Engineering students working in the lab as part of the UnLIMITED program at University of Saskatchewan.
David Stobbe/USask (above); istock (below)
Decolonization initiatives in health care have largely focused on overcoming implicit biases in diagnosis and shifting power in the collection, analysis, and interpretation of health data in Indigenous communities. But research is increasingly demonstrating the extent of bias when it comes to medical devices, which historically have not been widely tested on diverse populations. Several studies have confirmed that blood oxygen levels in non-white patients were overestimated by pulse oximeters, a crucial tool in assessing the severity of COVID-19. Similar racial and gender discrepancies have been observed in common medical equipment, including x-rays, CT scans, and spirometers.
Problematic biases may occur in a device’s inherent mechanics, the computational software or data used in development, or race-based interpretation of data. With AI becoming increasingly important in health care applications, researchers are making greater efforts to build diversity into database collection and appropriately integrate ethnicity or skin-type labeling in certain diagnoses, such as skin cancer testing.
An emerging solution for remote communities wanting to manufacture their own supplies is 3-D printing.
Indigenous peoples in remote communities are particularly impacted by health care inequities, often lacking access to competent staff, essential medical equipment, and reliable electricity, internet, and water supplies. Broken medical devices litter some communities, which may lack the equipment or specialized knowledge to fix them.
A biomedical innovation team at Western University in Ontario is designing around community limitations to potentially develop solutions such as more portable x-ray machines, smart stethoscopes that can relay information between remote clinics, and vaccine storage facilities that can maintain temperatures without electricity. “We’re trying to think about how to make devices that can be found, fabricated, and repaired in the communities they’re meant to serve,” says biophysics professor David Holdsworth.
An emerging solution for remote communities wanting to manufacture their own supplies is 3-D printing. Producing complex objects from open-source digital files, this process empowers communities to access necessary resources while significantly decreasing associated costs. During the pandemic, the University of Alaska rapidly created ventilation masks for local hospitals using 3-D printing.
To advance the decolonization of medical device design, the University of Saskatchewan recently launched an innovative new graduate program called UnLIMITED (Uniting for Leading Indigenous and non-Indigenous Medical Instrumentation, Technology, Entrepreneurship, and Design). “The program will involve research into medical devices, covering design, manufacturing, human and cultural factors, and entrepreneurship,” says mechanical and biomedical engineering professor Dr. Wenjun (Chris) Zhang. He adds that it will contribute to post-truth reconciliation and make Canada a world leader in the medical device economy.
With federal funding of $1.65 million over six years, graduate students in the program will be mentored by scholars, business leaders, and Indigenous community members. It’s part of a growing movement to address longstanding colonial biases in the medical field, ensuring that all populations have equal access to essential health care.