAndrew Weitz

Paula HammondJoshua LeonardJessica MeadeRobert NeremDavid RampullaGordana Vunjak-

NovakovicRon Weiss

Samuel AchilefuNancy AllbrittonZane ArpTatjana AtanasijevicDavid GraingerAmy HerrThomas JohnsonTiffani Lash

Richard BuxtonShawn ChenVincent HoElizabeth JonesRandy KingRichard LeapmanGuoying LiuCynthia McCulloughKathy NightingaleBruce RosenDaniel SodicksonPatricia WileyGeorge Zubal

Kate EganRanu JungBrian PogueMarjolein van

der MeulenMichael Wolfson

Andrea BelzRichard LeapmanJack LinehadRaymond MacDougallEd MargerrisonTodd MerchakSohi RastegarGreg Sorensen

NIBIB Strategic Plan working groups met Jan 22, 2020>55 participants in 7 sub-groups

NIBIB Organization: Kris Kandarpa, Kate Egan, Jackie Martinez, Saltant Satabayeva

https://videocast.nih.govJanuary 23 Advisory Council

Emergent Opportunities

Organ Simulators

Sensors Images

Computational Models

Palaninathan et al. MRS Comm. (2018) N Paoletti et al, CMSB 2017

Emergent Opportunities

Organ Simulators

Sensors Images

Computational Models

Palaninathan et al. MRS Comm. (2018) N Paoletti et al, CMSB 2017

Digital Twins

Virtual Clinical Trials

Badano et al., JAMA Netw Open. 2018

Toward the Future

500,000 participants

+

at least 1,000,000 subjects

>350,000 enrolled, 5/2018-11/2019

Summary: Engineering the Future of HealthImpact• Significant NIH-wide growth in Bioengineering: now ~12% of the NIH budget• NIBIB funding: high and growing demand, heavily leveraged, high ROI

NIBIB Potential• Explosion in technologies, knowledge: reduce barriers, improve access, democratize• Understand and apply dynamic biology for Future of Health

BIG Impact• Prevent disease, Reduce hospitalization & costs, Drive economic growth

Summary: Engineering the Future of HealthImpact• Significant NIH-wide growth in Bioengineering: now ~12% of the NIH budget• NIBIB funding: high and growing demand, heavily leveraged, high ROI

Opportunities• Explosion in technologies and biomedical knowledge• AI/ML to understand and exploit complex, dynamic biology

Summary: Engineering the Future of HealthImpact• Significant NIH-wide growth in Bioengineering: now ~12% of the NIH budget• NIBIB funding: high demand, heavily leveraged, high ROI

Opportunities• Explosion in technologies and biomedical knowledge• AI/ML to understand and exploit complex, dynamic biology

Future•Continuous monitoring: Shift to prevention, optimize healthspan• Reduce costs: democratize access

Slide Number 1Slide Number 2Slide Number 3Slide Number 4NIBIB: Bioengineering Impact at NIHNIBIB: Bioengineering Impact at NIHSlide Number 7Slide Number 82020: NIBIB Expanding MissionSlide Number 10Current Health CareFuture Health CareNIBIB Mission: Technology & InnovationSlide Number 14Slide Number 15Slide Number 16Slide Number 17Slide Number 18SmartPhone App: Anemia DetectionGAITS: Guidance and Impact Tracking SystemSlide Number 21Slide Number 22Slide Number 23Slide Number 24Slide Number 25Summary: Engineering the Future of HealthSummary: Engineering the Future of HealthSummary: Engineering the Future of Health