Hacking Away

Hacking Away 618 370 IEEE Pulse

Above: Bryan Ranger and collaborators at 2014 MedTech hackathon in Mbarara, Uganda (photo credit Lina A. Colucci).
Imagine a room filled with hundreds of highly accomplished people. There are doctors, engineers, software developers, entrepreneurs, designers, and scientists. All these people have put their busy work lives on pause for the same reason: to spend the next 24 to 72 hours in intense concentration, working together to solve a major healthcare challenge. Add endless cups of coffee and you’ve got the basis of a successful healthcare ‘hackathon.’
List of teams at 2014 MedTech hackathon in Mbarara, Uganda (photo credit Lina A. ColucciHackathons, unique beasts that are neither corporate brainstorming sessions, citizen science, nor start-up incubators, are playing an increasingly important role in medicine by incorporating aspects of all three. There are now hackathons being held in hospital and university settings around the world, with great minds coming together to tackle the toughest problems in medicine, from improving pediatric health to combating dementia. And these events are exploding rapidly in number and influence. Only a handful of healthcare-related hackathons were held in 2010, but since then, there have been more than 100 hackathons devoted to finding innovative solutions to problems in health worldwide.
Right: List of teams at 2014 MedTech hackathon in Mbarara, Uganda (photo credit Lina A. Colucci).
Perhaps the closest analogy to the spirit of these events is a group of kids trying to build a tree fort in the desert. The bizarreness of the scenario is part of the appeal—the sheer audacity of thinking that a group of people who may be meeting each other for the first time can make progress towards a seemingly impenetrable problem in just a weekend. And yet, progress has indeed been made. Healthcare innovations to come out of hackathons include a device for the early detection of foot ulcers in diabetic patients, predictive-analytics software that helps medical offices cut down on appointment waiting times, and an app that connects people with dementia to instructions made by their loved ones through electronic tags on objects that can be scanned with a cell phone.

Hacking Hackathons

Hackathon team at 2014 MedTech hackathon in Mbarara, Uganda (photo credit Lina A. Colucci)
Hackathon team at 2014 MedTech hackathon in Mbarara, Uganda (photo credit Lina A. Colucci)

Although hackathons got their start in the 1990s tech world as all-night coding binges, they have since been coopted in medicine. This makes sense because hackathons are a way of bringing together many areas of expertise in an increasingly complex arena that encompasses many specialties. While many universities now hold hackathons devoted to a variety of topics, MIT held the first healthcare hackathon in January 2010. A year later, MIT Hacking Medicine was born. This student-run group is devoted to organizing healthcare hackathons and helping other universities and hospitals plan and host their own hackathons. Since 2011, the group has held 37 events with over 5500 participants at universities and hospitals in the United States and abroad. With trial and error, Hacking Medicine has hacked its way to finding the recipe for a productive hackathon.
“The real core to what makes an event successful is as diverse a crowd of participants as possible,” says Allison Yost, current co-director of Hacking Medicine and PhD candidate in mechanical engineering. This means including not just medical experts but also people who might normally be intimidated to approach a healthcare problem. “A lot of people don’t think that as an engineer, as a designer, as a programmer that they have any sort of role innovating in this space,” says Yost. “We look at our events as being a success if people come out energized to help in [the healthcare] field.”

International Innovation

While MIT Hacking Medicine and collaborators have made the Boston area a sort of Mecca for healthcare hackathons, similar events have been held in cities across the United States—from Philadelphia to Seattle to New York to Portland to Washington DC to Austin. Just last month Hacking Medicine hosted a Rural Medicine Hackathon at the University of Montana. Other events have been organized by HackFit, a Boston-based startup company that includes exercise classes and healthy eating in the hackathons it hosts. Another organization called Health 2.0, which held some of the earliest healthcare hackathons, routinely hosts hackathons (which they call code-a-thons) in cities across the United States.
The health hackathon concept has grown internationally, too. According to the Health Hackathon Database on the MIT Hacking Medicine website, 56 hackathons were held in 17 countries outside the United States between 2010 and 2014. Two organizations have helped aid this expansion: Health 2.0 hosted code-a-thons in the Netherlands and China in 2012, and the Canadian organization Hacking Health held hackathons in Switzerland, Hungary, and Sweden in 2014.
Hackathons are also playing a growing role in the developing world. In July 2014, the Massachusetts General Hospital’s Consortium for Affordable Medical Technologies (CAMTech) co-organized a hackathon in India called the Jugaadathon. The first prize winner was BabySteps, an app that can be used for the early diagnosis of developmental delays in children. Other winners included a spray that can be used to set broken bones, a device that detects respiratory distress in infants, an app that that can predict whether someone has leprosy, and equipment that can be used to determine whether a pregnant woman can safely deliver her baby vaginally.
And in August 2014, CAMTech helped organize a medical technology hackathon at Mbarara University in Uganda. The 218 participants in this hackathon included both local clinicians and engineers, and specialists from four different continents. “I’ve worked on several global health projects over the past few years, and one of the issues I keep seeing is that technological solutions designed in the developed world do not always translate well in settings with limited resources—one of the main reasons for this is that there is not enough interaction with the end user,” said Bryan Ranger, who participated in this hackathon. Ranger is an MIT graduate student and member of MIT Hacking Medicine. “I think a strong value of having the hackathon [in Mbarara] is that it involved a lot of the local stakeholders in the process.” For his project, Ranger collaborated with a local prosthetist to work on using a camera phone app to make 3D models of limbs to help prosthetics fit better. Other hackathon teams came up with ideas for tackling road safety, maternal and newborn health challenges, and health care communication systems.

A Typical Weekend in an Atypical World

So what is a hackathon actually like? While hackathons vary in length, structure, and formality, the schedule for a typical hackathon looks something like the following.

Team at Hacking Pediatrics 2.0 hackathon (photo credit Lina A. Colucci)
Team at Hacking Pediatrics 2.0 hackathon (photo credit Lina A. Colucci)

On the first day of the hackathon, participants gather to hear opening remarks from the hackathon’s organizers. For themed hackathons, healthcare experts deliver background presentations to participants about problems and issues related to the theme. For example, to introduce the Stop Ebola Hackathon that was held at Massachusetts General Hospital in December 2014, organizers brought in a nurse who had worked with Doctors Without Borders in West Africa to discuss her experiences caring for Ebola patients. Presentations like these help both to inspire hackathon attendees and to clarify the challenges that they are trying to confront during the weekend.  Next, participants take turns at the microphone to informally pitch ideas to the group. They then have a chance to mingle and meet one another, and to form teams around different ideas. Teams spend the rest of the day (and sometimes night) “hacking” their projects.
According to Yost, cultivating an exciting atmosphere is also essential for hackathon success. This means not only inspiring participants early on the first day but also keeping participants’ spirits high by including meals, coffee, and maybe the occasional dance break. It also means discussing successes that have come out of previous hackathons and making healthcare problems personal. “The nice thing about healthcare is that we’re all consumers of it so everyone has some story that they can relate to,” says Yost.

Team at Hacking Pediatrics 2.0 hackathon at Boston Children's Hospital (photo credit Lina A. Colucci)
Team at Hacking Pediatrics 2.0 hackathon at Boston Children’s Hospital (photo credit Lina A. Colucci)

On the second (and sometimes third) day, teams continue to work on their ideas. A team may develop a prototype if its idea calls for one, and it may also try to develop a feasible business and implementation plan. In some hackathons, mentors with specific areas of expertise will help teams. Yost says that Hacking Medicine has discovered that it is vital to include participants with business acumen on hackathon teams so that teams develop feasible ideas.
At the end of the weekend, teams present their ideas to hackathon judges and other participants. Judges deliberate and announce winners and prizes. For example, there were two winners of the Stop Ebola Hackathon: a low-cost bracelet that monitors patient heart rate and temperature and alerts healthcare workers about problems, and a modular Ebola treatment unit that can be assembled in just 48 hours. Prizes often include monetary awards from sponsor companies and sometimes support from start-up incubators.

Promising Prototypes

Some hackathon proposals become successful products; some even become companies. Here are just a few major innovations that have emerged from hackathons:
PillPack: In 2011, MIT Hacking Medicine co-founder and MBA student Elliott Cohen met pharmacist TJ Parker at a hackathon. They knew that severe health complications can arise when people forget to take their medications—especially for the millions of people taking five or more medications a day.  At the hackathon, they developed a solution for this problem: PillPack, a full-service online pharmacy that sends customers medications in packets stamped with the day and time when they should be taken. The company officially launched in February 2014 and has raised 12.75 million dollars. It now has customers in more than 40 states.
Augmented Infant Resuscitator: At a 2012 Boston hackathon, Ugandan pediatrician Santorino Data sought to address a startling statistic: in the developing world, more than a million babies do not survive their first day because of breathing problems. One reason for this is that healthcare workers are not adequately trained to use resuscitation equipment. During the hackathon weekend, Santorino collaborated with MIT mechanical engineering graduate student Kevin Cedrone, clinician and researcher Kristian Olson, and design engineer Craig Milcarz to create an inexpensive sensor and feedback device that can be added to existing emergency ventilation equipment. With this device, healthcare workers get immediate feedback as to whether they are using the resuscitation equipment correctly. Since the hackathon, the team has filed a patent on their device, won a US$100,000 Innovation Award from CAMTech, won a Scale-Ups grant from the MIT D-Lab, won an MIT IDEAS Global Challenge award, won a US$250,000 grant from Saving Lives at Birth, and conducted field trials in Uganda.

Augmented Infant Resuscitator trial (image Kevin Cedrone)
Augmented Infant Resuscitator trial (image Kevin Cedrone).

Twiage: Twiage got its start at a 2013 hackathon at Boston’s Brigham and Women’s Hospital when EMT Crystal Law teamed up with John Rodley, an entrepreneur and Google Glass developer, and YiDing Yu, a resident physician at Brigham and Women’s. Yu and Law’s experience with the fast-paced world of emergency medicine was their inspiration for Twiage, a mobile (and Google Glass) app that allows EMTs to send emergency room doctors pictures of injuries, EKGs, and information about patients from the road, saving crucial time for heart attack, stroke, and trauma patients. Twiage has won several innovation awards, and has been tested at South Shore Hospital in Massachusetts, a cardiac, stroke, and trauma center with the state’s fifth busiest emergency room.

Upcoming Hackathons

Time will tell whether hackathons become an essential tool for healthcare innovation or go the way of doo-wop and disco. For now the concept continues to grow, and more events are coming up soon. MIT Hacking Medicine will host its Second Annual Grand Hackfest on 24 -26 April 24. And from May 31 to June 3, 2015, a national conference called the Health Datapalooza will include a hackathon focused on innovations related to health data.  Yost, for one, is happy to see healthcare hackthons gain traction and attention—“We are excited to keep growing; we’re excited that people are excited about it.”